Article Text

Download PDFPDF

66 Changes in dignity and respect at the end of life: cross-sectional analysis of data from the VOICES bereavement survey (2011–2015)
  1. Benjamin Allison,
  2. Preeti Sanhu and
  3. Katherine Sleeman
  1. The Cicely Saunders institute, King’s College London


Background An aim of the National End of Life Care Strategy (2008) was to improve dignity and respect in end of life care (EoLC). The VOICES survey was commissioned in 2011 as the first national post-bereavement postal survey, a key component of which was to assess dignity and respect at the end of life. The aim of this study was to explore changes in dignity and respect perceived by bereaved relatives over the five-year period that the VOICES survey was commissioned.

Methods Aggregate data from VOICES post-bereavement surveys (2011–2015) was obtained from the Office of National Statistics. Information about dignity and respect was extracted and dichotomised into satisfied (‘always’and ‘most of the time’) and unsatisfied (‘some of the time’and ‘never’). A chi-squared test for trend was used to analyse changes over time in dignity and respect, for each of seven categories of health care professionals.

Results There were 1 07 206 responses to the VOICES surveys over 5 years (average response rate 44.4%). Improvements in perceived dignity and respect from 2011 to 2015 were found with respect to five categories of health care professional: GPs (0.7% improvement in satisfaction to 60.9%, p=0.016); hospital doctors (1.7% improvement to 85.0%, p=0.0036); hospital nurses (5.2% improvement to 80.6%, p<0.0001); hospice doctors (0.8% improvement to 95.5%, p=0.0001); hospice nurses (1.9% improvement to 95.2%, p=0.0001). District/community nurses showed a 1.4% decrease in satisfaction to 92.6% (p<0.0001). Care home staff showed no change (p=0.2).

Conclusions The data has demonstrated a general trend of improvement with regard to dignity and respect experienced from healthcare professionals. District/community nurses showed a decrease in dignity and respect however, this could be attributed to a regression to the mean or due to their high baseline, therefore this would not be cause for concern. The low satisfaction demonstrated with GPs should be investigated.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.