Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer
Ko Sato1, Mika Baba2, Tatsuya Morita3,4
1Hospice, Ise Municipal General Hospital, Ise, Japan.
The American Journal of Hospice & Palliative Care
|December 13, 2023
Summary
Most families were satisfied with end-of-life care for terminal cancer patients without continuous electrocardiographic monitoring (CEM). However, clear explanations about monitoring choices are crucial for family satisfaction.
Area of Science:
- Palliative Care
- Oncology
- Medical Ethics
Background:
- Continuous electrocardiographic monitoring (CEM) is not recommended for purposeless physiological monitoring at end-of-life.
- Limited research exists on family perspectives regarding terminal cancer patients' deaths without CEM.
- Understanding family experiences is vital for improving end-of-life care quality.
Purpose of the Study:
- To investigate the impact of not using CEM on end-of-life care quality.
- To explore family feelings and psychological distress when CEM is absent in the final 24 hours.
- To compare experiences between monitored and non-monitored patients.
Main Methods:
- A multicenter, cross-sectional study.
- Self-report questionnaires distributed to 1087 bereaved families in Japanese palliative care units.
- Analysis of 394 valid responses comparing non-monitored (NM) and monitored (bedside-MB, remote-MC) groups.
Main Results:
- 85.5% of families in the NM-group reported satisfaction without CEM, though lower than monitored groups.
- 14% of NM-group families desired patient monitoring; adequate CEM explanation correlated with lower desire.
- No significant differences in overall care satisfaction or family psychological distress were found across groups.
Conclusions:
- While most families are satisfied without CEM, a higher proportion express dissatisfaction compared to monitored groups.
- Not using CEM is not a significant barrier to end-of-life care for terminal cancer patients.
- Providing sufficient explanations regarding CEM options is important for ensuring satisfactory family care experiences.
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