Effect of the duration of hospice and palliative care on the quality of dying and death in patients with terminal cancer: A nationwide multicentre study

Abstract

Early referral to hospice and palliative care (HPC) has significant benefits, but little is known about the appropriate time for referral. The purpose of this study of terminal cancer patients was to identify the most appropriate time for referral to HPC. Cross-sectional correlation study design was used. Participants were the bereaved relatives, who were the adult primary caregivers of the 1,829 terminal cancer patients who died 2-6 months previously in nationwide centres that provide HPC in Korea. A post-bereavement survey (Good Death Inventory, GDI) of family caregivers was used to assess patients' quality of dying and death. Relative to patients who were in HPC for 3-7 days and HPC for 8-21 days, those in HPC for 22-84 days had significantly higher quality of dying. Propensity score matched comparison between the group hospitalised for 22-84 days (n = 65) and the group hospitalised for 85 days or longer (n = 65) showed no significant differences in all the items on quality of dying and death. Our results suggest that terminal cancer patients who stay in HPC at least for 22 days have improved quality of dying and death.

Identifying and handling unbalanced baseline characteristics in a non-randomized, controlled, multicenter social care nurse intervention study for patients in advanced stages of cancer

“…Thereby, compared to patients provided with standard care, patients receiving early palliative care services showed an increased overall quality of life (QoL), a better perception of the own care situation as well as a longer life expectancy, while they were less prevalently diagnosed with depression and anxiety disorders [ 7 , 8 ]. Moreover, family members experienced the process of dying as less painful if their deceased patients had received more than 22 days of palliative or hospice care as compared to relatives of patients with shorter care intervals [ 9 ].…”

The Most Important Aspects for a Good Death: Perspectives from Parents of Children with Cancer

“…It is important to implement early integration between palliative care services and standard oncologic care for patients with cancer, and its proper timing has been emphasized in previous studies. 41 , 42 After comparing the perceived timeliness of palliative care enrollment among patients, one study showed that those who were promptly admitted to the palliative care unit had significantly higher GDI scores than those admitted later. 43 In the aforementioned study, pediatric patients and their caregivers were more frequently observed in groups admitted to the palliative care unit much later in the treatment course.…”

Inpatient Hospice Palliative Care Unit and Palliative Consultation Service Enhance Comprehensive Quality of Life Outcomes in Terminally Ill Cancer Patients: A Prospective Longitudinal Study

“…A study has shown that short or long survival time does not affect the accomplishment of CoQoLo in patients with terminal cancer [49]. Patients who received hospice care for 22-84 days have been reported to exhibit a significantly higher quality of dying than those who received hospice care for 3-21 days [19]. Such a short course of time can pose a challenge in providing hospice care; however, with the hospice care team members' endeavor, CoQoLo can be achieved within a short survival time.…”

“…Preparing for a good quality of dying and death is necessary in Chinese culture, as people expect those who remain to make efforts to address the final engagements of those who pass on. Previous studies have shown that the effectiveness of PCU with regard to care for terminally ill cancer patients is positively related to the quality of dying and death [18,19]. A crosssectional study indicated that home-based hospice palliative care could achieve higher CoQoLo levels for cancer patients than palliative care units, as rated by bereaved family members [20].…”