Related Experiment Video
Updated: May 31, 2026
04:36
Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Awareness of dying: it needs words
Martine E Lokker1, Lia van Zuylen, Laetitia Veerbeek
1Department of Public Health, Erasmus Medical Centre, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. m.lokker@erasmusmc.nl
Summary
Patients aware of impending death often find peace and value their lives more. However, caregiver perceptions of patient awareness vary, indicating a need for improved end-of-life communication.
Area of Science:
- Palliative Care
- End-of-Life Communication
- Patient Awareness
Background:
- Understanding patient awareness of dying is crucial for quality end-of-life care.
- Previous research highlights the importance of open communication during the dying process.
Purpose of the Study:
- To assess the extent to which dying patients are aware of their imminent death.
- To investigate associations between patient awareness and characteristics, symptoms, and acceptance of dying.
- To evaluate agreement between medical records, nurses', and family caregivers' perceptions of patient awareness.
Main Methods:
- Questionnaires were administered to nurses and family caregivers of 475 deceased patients across three care settings.
- Medical records were reviewed for indications of patients being informed about their prognosis.
- Data collected from 472 nurses and 280 family caregivers (59% response rate).
Main Results:
- Awareness of imminent death was reported in 51% of medical records, 58% by nurses, and 62% by family caregivers.
- Patients perceived by family caregivers as aware of dying showed greater acceptance and life satisfaction.
- Inter-rater agreement on patient awareness was fair (Cohen's kappa = 0.23-0.31).
Conclusions:
- Awareness of dying correlates with acceptance of dying, suggesting open communication enhances end-of-life quality.
- Discrepancies in perceived patient awareness among different caregivers indicate significant room for communication improvement.
- Enhanced communication strategies are needed to ensure consistent understanding of patient awareness at the end of life.
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