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Evaluating end-stage cancer patients' preferences for spending their final days at home or in hospital

Year 2024, Volume: 9 Issue: 3, 65 - 70, 25.10.2024

Gökmen Özceylan

https://doi.org/10.22391/fppc.1441160

Abstract

Introduction: This study aimed to explore the preferences of end-stage cancer patients regarding spending their final days at home or in a hospital, focusing on the impact of cancer types and symptoms necessitating palliative care admission during this period.
Methods: The study was conducted with 274 patients diagnosed with end-stage cancer and admitted to the palliative service of Dr. İFC City Hospital in Tekirdağ province. Opinions were collected from all patients while they were fully conscious. The relationships between patients' preferences for their place of death and their age, gender, socioeconomic status, duration of stay in palliative care, admission complaints, and diagnoses were examined. A significance level of p<0.05 was considered statistically meaningful.
Results: Approximately one-third of the participating patients preferred to die at home under home care supervision. It was found that these preferences were not influenced by the patients' age, gender, socioeconomic status, or duration of stay in palliative care but were affected by their cancer diagnoses and symptoms leading to admission. Patients with pancreatic cancer preferred to die in the hospital, while those with prostate and breast cancer were more likely to choose home death.
Conclusion: If a system equipped with an effective planned home care program, managed by a multidisciplinary team in palliative care services, can be provided to meet the needs of patients and caregivers when they approach hospitals in their final stages, it could enable the right group of patients to spend their end-of-life at home, in accordance with their preferences.

Keywords

Terminal cancer home care palliative care place of death

References

  • 1. Miniksar OH, Korkmaz Disli Z, Tunc Z, Acun Delen L, Honca M. Determination of knowledge and opinions on palliative care of workers in ıntensive care and palliative care units: a survey study (in Turkish). J Tradit Med Complement Ther. 2020;3(1):61-8. https://doi.org/10.5336/jtracom.2019-72380
  • 2. Kavsur Z, Sevimli E. The comparıson pallıatıve care servıces of Turkey wıth some developed countrıes (in Turkish). USBAD. 2020;(4):715-30. https://doi.org/10.47994/usbad.780187
  • 3. Fisher RS, Boas W vaerişi1. WHO. Declaration of Astana. Available at: https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf. Accessed: 07.02.2024
  • 4. Radbruch L, De Lima L, Knaul F, Wenk R, Zipporah A, Bhatnaghar S, et al. Redefining palliative care-A new consensus-based definition. J Pain Symptom Manage. 2020;60(4):754-64. https://doi.org/10.1016/j.jpainsymman.2020.04.027
  • 5. Kavalieratos D, Gelfman LP, Tycon LE, Riegel B, Bekelman DB, Ikejani DZ, et al. Integration of palliative care i heart failure: Rationale, evidence, and future priorities. J.JACC 2017;70(15):1919-30. https://doi.org/10.1016/j.jacc.2017.08.036
  • 6. Bannon F, Cairnduff V, Fitzpatrick D, Blaney J, Gomes B, Gavin A, et al. Insights into the factors associated with achieving the preference of home death in terminal cancer: A national population-based study. Palliat Support Care. 2018;16(6):749-55. https://doi.org/10.1017/S1478951517000876
  • 7. Ko E, Kwak E, Nelson-Becker H. What constitutes a good and bad death? Perspectives of homeless older adults. Death Studies.2015;39:422-32. https://doi.org/10.1080/07481187.2014.958629
  • 8. Nysæter TM, Olsson C, Sandsdalen T, Wilde-Larsson B, Hov R, Larsson M. Preferences for home care to enable home death among adult patients with cancer in late palliative phase - a grounded theory study. BMC Palliat Care. 2022;21(1):49. https://doi.org/10.1186/s12904-022-00939-y 23.02.2024 09:23
  • 9. Wales J, Kurahashi AM, Husain A. The interaction of socioeconomic status with place of death: a qualitative analysis of physician experiences. BMC Palliat Care.2018; 17:87 https://doi.org/10.1186/s12904-018-0341-1
  • 10. Aksakal H. An investigation on care location preference for palliative care patients (in Turkish). Sağ Aka Der.2018;10(2): 200-6. https://doi.org/10.52880/sagakaderg.1196739
  • 11. Gomes B, Calanzani N, Gysels M, Hall S, Higginson IJ. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care. 2013;12(1):7. https://doi.org/10.1186/1472-684X-12-7
  • 12. Pinto S, Lopes S, Bruno de Sousa A, Delalibera M, Gomes B, Patient and family preferences about place of end-of-life care and death: An umbrella review, JPSM. 10.1016/j.jpainsymman.2024.01.014, (2024). https://doi.org/10.1016/j.jpainsymman.2024.01.014
  • 13. Uzuncu H, Buyruk H, Alnak E, Yıldırım G. Suggestions on providing humanistic health care for terminally ill cancer patients in the intensive care unit (in Turkish). Cumhuriyet Med J 2013; 35: 143-51. http://dx.doi.org/10.7197/1305-0028.1072
  • 14. Seow H, Salam-White L, Bainbridge D. Community-based specialist palliative care teams and health system costs at end of life: a retrospective matched cohort study. CMAJ Open. 2019; 7(1):73-80. pmid:30755414 https://doi.org/10.9778/cmajo.20180113
  • 15. Bekelman JE, Halpern SD, Blankart CR, Bynum JP, Cohen J, Fowler R, et al. International consortium for end-of-life research (ICELR). Comparison of site of death, health care utilization, and hospital expenditures for patients dying with cancer in 7 developed countries. JAMA. 2016;315(3):272-83. pm:26784775 https://doi.org/10.1001/jama.2015.18603
  • 16. Seven M, Akyuz A, Sever N, Dincer S. Studying the physical and psychological symptoms of patients with cancer (in Turkish). TSK Koruyucu Hekimlik Bülteni.2013;12(3), 219-24.
  • 17. Tuna H, Unver G, Molu B. Symptom clustering and nursing in end-stage cancer patients with palliative care (in Turkish). Journal of Ankara Health Sciences. 2018;7(2):64-9. https://doi/10.1501/Asbd_0000000087
  • 18. Mazur R, Trna J. Principles of palliative and supportive care in pancreatic cancer: A Review. Biomedicines. 2023;11(10):2690. https://doi.org/10.3390/biomedicines11102690
  • 19. National Cancer Institute (NCI)- Nutrition in Cancer Care (PDQ®) summary. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq Accessed: 30.01.2024
  • 20. Hegagi M, James P, Hsu A, Tanuseputro P. Home care use and out-of-hospital death in pancreatic cancer patients: A Retrospective cohort study. J Palliat Care. 2023;38(2):175-83. https://doi.org/10.1177/08258597221075088
  • 21. Chapple A, Evans J, McPherson A, Payne S. Patients with pancreatic cancer and relatives talk about preferred place of death and what influenced their preferences: a qualitative study. BMJ Support Palliat Care. 2011;1(3):291-5. https://doi.org/10.1136/bmjspcare-2011-000091
  • 22. Holm M, Doveson S, Lindqvist O, Wennman-Larsen A, Frannson P. Quality of life in men with metastatic prostate cancer in their final years before death- a retrospective analysis of prospective data. BMC Palliat Care.2018;17:126. https://doi.org/10.1186/s12904-018-0381-6
  • 23. Lindqvist O, Widmark A, Rasmussen BH. Reclaiming wellness--living with bodily problems, as narrated by men with advanced prostate cancer. Cancer Nursing. 2006;29(4):327-37. https://doi.org/10.1097/00002820-200607000-00012
  • 24. Beccaro M, Costantini M, Giorgi Rossi P, Miccinesi G, Grimaldi M, Bruzzi P; ISDOC Study Group. Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Community Health. 2006;60(5):412-6. https://doi.org/10.1136/jech.2005.043646

