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Christina Nash,Laura Forbes
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Lisa-Marie Back
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Digital Poster
Factors Associated with Comfort/Confidence when Having End-of-Life Conversations with Substitute Decision Makers in Long-Term Care
Names, Organizational Affiliations, and Locations of all Authors
L. Back, C. Lengyel, Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB
Long-term care (LTC) healthcare providers (HCP) find opportunities for end-of-life (EOL) discussions challenging, resulting in unwanted or untimely interventions for residents and leaving substitute decision makers (SDM) feeling unsupported during the dying process.
Objective(s)/Process or Summary of Content
Examine factors associated with a high level of HCP comfort/confidence when having EOL conversations with SDMs.
Method(s)/Systemic Approach Used
An online survey using Qualtrics software was sent to LTC HCPs across Canada from April 21 to September 16, 2021. Participant demographics, facility characteristics, along with information on current EOL policy and practice was collected. Seventy completed surveys were analyzed using descriptive statistics (100% Female; 40.8 years ±11.54) and Binomial Linear Regression.
Respondents included registered dietitians (83%), nurses (10%), speech language pathologists, social workers, occupational therapists (4%) and administrators (3%). While it was not possible to conclusively determine factors associated with comfort/confidence of health care providers due to the sample size of various factors, the Omnibus Test of Model Coefficients indicated that presence of policies reflecting when to have EOL conversations is statistically significant (p-value = 0.025). While not statistically significant, province (p-value = 0.067), and how EOL conversations typically happen (i.e., HCP:SDM; as a team, combination of these, or not at all) (p-value = 0.068) may also play a role in HCP comfort/confidence when having EOL conversations with SDMs.
Conclusion: Having policies in LTC outlining when to have EOL conversations is important to HCP comfort/confidence with EOL conversations. Furthermore, how conversations occur may also play a role in HCP comfort/confidence. LTC location is likely important as presence of EOL policies may differ from region to region.
Significance to Dietetics
Significance to the Field of Dietetics: This information can be used to support development of EOL care policies and guidelines for use by dietitians and HCPs in LTC.
Funded by
Funded by: Riverview Health Centre and Canadian Foundation for Dietetic Research
Original Work
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