Family Perceptions of End-of-Life Care Quality in Patients With Stroke: A Descriptive and Comparative Survey Study

Abstract

Background and Objetives

End-of-life (EOL) care in acute stroke is complex. Understanding family experiences is essential to improve care quality and promote a dignified death. This study aimed to assess family members perceptions of EOL care in patients who died after stroke and to identify factors associated with perceived dignified death.

Methods

A cross-sectional survey of relatives of deceased stroke patients during 1 year was conducted. Of 111 eligible cases, 68 questionnaires were returned (61.3%). Following the descriptive analysis, we compared relatives who perceived the death as dignified with those who did not. Survey responses were then integrated with clinical data regarding treatment history and place of death.

Results

Most relatives (82.4%) considered that the patient died with dignity. Perceived dignified death was significantly associated with adequate and comprehensible prognostic information, respectful communication, respect for patient and family preferences, adequate symptom control, being accompanied at the time of death, and empathetic staff attitudes (all P < 0.05). No significant associations were observed with room type, religious variables, clerical visits, expectedness of death, continuous sedation, IV fluids, antibiotics, enteral nutrition, or location of death; symptom control ratings did not differ between sedated and non-sedated patients.

Conclusions

Most relatives perceived the death as dignified and they were generally satisfied with EOL care. Dignity was primarily linked to communication, respect for preferences, emotional support, and humane care rather than specific medical interventions.