Son evre kanser hastalarının son günlerini evde veya hastanede geçirme tercihlerinin değerlendirilmesi

Year 2024, Volume: 9 Issue: 3, 65 - 70, 25.10.2024

Gökmen Özceylan

https://doi.org/10.22391/fppc.1441160

Abstract

Giriş: Bu çalışma, son evre kanser hastalarının son günlerini evde veya hastanede geçirme tercihlerini, bu tercihlerinde palyatif servisine yatış semptomlarının ve kanser türlerinin etkisine odaklanarak araştırmayı amaçlamaktadır.
Yöntem: Araştırma, Tekirdağ ilinde bulunan Dr. İFC Şehir Hastanesi'nin palyatif servisine kabul edilen 274 son evre kanser tanısı almış hasta ile yürütülmüştür. Tüm hastalardan tamamen bilinçli oldukları sırada görüşler toplanmıştır. Hastaların ölüm yerine ilişkin tercihleri ile yaşları, cinsiyetleri, sosyoekonomik durumları, palyatif serviste yatma süreleri yatış şikayetleri ve tanıları arasındaki ilişkiler incelenmiştir. Anlamlılık düzeyi olarak p<0,05 değeri istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Katılan hastaların yaklaşık üçte biri son günlerini evde, evde bakım gözetimi altında ölmeyi tercih etti. Bu tercihlerin hastaların yaşları, cinsiyetleri, sosyoekonomik durumları veya palyatif bakımda yatma sürelerinden etkilenmediği; ancak kanser tanıları ve palyatif servise yatışlarına neden olan semptomlardan etkilendiği tespit edildi. Pankreas kanseri olan hastalar hastanede ölmeyi tercih ederken, prostat ve meme kanseri olan hastalar evde ölümü daha fazla tercih ettiler.
Sonuç: Eğer, son evrelerinde hastanelere başvuran kanser hastalarının ve bakım verenlerin ihtiyaçlarını karşılayabilecek şekilde, palyatif servislerde multidisipliner bir ekip tarafından yönetilen etkili ve planlı bir evde bakım programı sağlanabilirse, saptanan doğru hasta grubunun, tercihlerine uygun olarak, hayatlarının son dönemlerini evde geçirmelerini sağlanabilir.

