Care strategy for death rattle in terminally ill cancer patients and their family members: recommendations from a cross-sectional nationwide survey of bereaved family members' perceptions.

Abstract

CONTEXT:

Bereaved family members witnessing a patient's death rattle often experience distress. However, the benefits of specific care measures aimed at decreasing death rattle-associated family distress have not yet been evaluated.

OBJECTIVES:

To clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues.

METHODS:

A cross-sectional questionnaire survey of bereaved family members of cancer patients was conducted in 95 palliative care units in June 2007.

RESULTS:

Six hundred sixty-three questionnaires were mailed out, and 390 (61%) responses were analyzed. Among these, 181 (46%) respondents experienced death rattle. Of these, 66% reported high distress levels and 53% perceived a strong need for improved death rattle care. Factors influencing high distress levels were the gender (female) of family members, unawareness about death rattle being a natural phenomenon, and their fear and distressing interpretations of death rattle. Factors influencing perceptions of a strong need for improved care were the gender (male) of family members, severity of death rattle, death rattle-associated discomfort to patients, family members' experiences of inadequate nursing care (e.g., repositioning) and insufficient consultation about suctioning, and their perception of uncomfortable smells.

CONCLUSION:

To decrease family-perceived distress, medical staff should alleviate patient symptoms and suffering with a comprehensive care strategy, try to decrease uncomfortable smells, and communicate with family members to address distressing interpretations and fears.

• Authors: Yoichi Shimizu, Mitsunori Miyashita, Tatsuya Morita, Kazuki Sato, Satoru Tsuneto, Yasuo Shima
• Journal: Journal of pain and symptom management (J Pain Symptom Manage) Vol. 48 Issue 1 Pg. 2-12 (Jul 2014) ISSN: 1873-6513 [Electronic] United States
• PMID: 24161372 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Topics

• Bereavement
• Cross-Sectional Studies
• Family (psychology)
• Female
• Humans
• Japan
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasms (complications, therapy)
• Odorants
• Palliative Care (methods)
• Respiratory Sounds
• Sex Factors
• Stress, Psychological (etiology)
• Surveys and Questionnaires
• Terminal Care (psychology)
• Terminally Ill