Résumé :
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[BDSP. Notice produite par INIST kETR0xyi. Diffusion soumise à autorisation]. Context A clear understanding of what patients, families, and health care practitioners view as important at the end of life is integral to the success of improving care of dying patients. Empirical evidence defining such factors, however, is lacking. Objective To determine the factors considered important at the end of life by patients, their families, physicians, and other care providers. Design and Setting Cross-sectional, stratified random national survey conducted in March-August 1999. Participants Seriously ill patients (n=340), recently bereaved family (n=332), physicians (n=361), and other care providers (nurses, social workers, chaplains, and hospice volunteers ; n=429). Main Outcome Measures Importance of 44 attributes of quality at the end of life (5-point scale) and rankings of 9 major attributes, compared in the 4 groups. Results Twenty-six items consistently were rated as being important (>70% responding that item is important) across all 4 groups, including pain and symptom management, preparation for death, achieving a sense of completion, decisions about treatment preferences, and being treated as a "whole person." Eight items received strong importance ratings from patients but less from physicians (P<. including being mentally aware having funeral arrangements planned not a burden helping others and coming to peace with god.>
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