Keywords

Terminal kanser evde bakım palyatif bakım ölüm yeri

Ethical Statement

a. For this study, ethical approval was obtained from the Tekirdağ Dr. İFC City Hospital Clinical Ethics Committee with the decision number 68, dated 01.12.2023. b. For this study, informed consent forms have been obtained from all patients. c. All permissions for conducting this study have been obtained from both patients and institutions.

Supporting Institution

The author declares that no financial support was received from any institution or individual for this study.

Thanks

The author expresses gratitude to the staff of the palliative care unit and home care unit where this study was conducted.

References

  • 1. Miniksar OH, Korkmaz Disli Z, Tunc Z, Acun Delen L, Honca M. Determination of knowledge and opinions on palliative care of workers in ıntensive care and palliative care units: a survey study (in Turkish). J Tradit Med Complement Ther. 2020;3(1):61-8. https://doi.org/10.5336/jtracom.2019-72380
  • 2. Kavsur Z, Sevimli E. The comparıson pallıatıve care servıces of Turkey wıth some developed countrıes (in Turkish). USBAD. 2020;(4):715-30. https://doi.org/10.47994/usbad.780187
  • 3. Fisher RS, Boas W vaerişi1. WHO. Declaration of Astana. Available at: https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf. Accessed: 07.02.2024
  • 4. Radbruch L, De Lima L, Knaul F, Wenk R, Zipporah A, Bhatnaghar S, et al. Redefining palliative care-A new consensus-based definition. J Pain Symptom Manage. 2020;60(4):754-64. https://doi.org/10.1016/j.jpainsymman.2020.04.027
  • 5. Kavalieratos D, Gelfman LP, Tycon LE, Riegel B, Bekelman DB, Ikejani DZ, et al. Integration of palliative care i heart failure: Rationale, evidence, and future priorities. J.JACC 2017;70(15):1919-30. https://doi.org/10.1016/j.jacc.2017.08.036
  • 6. Bannon F, Cairnduff V, Fitzpatrick D, Blaney J, Gomes B, Gavin A, et al. Insights into the factors associated with achieving the preference of home death in terminal cancer: A national population-based study. Palliat Support Care. 2018;16(6):749-55. https://doi.org/10.1017/S1478951517000876
  • 7. Ko E, Kwak E, Nelson-Becker H. What constitutes a good and bad death? Perspectives of homeless older adults. Death Studies.2015;39:422-32. https://doi.org/10.1080/07481187.2014.958629
  • 8. Nysæter TM, Olsson C, Sandsdalen T, Wilde-Larsson B, Hov R, Larsson M. Preferences for home care to enable home death among adult patients with cancer in late palliative phase - a grounded theory study. BMC Palliat Care. 2022;21(1):49. https://doi.org/10.1186/s12904-022-00939-y 23.02.2024 09:23
  • 9. Wales J, Kurahashi AM, Husain A. The interaction of socioeconomic status with place of death: a qualitative analysis of physician experiences. BMC Palliat Care.2018; 17:87 https://doi.org/10.1186/s12904-018-0341-1
  • 10. Aksakal H. An investigation on care location preference for palliative care patients (in Turkish). Sağ Aka Der.2018;10(2): 200-6. https://doi.org/10.52880/sagakaderg.1196739
  • 11. Gomes B, Calanzani N, Gysels M, Hall S, Higginson IJ. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care. 2013;12(1):7. https://doi.org/10.1186/1472-684X-12-7
  • 12. Pinto S, Lopes S, Bruno de Sousa A, Delalibera M, Gomes B, Patient and family preferences about place of end-of-life care and death: An umbrella review, JPSM. 10.1016/j.jpainsymman.2024.01.014, (2024). https://doi.org/10.1016/j.jpainsymman.2024.01.014
  • 13. Uzuncu H, Buyruk H, Alnak E, Yıldırım G. Suggestions on providing humanistic health care for terminally ill cancer patients in the intensive care unit (in Turkish). Cumhuriyet Med J 2013; 35: 143-51. http://dx.doi.org/10.7197/1305-0028.1072
  • 14. Seow H, Salam-White L, Bainbridge D. Community-based specialist palliative care teams and health system costs at end of life: a retrospective matched cohort study. CMAJ Open. 2019; 7(1):73-80. pmid:30755414 https://doi.org/10.9778/cmajo.20180113
  • 15. Bekelman JE, Halpern SD, Blankart CR, Bynum JP, Cohen J, Fowler R, et al. International consortium for end-of-life research (ICELR). Comparison of site of death, health care utilization, and hospital expenditures for patients dying with cancer in 7 developed countries. JAMA. 2016;315(3):272-83. pm:26784775 https://doi.org/10.1001/jama.2015.18603
  • 16. Seven M, Akyuz A, Sever N, Dincer S. Studying the physical and psychological symptoms of patients with cancer (in Turkish). TSK Koruyucu Hekimlik Bülteni.2013;12(3), 219-24.
  • 17. Tuna H, Unver G, Molu B. Symptom clustering and nursing in end-stage cancer patients with palliative care (in Turkish). Journal of Ankara Health Sciences. 2018;7(2):64-9. https://doi/10.1501/Asbd_0000000087
  • 18. Mazur R, Trna J. Principles of palliative and supportive care in pancreatic cancer: A Review. Biomedicines. 2023;11(10):2690. https://doi.org/10.3390/biomedicines11102690
  • 19. National Cancer Institute (NCI)- Nutrition in Cancer Care (PDQ®) summary. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq Accessed: 30.01.2024
  • 20. Hegagi M, James P, Hsu A, Tanuseputro P. Home care use and out-of-hospital death in pancreatic cancer patients: A Retrospective cohort study. J Palliat Care. 2023;38(2):175-83. https://doi.org/10.1177/08258597221075088
  • 21. Chapple A, Evans J, McPherson A, Payne S. Patients with pancreatic cancer and relatives talk about preferred place of death and what influenced their preferences: a qualitative study. BMJ Support Palliat Care. 2011;1(3):291-5. https://doi.org/10.1136/bmjspcare-2011-000091
  • 22. Holm M, Doveson S, Lindqvist O, Wennman-Larsen A, Frannson P. Quality of life in men with metastatic prostate cancer in their final years before death- a retrospective analysis of prospective data. BMC Palliat Care.2018;17:126. https://doi.org/10.1186/s12904-018-0381-6
  • 23. Lindqvist O, Widmark A, Rasmussen BH. Reclaiming wellness--living with bodily problems, as narrated by men with advanced prostate cancer. Cancer Nursing. 2006;29(4):327-37. https://doi.org/10.1097/00002820-200607000-00012
  • 24. Beccaro M, Costantini M, Giorgi Rossi P, Miccinesi G, Grimaldi M, Bruzzi P; ISDOC Study Group. Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Community Health. 2006;60(5):412-6. https://doi.org/10.1136/jech.2005.043646
There are 24 citations in total.

