Analysis of Palliative Care Knowledge and Symptom Burden Among Female Veterans With Serious Illness: A Cross-Sectional Study

Abstract

Background: The female Veteran population is rapidly growing, as is their use of Veterans Affairs (VA) medical centers (VAMCs). Additionally, 90% of female Veterans are under 65 years old, meaning healthcare providers at VAMCs must be ready to manage the complex serious illnesses that affect female Veterans as they age. These serious illnesses require proper medical management, which can include palliative care. However, little palliative care research includes female Veterans. Aims: The aims of this cross-sectional study were to examine palliative care knowledge and symptom burden among female Veterans’ and examine factors associated a symptom burden scale. Methods: Consenting participants completed online questionnaires, including the Palliative Care Knowledge Scale (PaCKS), Condensed Memorial Symptom Assessment Scale (CMSAS), and demographics. Descriptive statistics characterized the sample, bivariate association were carried out with a Chi-square and t test. A generalized linear model explored associations between CMSAS and its subscales with sociodemographic, number of serious illnesses, and facility type (VAMC vs civilian facility). Results: 152 female Veterans completed the survey. PaCKS scores were consistent across our sample. Physical symptoms were rated higher for those receiving care at VAMCs compared to civilian facilities ( P = .02) in the bivariate analysis. The factors associated with CMSAS were age, employment status and number of serious illnesses (all P < .05). Conclusions: Palliative care can assist female Veterans with serious illness. More research is needed to further explore variables associated with symptom burden among female Veterans such as age, employment status, and number of serious illnesses.

Coming to Terms

“…Even with the notable innovation and success of their palliative and hospice care programs across the United States, it begs the question of why these participants described such poor quality of life. This finding was echoed in the quantitative arm of this study with those receiving care at VHA facilities having worse physical symptoms associated with their serious illness than female veterans receiving care at civilian facilities 30 . In addition, female veterans receiving care at VHA facilities have more serious illnesses than those receiving care at VHA facilities, 30 which likely accounts for the poor quality of life described by this study's results.…”

“…This finding was echoed in the quantitative arm of this study with those receiving care at VHA facilities having worse physical symptoms associated with their serious illness than female veterans receiving care at civilian facilities. 30 In addition, female veterans receiving care at VHA facilities have more serious illnesses than those receiving care at VHA facilities, 30 which likely accounts for the poor quality of life described by this study's results. Other studies have suggested that VHA facilities tended to have a higher rate of palliative care consultations within 30 days of death and were more likely to die in dedicated palliative and hospice care units compared with civilian facilities.…”