In long-term care facilities often many care providers are involved, which could make it difficult to reach consensus in care. This may harm the relation between care providers and can complicate care. This study aimed to describe and compare in six European countries the degree of consensus among everyone involved in care decisions, from the perspective of relatives and care staff. Another aim was to assess which factors are associated with reporting that full consensus was reached, from the perspective of care staff and relatives. In Belgium, England, Finland, Italy, the Netherlands and Poland a random sample of representative long-term care facilities reported all deaths of residents in the previous three months (n = 1707). This study included residents about whom care staff (n = 1284) and relatives (n = 790) indicated in questionnaires the degree of consensus among all involved in the decision or care process. To account for clustering on facility level, Generalized Estimating Equations were conducted to analyse the degree of consensus across countries and factors associated with full consensus. Relatives indicated full consensus in more than half of the residents in all countries (NL 57.9% - EN 68%), except in Finland (40.7%). Care staff reported full consensus in 59.5% of residents in Finland to 86.1% of residents in England. Relatives more likely reported full consensus when: the resident was more comfortable or talked about treatment preferences, a care provider explained what palliative care is, family-physician communication was well perceived, their relation to the resident was other than child (compared to spouse/partner) or if they lived in Poland or Belgium (compared to Finland). Care staff more often indicated full consensus when they rated a higher comfort level of the resident, or if they lived in Italy, the Netherland, Poland or England (compared to Finland). In most countries the frequency of full consensus among all involved in care decisions was relatively high. Across countries care staff indicated full consensus more often and no consensus less often than relatives. Advance care planning, comfort and good communication between relatives and care professionals could play a role in achieving full consensus.

中文翻译：

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长期护理机构中居民的治疗共识：来自欧洲6个国家/地区的PACE横断面研究中亲戚和护理人员的观点

在长期护理机构中，通常涉及许多护理提供者，这可能使得难以在护理方面达成共识。这可能会损害护理人员之间的关系，并使护理复杂化。这项研究旨在从亲戚和护理人员的角度描述和比较六个欧洲国家中参与护理决策的每个人的共识程度。另一个目的是从护理人员和亲戚的角度评估哪些因素与报告已达成完全共识有关。在比利时，英国，芬兰，意大利，荷兰和波兰，随机抽样的代表性长期护理机构报告了前三个月居民的全部死亡（n = 1707）。这项研究包括问卷调查中指出护理人员（n = 1284）和亲戚（n = 790）的居民在决策或护理过程中所有参与者的共识程度。为了考虑设施水平上的聚类，进行了广义估计方程来分析各国之间的共识程度以及与完全共识相关的因素。亲戚表示，除芬兰（40.7％）以外，所有国家/地区的半数以上居民都完全达成共识（NL 57.9％-EN 68％）。护理人员报告说，芬兰的59.5％的居民与英格兰的86.1％的居民达成了完全共识。在以下情况下，亲戚更有可能达成完全共识：居民更安心或谈论治疗偏爱，医护人员解释了姑息治疗，家庭医生的沟通容易被察觉，他们与居民的关系不是孩子（与配偶/伴侣相比），或者居住在波兰或比利时（与芬兰相比）。护理人员在给居民更高的舒适度时，或者居住在意大利，荷兰，波兰或英国（与芬兰相比）时，往往会表示完全共识。在大多数国家，参与护理决策的所有人之间达成完全共识的频率相对较高。跨国护理人员表示，与亲戚相比，达成完全共识的频率更高，而没有达成共识的频率更低。事先的照护计划，亲戚与照护专业人员之间的舒适度和良好的沟通可以在达成完全共识方面发挥作用。护理人员在给居民更高的舒适度时，或者居住在意大利，荷兰，波兰或英国（与芬兰相比）时，往往会表示完全共识。在大多数国家，参与护理决策的所有人之间达成完全共识的频率相对较高。跨国护理人员表示，与亲戚相比，达成完全共识的频率更高，而没有达成共识的频率更低。事先的照护计划，亲戚与照护专业人员之间的舒适度和良好的沟通可以在达成完全共识方面发挥作用。护理人员在给居民更高的舒适度时，或者居住在意大利，荷兰，波兰或英国（与芬兰相比）时，往往会表示完全共识。在大多数国家，参与护理决策的所有人之间达成完全共识的频率相对较高。跨国护理人员表示，与亲戚相比，达成完全共识的频率更高，而没有达成共识的频率更低。事先的照护计划，亲戚与照护专业人员之间的舒适度和良好的沟通可以在达成完全共识方面发挥作用。跨国护理人员表示，与亲戚相比，达成完全共识的频率更高，而没有达成共识的频率更低。事先的照护计划，亲戚与照护专业人员之间的舒适度和良好的沟通可以在达成完全共识方面发挥作用。跨国护理人员表示，与亲戚相比，达成完全共识的频率更高，而达成共识的频率更低。事先的照护计划，亲戚与照护专业人员之间的舒适度和良好的沟通可以在达成完全共识方面发挥作用。