[Relatives' attitude towards death in hospital]. / Pårørendes opfattelse af døden på hospital.

INTRODUCTION: A survey was conducted over 13 months to measure the satisfaction level of relatives to patients, who had died in hospital. METHODS: The survey contained a questionnaire of 75 questions measuring satisfaction in different areas: the amount and quality of information given to the relatives by doctors, the support and care provided by the staff, and the quality of the physical environment. RESULTS: Out of 619 questionnaires posted, 462 were returned (74.6% response rate). Only half the relatives were satisfied with the level of information given by doctors to themselves and the one dying. Twenty-four per cent of the respondents were dissatisfied by the length of time taken by doctors to inform them about the situation. A broad majority of respondents (85%) were very satisfied with the care and support provided by the nursing staff. Sixty-six per cent of the patients died in private wards. Fifty-five per cent of the relatives were satisfied with the quality of the patient's room, but only 37% were satisfied with the environment offered to them. One in five was especially dissatisfied by the lack of a special room, which would permit enabling private conversations in an undisturbed environment. DISCUSSION: Our survey shows that doctors' communication with the relatives of dying patients needs to be improved. There also seems to be a need for providing a better environment for the relatives of dying patients by reserving separate rooms for rest and conversation.

Chest radiograph--a poor method for determining the size of a pneumothorax.

The ability of chest radiographs to determine the size of a pneumothorax was tested in 16 patients using computed tomographic (CT) scan as a reference method. To determine if CT with a slice thickness of 12 mm could be used, its accuracy was assessed in a lung model experiment. The lung model consisted of a water-filled plastic bag (lung) fitted into a plastic chamber (hemithorax), both of approximately the same size and shape as in man. Water was drawn off in incremental steps and a CT was done after each step. The area of the pneumothorax was calculated by computer and when multiplied by slice thickness and number of slices, the total volume of the pneumothorax could be compared with the extracted amount of water. A good correlation (r = 0.99), with the line of regression close to the line of identity, was found between the CT investigation and the artificial pneumothorax. In the patients, the size of the pneumothorax, judged by radiograph using two different methods of calculation, was correlated to the size obtained by CT. The correlation was poor (r = 0.71) irrespective of method of calculation. The size of the pneumothorax estimated by CT showed a good correlation (r = 0.99) to the initial aspirated air volumes in 12 of the 16 patients treated with drainage. A cautious attitude toward the use of chest radiographs for calculations of the degree of lung collapse in patients with pneumothorax is recommended.