Abstract

CARNEIRO, Rui; SOUSA, Elisabete; GUERREIRO, Tiago  and  ROCHA, Nelson. Quality and Satisfation with the Care of Chronically Seriously Ill Patients in an Internal Medicine Ward. Arq Med [online]. 2009, vol.23, n.3, pp.95-101. ISSN 2183-2447.

For many chronically ill patients, hospitalization is an opportunity to reconsider treatment goals. We interviewed 33 patients [mainly women; men age: 74.3 (±11.2) years], suffering of advanced and chronic disease, admitted to a Internal Medicine ward, in order to gather information about the importance and satisfaction felt in several domains of care. Then, the treating physician selected those items felt to be the most important to the patient in question. Most patients had chronically advanced non-oncologic conditions, mainly heart and respiratory diseases (21.9%). The median Karnofsky and Katz scores were 30% and 1. More than 90% of patients were, at least, satisfied with the quality of care; 40% were very satisfied. While the items rated by patients/ families as “very important” in the definition of quality of care were receiving good diagnostic and prognostic information (93.8% of the answers), symptom control (90.9%) and having facilitated access to health team (90.9%), the correspondent doctors thought to be the good symptom management (88.5%), the accessibility to the health care system (34.6%) and communication about therapeutic options (30.8%) the most important factors. Patients/ families were more satisfied with domains of care reflecting information about therapeutic plan and the involvement in the decision process. Patients and medical team do not give the same importance to various domains of care. Patients privilege communicational aspects over the ones merely formal or related to the physical aspects of the wards. Patient-centred delivery of care allows to redefine goals of care and to promote satisfaction.

Keywords : palliative care; quality and satisfaction of care.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )