Research

Family members' experiences of the impact of the LCP in a palliative care unit and a geriatric ward in Sweden

Abstract

Background:

The Liverpool Care Pathway for the Dying Patient (LCP) was developed to transfer palliative care standards for the last hours or days of life, including family support, from hospice to other care settings.

Aim:

This study sought to explore family members' experiences of end-of-life care in a palliative care unit and in a general geriatric ward in Sweden before and after implementation of the LCP.

Methods:

Experiences were evaluated in relation to the goals of the LCP. Family members of patients deceased before and after implementation answered a questionnaire 3–6 months after the death. Comparisons between the samples were assessed by non-parametric tests.

Results:

There were significant differences concerning dialogue about existential issues that arise and about emotions and practical issues faced in bereavement. Significant improvements after the implementation of the LCP were reported in experiences regarding physicians' ability to listen to family members' concerns.

Conclusion:

The results suggest that using a structure such as that provided by the LCP may improve communication between physicians and the families of dying patients.

References

Chan R, Webster J (2010) End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database Syst Rev 1: CD008006. doi: https://doi.org/10.1002/14651858.CD008006.pub2 Medline, Google Scholar
Clark J, Marshall B, Sheward K, Allan S (2012) Staff perceptions of the impact of the Liverpool Care Pathway in aged residential care in New Zealand. Int J Palliat Nurs 18(4): 171–8 Link, Google Scholar
Costantini M, Romoli V, Leo SD et al. (2014a) Liverpool Care Pathway for patients with cancer in hospital: a cluster randomised trial. Lancet 383(9913): 226–37. doi: https://doi.org/10.1016/S0140-6736(13)61725-0 Crossref, Medline, Google Scholar
Costantini M, Pellegrini F, Di Leo S et al. (2014b) The Liverpool Care Pathway for cancer patients dying in hospital medical wards: a before-after cluster phase II trial of outcomes reported by family members. Palliat Med 28(1): 10–7. doi: https://doi.org/10.1177/0269216313487569 Crossref, Medline, Google Scholar
Dee JF, Endacott R (2011) Doing the right thing at the right time. J Nurs Manag 19(2): 186–92. doi: https://doi.org/10.1111/j.1365-2834.2010.01200.x Crossref, Medline, Google Scholar
Duffy A, Woodland, C (2006) Introducing the Liverpool Care Pathway into nursing homes. Nurs Older People 18(9): 33–6 Crossref, Medline, Google Scholar
Ekeström M-L (2012) LCP Liverpool Care Pathway. [In Swedish] Tidningen Ä 1(1): 15–6 Google Scholar
Ellershaw J (2007) Care of the dying: what a difference an LCP makes! Palliat Med 21(5): 365–8. doi: https://doi.org/10.1177/0269216307081117 Crossref, Medline, Google Scholar
Ellershaw J, Fürst CJ, Lunder U et al. (2013) Care of the dying and the LCP in England: an international perspective. Eur J Palliat Care 20(3): 120–3 Google Scholar
Ellershaw J, Wilkinson S (2011) Care of the Dying: A Pathway to Excellence. 2nd edn. OUP Press, Oxford Google Scholar
Fürst CJ (2012) Final Report. Liverpool Care Pathway (LCP) för vård av döende. http://bit.ly/1o9pfyf (accessed 5 August 2014) Google Scholar
Heyland DK, Dodek P, Rocker G et al. (2006) What matters most in end-of-life care: perceptions of seriously ill patients and their family members. CMAJ 174(5): 627–33 Crossref, Medline, Google Scholar
Jack BA, Gambles M, Murphy D, Ellershaw JE (2003) Nurses' perceptions of the Liverpool Care Pathway for the dying patient in the acute hospital setting. Int J Palliat Nurs 9(9): 375–81 Link, Google Scholar
