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Medline ® Abstract for Reference 24

of 'Benefits, services, and models of subspecialty palliative care'

Quality end-of-life care: patients' perspectives.
Singer PA, Martin DK, Kelner M
JAMA. 1999;281(2):163.
CONTEXT: Quality end-of-life care is increasingly recognized as an ethical obligation of health care providers, both clinicians and organizations. However, this concept has not been examined from the perspective of patients.
OBJECTIVE: To identify and describe elements of quality end-of-life care from the patient's perspective.
DESIGN: Qualitative study using in-depth, open-ended, face-to-face interviews and content analysis.
SETTING: Toronto, Ontario.
PARTICIPANTS: A total of 126 participants from 3 patient groups: dialysis patients (n = 48), people with human immunodeficiency virus infection (n = 40), and residents of a long-term care facility (n = 38).
OUTCOME MEASURES: Participants' views on end-of-life issues.
RESULTS: Participants identified 5 domains of quality end-of-life care: receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones.
CONCLUSION: These domains, which characterize patients' perspectives on end-of-life care, can serve as focal points for improving the quality of end-of-life care.
Toronto Hospital and the Department of Medicine, Joint Centre for Bioethics, University of Toronto, Ontario, Canada. peter.singer@utoronto.ca