Details

Primary Language English
Subjects Family Medicine, Palliative Care
Journal Section Original Research
Authors

Gökmen Özceylan 0000-0002-2388-4158

Publication Date October 25, 2024
Submission Date February 21, 2024
Acceptance Date June 28, 2024
Published in Issue Year 2024Volume: 9 Issue: 3

Cite

APA Özceylan, G. (2024). Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital. Family Practice and Palliative Care, 9(3), 65-70. https://doi.org/10.22391/fppc.1441160
AMA Özceylan G. Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital. Fam Pract Palliat Care. October 2024;9(3):65-70. doi:10.22391/fppc.1441160
Chicago Özceylan, Gökmen. “Evaluating End-Stage Cancer patients’ Preferences for Spending Their Final Days at Home or in Hospital”. Family Practice and Palliative Care 9, no. 3 (October 2024): 65-70. https://doi.org/10.22391/fppc.1441160.
EndNote Özceylan G (October 1, 2024) Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital. Family Practice and Palliative Care 9 3 65–70.
IEEE G. Özceylan, “Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital”, Fam Pract Palliat Care, vol. 9, no. 3, pp. 65–70, 2024, doi: 10.22391/fppc.1441160.
ISNAD Özceylan, Gökmen. “Evaluating End-Stage Cancer patients’ Preferences for Spending Their Final Days at Home or in Hospital”. Family Practice and Palliative Care 9/3 (October 2024), 65-70. https://doi.org/10.22391/fppc.1441160.
JAMA Özceylan G. Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital. Fam Pract Palliat Care. 2024;9:65–70.
MLA Özceylan, Gökmen. “Evaluating End-Stage Cancer patients’ Preferences for Spending Their Final Days at Home or in Hospital”. Family Practice and Palliative Care, vol. 9, no. 3, 2024, pp. 65-70, doi:10.22391/fppc.1441160.
Vancouver Özceylan G. Evaluating end-stage cancer patients’ preferences for spending their final days at home or in hospital. Fam Pract Palliat Care. 2024;9(3):65-70.
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Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505