End-of-Life Care During the Pandemic. Perspectives from Healthcare Professionals in Home-based Palliative Care in Colombia

Abstract

Introduction: The COVID-19 pandemic has had a significant social and health impact. Given the high risk of contagion and the potential collap-se of the healthcare system, strategies such as social isolation, the use of personal protective equipment, and an increased reliance on telemedicine were adopted. These measures altered the dynamics of end-of-life patient care. Methodology: This observational cross-sectional study explored the experiences of home care staff providing end-of-life care and the impact of the pandemic on the care process, as well as on their quality of life and emotional well-being. A survey incorporating the adapted Care Of the Dying Evaluation (iCODE) questionnaire was conducted, alongside an assessment of quality of life using question 30 of the EORTC QLQ, and emotional well-being using the PANAS scale. Results: The experiences of 131 deceased patients were characterized. Professionals reported adequate therapeutic efforts in managing pain, dyspnea, and delirium. Additionally, they noted that the pandemic impe-ded treatment in 24% of the patients. The average quality of life score for professionals was 6 points, with a predominantly positive affect reported. Conclusions: Healthcare professionals in home-based care programs ob-served that the pandemic affected the treatment of nearly a quarter of end-of-life patients. Nonetheless, they highlighted that satisfactory symp-tomatic care and control were maintained. Additionally, they reported an adequate quality of life.