Koller M, Aaronson NK, Blazeby J et al. (2007) Translation procedures for standardised quality of life questionnaires: The European Organisation for Research and Treatment of Cancer (EORTC) approach. Eur J Cancer 43(12): 1810–20 Crossref, Medline, Google Scholar
Leo SD, Bono L, Romoli V et al. (2014) Implementation of the Liverpool Care Pathway (LCP) for the dying patient in the inpatient hospice setting: development and preliminary assessment of the Italian LCP program. Am J Hosp Palliat Care 31(1): 61–8. doi: https://doi.org/10.1177/1049909113482355 Crossref, Medline, Google Scholar
Lundberg T, Olsson M, Fürst CJ (2013) The perspectives of bereaved family members on their experiences of support in palliative care. Int J Palliat Nurs 19(6): 282–8 Link, Google Scholar
Lunder S, Sauter S, Fürst CJ (2004) Evidence-based palliative care: beliefs and evidence for changing practice. Palliat Med 18(4): 265–6 Crossref, Medline, Google Scholar
Lundquist G, Rasmussen BH, Axelsson B (2011) Information of imminent death or not: does it make a difference? J Clin Oncol 29(29): 3927–31. doi: https://doi.org/10.1200/JCO.2011.34.6247 Crossref, Medline, Google Scholar
Lundström S, Axelsson B, Heedman PA, Fransson G, Fürst CJ (2012) Developing a national quality register in end-of-life care: the Swedish experience. Palliat Med 26(4): 313–21. doi: https://doi.org/10.1177/0269216311414758 Crossref, Medline, Google Scholar
Martinsson L, Heedman PA, Lundström S, Fransson G, Axelsson B (2011) VValidation study of an end-of-life questionnaire from the Swedish Register of Palliative Care. Acta Oncol 50(5): 642–7. doi: https://doi.org/10.3109/0284186X.2011.554434 Crossref, Medline, Google Scholar
McNicholl MP, Dunne K, Garvey A, Sharkey R, Bradley A (2006) Using the Liverpool Care Pathway for a dying patient. Nurs Stand 20(38): 46–50 Crossref, Medline, Google Scholar
Murray CD, McDonald C, Atkin H (2014) The communication experiences of patients with palliative care needs: a systematic review and meta-synthesis of qualitative findings. Palliat Support Care [Epub ahead of print] doi: https://doi.org/10.1017/S1478951514000455 Google Scholar
Neuberger J, Aaronovitch D, Bonser T et al. (2013) More Care, Less Pathway. A Review of the Liverpool Care Pathway. Department of Health Google Scholar
O'Hara T (2011) Nurses' views on using the Liverpool care pathway in an acute hospital setting. Int J Palliat Nurs 17(5): 239–44 Link, Google Scholar
Parry R, Seymour J, Whittaker B, Bird L, Cox K (2013) Evidence Briefing Pathway for the Dying Phase in End of Life Care. National End of Life Care Programme Google Scholar
Regionala Cancercentrum i Samverkan (2012) Nationellt Vårdprogram för Palliativ Vård 2012-2014 [In Swedish] www.cancercentrum.se/PageFiles/1722/Nat_vp_pall_2012.pdf (accessed 1 August 2014) Google Scholar
Seymour J, Horne G (2013) The withdrawal of the Liverpool Care Pathway in England: implications for clinical practice and policy. Int J Palliat Nurs 19(8): 369–71 Link, Google Scholar
Simon S, Higginson IJ (2009) Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it. Palliat Med 23(1): 23–8. doi: https://doi.org/10.1177/0269216308098802 Crossref, Medline, Google Scholar
Smith S, Pugh E, McEvoy M (2012) Involving families in end of life care. Nurs Manag 19(4): 16–22 Crossref, Google Scholar
Veerbeek L, van der Heide A, de Vogel-Voogt E et al. (2008) Using the LCP: bereaved relatives' assessments of communication and bereavement. Am J Hosp Palliat Care 25(3): 207–14. doi: https://doi.org/10.1177/1049909108315515 Crossref, Medline, Google Scholar

International Journal of Palliative Nursing

2 August 2014Volume 20Issue 8

ISSN (print): 1357-6321
ISSN (online): 2052-286X

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History

Published online 23 August 2014

Published in print 2 August 2014

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