Quality of Dying and Death Questionnaire for Family Members - Version 3.2A - University
of Washington Schools of Medicine and Nursing
University of Washington/Harborview Medical Center - Integrating Palliative and
Critical Care Program: Quality of Dying and Death Questionnaire for Family Members
- Version 3.2A
An extensive questionnaire for families relating to experiences they and their loved
one may have had while receiving palliative care in the Intensive Care Unit.
Evaluation Tools - Satisfaction/Perception of Care
University of Washington
Harborview Medical Center
325 9th Ave., Box 359762
Seattle WA 98104
J. Randall Curtis, M.D., M.P.H.
How the grantee used this instrument:
This questionnaire is for family members who were present during the last few days
of a loved one's life. Responses were used by the grantee to evaluate the palliative
care program in the Intensive Care Unit.
death, dying, family members, after-death interview, post death interview, quality
improvement, family experience, family perception of care, family satisfaction,
patient experience, satisfaction survey
To use this tool:
Please credit the source in any publications using this tool. For further information
on scoring and analyses and for published references, please see the "Instruments"
and "Publications" pages at http://depts.washington.edu/eolcare.
Developed specifically for this project by the project team.
To view this tool:
Quality of Dying and Death Questionnaire for Family Members - Version
(Viewing PDF files requires downloading and installation of the free
Adobe Acrobat Reader.)
Posted: July 2006
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Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation
dedicated to long-term changes in health care institutions to substantially improve
care for dying people and their families.