title: Experiences of hospital care reported by bereaved relatives of patients after a stroke: a retrospective survey using the VOICES questionnaire.
abstract: OBJECTIVE
  This paper is a report of a study conducted to explore the determinants of satisfaction with health and social care services in the last 3 months and 3 days of life as reported by bereaved relatives of those who died from a stroke in an institutional setting.
  
  
  BACKGROUND
  There is limited research about how best to meet the needs of those who die from stroke. A thorough understanding of the determinants of satisfaction with end of life care is crucial for effective service provision to increase awareness of the needs of dying patients.
  
  
  METHODS
  During a six-month period in 2003, a population-based survey of bereaved relatives of patients after stroke was conducted using a stroke-specific version of the Views of Informal Carers Evaluation of Services postal questionnaire (183 informants, response rate 37%). The sub-sample included those informants who reported that the deceased person had died in an institutional setting (91%, n = 165). The analysis was divided into two phases: univariate (Pearson chi-square test) and multivariate phase (logistic regression).
  
  
  RESULTS
  Logistic regressions showed that discussing any worries about the treatment of the deceased person and feeling that the doctors and nurses knew enough about their condition were predictors of satisfaction with doctors and nurses in the last 3 months of life. Meeting the personal care needs of the deceased person, being involved in decisions and feeling that the deceased person died in the right place were predictors of satisfaction with care in the last 3 days of life.
  
  
  CONCLUSIONS
  End of life care needs to address the individual needs of patients who die from stroke and those close to them. This study shows that individualised end of life care increases satisfaction and, although the data reported in this paper reflect care in 2003, there is no more recent evidence that contradicts this important overall finding.
authors.affiliation: NETSCC, Health Technology Assessment, Science Support Directorate, University of Southampton Science Park, UK. A.J.Young@southampton.ac.uk
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Young
authors.forename: Angie
authors.initials: A
authors.lastname: Rogers
authors.forename: Louise
authors.initials: L
authors.lastname: Dent
authors.forename: Julia M
authors.initials: JM
authors.lastname: Addington-Hall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003258:Consumer Behavior; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011368:Professional-Family Relations; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D013223:Statistics as Topic; D020521:Stroke / Q000451:nursing* / Q000523:psychology; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology / Q000592:standards*; D006113:United Kingdom