A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana

Am J Hosp Palliat Care. 2016 Mar;33(2):144-9. doi: 10.1177/1049909114557350. Epub 2014 Nov 2.

Abstract

Purpose: To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana.

Findings: A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group.

Conclusions: A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying.

Keywords: end-of-life decision making; interdisciplinary team; outcome evaluation; palliative care; quality of care; teaching hospital in Ghana; terminal illness.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Attitude to Death
  • Decision Making*
  • Family / psychology
  • Female
  • Ghana
  • Hospitals, Teaching
  • Humans
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Pain Management / methods
  • Palliative Care / organization & administration*
  • Patient Care Planning / organization & administration
  • Patient Care Team / organization & administration*
  • Quality of Health Care / organization & administration*
  • Retrospective Studies
  • Terminal Care / organization & administration*