Table 2

Characteristics of patients (n = 161), their families and physicians, outcome and potential confoundersa
Patients
Female gender,% 69
Age at death (mean, SD) 86.0 (6.3)
Length of stay in nursing home (mean number of years, SD) 1.0 (0.7)
Dementia severity (mean BANS-S score, SD)
- at baseline 14.3 (4.2)
- at last semi-annual assessment before deathb 15.7 (4.2)
Advanced dementia (GDS 7 and (CPS 5 or 6)),%
- at baseline 13
- one month before death 41
Families
Female gender,% 64
Age at baseline assessment (mean, SD) 60.3 (11.7)
Relationship to deceased resident,%
- child (including child and legal representative or other combinations) 59
- spouse 19
- other 22
Highest completed education,%c
- none or primary/elementary school 6
- (high school preparing for) technical/trade school 56
- high school preparing for BSc or MSc 10
- BSc or MSc degree 28
Physicians (weighted for number of patients they treated)
Female gender,% 61
Age at assessment of perception of dementia 43.1 (8.6)
Experience as a physician in nursing home (mean number of years, SD) 11.5 (8.1)
Full time equivalent (mean, SD) 0.78 (0.17)
Outcome and potential confoundersc
EOLD-CAD score for comfort (mean, SD)d 34.1 (5.6)
Assessment of EOLD-CAD by physician (versus nurse under supervision of physician),% 47
Time between patient’s death, mean number of years (SD), and 0.80 (0.67)
- baseline assessment (family, and most physician understanding variables)
- physician’s assessment of perception of dementia 0.18 (0.74)
- death of the first subject in study 1.93 (0.72)

BANS-S, Bedford Alzheimer Nursing Severity-Scale (possible range 7 to 28; scores of 17 and higher represent severe dementia [29]); CPS, Cognitive Performance Scale; EOLD-CAD, End-of-life in Dementia-Comfort Assessment in Dying scale (possible range: 14 to 42, higher scores represent better comfort); GDS, Global Deterioration Scale; SD, standard deviation.

aMissing values were 3 for both BANS-S assessments, 11 for advanced dementia at baseline, 1 for relationship family to deceased resident, 2 for family education, 8 for physician demographics, 17 for physician experience, 21 for full time equivalent, 8 for assessment of EOLD-CAD by physician, 8 for time between death and physician’s assessment of perception of dementia, and there were no missing values for the other characteristics.

bThe last assessment before death was the baseline assessment in 50% of cases, and a semi-annual assessment (the first through the fifth) in the other 50% of cases.

cHighest completed education was also a potential confounder.

dNurses’ mean EOLD-CAD scores were not significantly lower than physician’s mean ratings of different patients in the DEOLD study (33.8 SD 6.7 versus 34.4 SD 4.4; P = 0.53; no pairwise comparison possible; adjusted for in analyses even though it did not change results).

van der Steen et al.

van der Steen et al. BMC Medicine 2013 11:105   doi:10.1186/1741-7015-11-105

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