BACKGROUND Nursing homes are becoming more important for end-of-life care. Within the industrialised world, Germany is among the countries with the most end-of-life hospitalizations in nursing home residents. To improve end-of-life care, investigation in the status quo is required. The objective was to gain a better understanding of the perspectives of nursing home staff on the current situation of end-of-life care in Germany. METHODS A cross-sectional study was conducted as a postal survey among a random sample of 1069 German nursing homes in 2019. The survey was primarily addressed to nursing staff management. Data was analyzed using descriptive statistics. Staff was asked to rate different items regarding common practices and potential deficits of end-of-life care on a 5-point-Likert-scale. Estimations of the proportions of in-hospital deaths, residents with advance directives (AD), cases in which documented ADs were ignored, and most important measures for improvement of end-of-life care were requested. RESULTS 486 (45.5%) questionnaires were returned, mostly by nursing staff managers (64.7%) and nursing home directors (29.9%). 64.4% of the respondents rated end-of-life care rather good, the remainder rated it as rather bad. The prevalence of in-hospital death was estimated by the respondents at 31.5% (SD: 19.9). Approximately a third suggested that residents receive hospital treatments too frequently. Respondents estimated that 45.9% (SD: 21.6) of the residents held ADs and that 28.4% (SD: 26.8) of available ADs are not being considered. Increased staffing, better qualification, closer involvement of general practitioners and better availability of palliative care concepts were the most important measures for improvement. CONCLUSIONS Together with higher staffing, better availability and integration of palliative care concepts may well improve end-of-life care. Prerequisite for stronger ties between nursing home and palliative care is high-quality education of those involved in end-of-life care.

中文翻译：

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疗养院工作人员对德国养老院居民临终护理的看法：横断面调查。

背景技术对于临终护理而言，疗养院变得越来越重要。在工业化的世界中，德国是养老院住院患者中寿终正寝的国家之一。为了改善临终关怀，需要对现状进行调查。目的是更好地了解养老院工作人员对德国临终护理现状的看法。方法采用横断面研究作为邮政调查，于2019年对1069家德国养老院进行随机抽样。该调查主要针对护理人员管理。使用描述性统计数据分析数据。要求工作人员以5分Likert量表对有关常见做法和临终关怀的潜在缺陷的不同项目进行评分。估计院内死亡比例，拥有预先指示（AD）的居民，需要忽略记录在案的AD，并要求采取最重要的措施来改善临终护理。结果共收到486份（45.5％）问卷，主要由护理人员经理（64.7％）和疗养院主任（29.9％）提供。64.4％的被调查者对临终护理的评价为良好，其余人则认为其为不良。受访者估计院内死亡的流行率为31.5％（SD：19.9）。大约三分之一的人建议居民太频繁地接受医院治疗。受访者估计有45.9％（SD：21.6）的居民拥有AD，而没有考虑28.4％（SD：26.8）的可用AD。人员增加，资格更高，最重要的改进措施是全科医生的更紧密参与和姑息治疗概念的更好可用性。结论再加上人员配备增加，姑息治疗概念的更好可用性和整合性可以很好地改善临终关怀。养老院和姑息治疗之间加强联系的前提是对临终护理人员进行高质量的教育。