title: How people die in hospital general wards: a descriptive study.
abstract: To describe how patients die in hospital, 370 patients (age >18 years; in hospital for>24 hours) who died on the general wards of 40 Italian hospitals were assessed. Differences between patients whose death was expected and patients whose death was unexpected were evaluated. Data on treatments and care in proximity of death were collected after interviewing the nurse responsible for the patient within 72 hours of the patient's death, and from clinical and nursing records. For 58% of patients, death was highly expected. Symptom control was inadequate for the most severely ill patients: 75% experienced at least one "severe" symptom (42% pain and 45% dyspnea). Nurses tended to judge patients' global care as "good" or "very good" (76%), in spite of the persistence of symptoms and the scant use of analgesics. Despite some encouraging signs of sensitivity to end-of-life problems, acute inpatient institutions in Italy still deal inadequately with the needs of dying persons.
authors.affiliation: Lino Maestroni Palliative Medicine Research Institute, Cremona, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Toscani
authors.forename: Paola
authors.initials: P
authors.lastname: Di Giulio
authors.forename: Cinzia
authors.initials: C
authors.lastname: Brunelli
authors.forename: Guido
authors.initials: G
authors.lastname: Miccinesi
authors.forename: Dario
authors.initials: D
authors.lastname: Laquintana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002423:Cause of Death; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010166:Palliative Care / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000706:statistics & numerical data*