Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada Article Swipe
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· 2022
· Open Access
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· DOI: https://doi.org/10.1136/bmjopen-2022-062937
Objective To compare end-of-life in-person family presence, patient–family communication and healthcare team–family communication encounters in hospitalised decedents before and during the COVID-19 pandemic. Design In a regional multicentre retrospective cohort study, electronic health record data were abstracted for a prepandemic group (pre-COVID) and two intrapandemic (March–August 2020, wave 1) groups, one COVID-19 free (COVID-ve) and one with COVID-19 infection (COVID+ve). Pre-COVID and COVID-ve groups were matched 2:1 (age, sex and care service) with the COVID+ve group. Setting One quaternary and two tertiary adult, acute care hospitals in Ottawa, Canada. Participants Decedents (n=425): COVID+ve (n=85), COVID-ve (n=170) and pre-COVID (n=170). Main outcome measures End-of-life (last 48 hours) in-person family presence and virtual (video) patient–family communication, and end-of-life (last 5 days) virtual team–family communication encounter occurrences were examined using logistic regression with ORs and 95% CIs. End-of-life (last 5 days) rates of in-person and telephone team–family communication encounters were examined using mixed-effects negative binomial models with incidence rate ratios (IRRs) and 95% CIs. Results End-of-life in-person family presence decreased progressively across pre-COVID (90.6%), COVID-ve (79.4%) and COVID+ve (47.1%) groups: adjusted ORs=0.38 (0.2–0.73) and 0.09 (0.04–0.17) for COVID-ve and COVID+ve groups, respectively. COVID-ve and COVID+ve groups had reduced in-person but increased telephone team–family communication encounters: IRRs=0.76 (0.64–0.9) and 0.61 (0.47–0.79) for in-person, and IRRs=2.6 (2.1–3.3) and 4.8 (3.7–6.1) for telephone communications, respectively. Virtual team–family communication encounters occurred in 17/85 (20%) and 10/170 (5.9%) of the COVID+ve and COVID-ve groups, respectively: adjusted OR=3.68 (1.51–8.95). Conclusions In hospitalised COVID-19 pandemic wave 1 decedents, in-person family presence and in-person team–family communication encounters decreased at end of life, particularly in the COVID+ve group; virtual modalities were adopted for communication, and telephone use increased in team–family communication encounters. The implications of these communication changes for the patient, family and healthcare team warrant further study.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjopen-2022-062937
- https://bmjopen.bmj.com/content/bmjopen/12/6/e062937.full.pdf
- OA Status
- gold
- Cited By
- 4
- References
- 36
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4283710206
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4283710206Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/bmjopen-2022-062937Digital Object Identifier
- Title
-
Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, CanadaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-06-01Full publication date if available
- Authors
-
Peter G. Lawlor, Henrique A. Parsons, Samantha Rose Adeli, Ella Besserer, Leila Cohen, Valérie Gratton, Rebekah Murphy, Grace Warmels, Adrianna Bruni, Monisha Kabir, Chelsea Noël, Brandon Heidinger, Koby Anderson, Kyle Arsenault‐Mehta, Krista Wooller, Julie Lapenskie, Colleen Webber, Daniel Bédard, Paula Enright, Isabelle Desjardins, Khadija Bhimji, Claire Dyason, Akshai Iyengar, Shirley H. Bush, Sarina R. Isenberg, Peter Tanuseputro, Brandi Vanderspank‐Wright, James DownarList of authors in order
- Landing page
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https://doi.org/10.1136/bmjopen-2022-062937Publisher landing page
- PDF URL
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https://bmjopen.bmj.com/content/bmjopen/12/6/e062937.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://bmjopen.bmj.com/content/bmjopen/12/6/e062937.full.pdfDirect OA link when available
- Concepts
-
Medicine, End-of-life care, Coronavirus disease 2019 (COVID-19), Retrospective cohort study, Pandemic, Logistic regression, Cohort, Cohort study, Incidence (geometry), Demography, Family medicine, Palliative care, Internal medicine, Nursing, Disease, Infectious disease (medical specialty), Sociology, Physics, OpticsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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4Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 2, 2023: 1Per-year citation counts (last 5 years)
- References (count)
-
36Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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