title: Patients', family caregivers', and professionals' perspectives on quality of palliative care: a qualitative study.
abstract: BACKGROUND
  The quality of palliative care is the foremost preoccupation of clinicians, decision-makers, and managers as well as patients and families. Major input from healthcare professionals is required to develop indicators for the quality of palliative care, but the involvement of patients and families is also recognized as essential, even though this is rarely achieved in practice.
  
  
  OBJECTIVE
  The objectives of this study were to identify (1) convergences and divergences in the points of view of different stakeholders (patients, families, healthcare professionals) relative to key elements of the quality of palliative care and (2) avenues for refining existing indicators of quality of palliative care.
  
  
  METHODS
  Cross-sectional qualitative study.
  
  
  METHODS
  There were six settings: two hospital-based palliative care units, one hospice, and three other medical units where a mobile palliative care team intervene. Semi-structured interviews were conducted among 61 patients, families, healthcare professionals, and managers.
  
  
  RESULTS
  Four major dimensions of quality of care are deemed critical by patients, their families, and professionals: comprehensive support for the patients themselves, clinical management, involvement of families, and care for the imminently dying person and death. Differences exist between various stakeholders regarding perceptions of some dimensions of quality of care. Avenues for improving current quality of care indicators are identified.
  
  
  CONCLUSIONS
  Our study results can be used to refine or develop quality indicators that truly mirror the points of view of patients and their families and of healthcare professionals.
authors.affiliation: Division of Geriatrics, Department of Family Medicine, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC, Canada isabelle.vedel@mcgill.ca.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vedel
authors.affiliation: Haute Autorité de santé, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Ghadi
authors.affiliation: Desautels Faculty of Management, McGill University, Montreal, QC, Canada.
authors.forename: Liette
authors.initials: L
authors.lastname: Lapointe
authors.affiliation: Institut du Management, Ecole des Hautes Etudes en Santé Publique, Rennes, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Routelous
authors.affiliation: AP-HP, Hôpital Ambroise Paré, Département de Santé Publique, Université Versailles St-Quentin, Boulogne-Billancourt, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Aegerter
authors.affiliation: Pôle Recherche, Maison Médicale Jeanne Garnier, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Guirimand
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D010297:Paris; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Palliative care; qualitative research; quality indicators; quality of healthcare