Dying in hospital is worse for non‐cancer patients. A regional cross‐sectional survey of bereaved relatives' views

Abstract

Objective The aim of the study is to examine differences in hospital care between patients with cancer and non‐cancer conditions in their dying phase, perceived by bereaved relatives. Methods A retrospective cross‐sectional post‐bereavement survey, with the total population of 351 deceased, 91 cancer patients and 46 non‐cancer patients, who spent their last 2 days of life in hospital. A validated German version of the VOICES‐questionnaire (‘VOICES‐LYOL‐Cologne’) was used. Results There were substantial differences between the two groups in the rating of sufficient practical care such as pain relief or support to eat or drink (p = 0.005) and sufficient emotional care needs (p = 0.006) and in the quality of communication with healthcare professionals (p < 0.001), with non‐cancer patients scoring lowest in all these dimensions. Conclusion In all surveyed dimensions on the quality of care in the dying phase, non‐cancer patients' relatives rated the provided care worse than those of cancer patients. To compensate any differences in care in the dying phase between diagnosis groups, hospital care should be provided as needs‐oriented and non‐indication‐specific.

Symptom burden, service use and care dissatisfaction among older adults with cancer, cardiovascular disease, respiratory disease, dementia and neurological disease during the last 3 months before death: A pooled analysis of mortality follow-back surveys

“…We conducted a secondary analysis of pooled data using cross-sectional mortality follow-back surveys from three studies: QUALYCARE 17 ; OPTCare Elderly 18 ; and the Inter-national Access, Right and Empowerment 1 (IARE 1). 19 , 20 …”

“…[14][15][16] Differences between causes of death have not been examined to the best of our knowledge. Therefore, in this secondary analysis, we pooled data from three studies using mortality follow-back surveys [17][18][19][20] Our aims were to: (1) gain a thorough understanding of service use, patient circumstances, symptom burden, practical problems and dissatisfaction with end-of-life care for older adults by cause of death and (2) explore factors related to symptom burden, practical problems and dissatisfaction, focussing on the causes of death.…”

“… 14 – 16 Diff-erences between causes of death have not been examined to the best of our knowledge. Therefore, in this secondary analysis, we pooled data from three studies using mortality follow-back surveys 17 – 20 …”

Timely integration of palliative care into cancer care

“…Also in Sweden, as shown by Adolfsson et al, physicians from various hospital departments stated that they still introduce palliative care rather late in the cancer trajectory, despite positive attitudes towards the benefits of integration of palliative care into oncology (Adolfsson et al, 2022). And good to realise that non-cancer patients experience worse hospital care in the dying phase compared with patients with cancer, regarding symptom management, emotional support and quality of communication with healthcare professionals, as shown by Kasdorf et al (2022).…”