Good death study of elderly patients with terminal cancer in Taiwan

Cheng, Shao‐Yi; Hu, Wen-Yu; Liu, W J; Yao, Chien‐An; Chen, C Y; Chiu, Tai‐Yuan

doi:10.1177/0269216307087142

Cited by 61 publications

(64 citation statements)

References 21 publications

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“…In the present study, the overall proportion of unawareness of disease/prognosis is 35.1%, with 24.6% and 44.1% in the nonelderly group and elderly groups, respectively. This finding is compatible with previous research in Taiwan, which indicated that nonelderly patients had a higher level of disease awareness than elderly patients prior to death [29]. Another study from Taiwan revealed that truth‐telling problems occurred in nearly one‐half (42.6%) of the elderly population (>65 years old) with advanced cancer in Taiwan [30].…”

Section: Discussionsupporting

confidence: 90%

A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

Yang

Chiu

Huang

et al. 2013

The Kaohsiung J of Med Scie

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While symptomatic differences exist between younger and older advanced cancer patients, few studies have examined the differences in their care with respect to age. Our goals were to examine the influences of age differences on physical, psychosocial and spiritual distress among advanced cancer patients. Advanced cancer patients who resided in Kaohsiung Medical University Hospital during 2007-2008 were recruited. Data were collected through professional consultants. The influences of age variations on physical, psychosocial and spiritual distress in nonelderly (<60 years old) and elderly (≧60 years old) patients were analyzed. A total of 1013 advanced cancer patients were included in the analyses with 467 nonelderly patients and 546 elderly patients. Nonelderly patients were identified to have a higher baseline pain level (4.0 vs. 2.8, p<0.001), breakthrough pain (19.3% vs. 9.9%, p<0.01), insomnia (6.4% vs. 2.7%, p=0.006), emotional distress (69.0% vs. 60.6%, p=0.013), and unwillingness to pass away because of concern for loved ones (18.8% vs. 11.9%, p=0.003) with significant difference. Elderly ones were concerned about unfulfilled wishes (29.7% vs. 18.4%, p<0.001) in spiritual concerns. After adjustments in regression models, nonelderly age (<60 years old) still revealed significant positive or negative impact on all categories of distress. Patients aged under 60 years have more physical, psychosocial and spiritual suffering. This study suggested that professional practitioners should provide intensive care for vulnerable terminally ill cancer patients.

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Section: Discussionsupporting

confidence: 90%

A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

Yang

Chiu

Huang

et al. 2013

The Kaohsiung J of Med Scie

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“…Each item was appraised on a scale of 1 ¼ 'extremely poor' to 5 ¼ 'extremely good'. The six categories and 12 items were as follows: (1) Reliability and validity of the GDS in Taiwanese palliative care units have been well established (17,18). Cronbach's alpha (a) was used to assess the internal consistency of this good-death measure in the present study and was shown to be 0.71 for the five domains.…”

Section: The As For Good Death Servicesmentioning

confidence: 99%

“…The estimated mean and SD of the GDS were 13.77 and 2.01, respectively, based on a previous study (18). We used two-sample t-tests for comparing mean differences to calculate the required sample size.…”

Section: Sample Size Determinationmentioning

confidence: 99%

Evaluation of Inpatient Multidisciplinary Palliative Care Unit on Terminally Ill Cancer Patients from Providers' Perspectives: A Propensity Score Analysis

Cheng

Fang

et al. 2012

Japanese Journal of Clinical Oncology

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Objective: The effectiveness of inpatient palliative care units, a complex intervention, is challenging to evaluate due to methodological and practical difficulties. We conducted a study to evaluate providers' perceived effectiveness of one such unit. Methods: A non-concurrent, prospective, controlled study using the Audit Scale for good death services as an indicator of process of care and the Good Death Scale as the outcome of provider assessment of quality of dying was conducted. Eighty of 212 terminally ill cancer patients were matched from a tertiary medical center in Taiwan. Patients in the unit served as the intervention group and patients in the oncology ward served as controls. Multiple logistic regression was applied to estimate the propensity of choosing the unit for each patient, and linear regression analysis was conducted to identify predictive factors for mean change scores of the Good Death Scale. Results: Male gender (P , 0.001, 95% confidence interval ¼ 0.73-2.43) was associated with better quality of dying while having hepatocellular carcinoma (P , 0.004, 95% confidence interval ¼ 22.22 to 20.44) was associated with worse quality. For those in the unit, higher total Audit Scale scores were positively related to the outcome of quality of dying. The unit (P , 0.001, 95% confidence interval ¼ 8.67-12.97) and higher Good Death Scale at admission (P , 0.001, 95% confidence interval ¼ 0.44-1.13) were predictors of Audit Scale scores. Conclusions: Admission to a palliative care unit was associated with higher provider assessments of quality of dying for terminally ill cancer patients. These units should be considered as options for hospitals looking for ways to improve the quality of dying for patients.

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“…There is a growing body of both quantitative and qualitative research on the topic of a good death [3,4,5], including work on a Good Death Inventory [6] and a Quality of Dying and Death scale [7]. Research on quality of death has focused on the perspective of clinical caregivers [8,9], the dying person [10,11] or a combination of healthcare participants [12,13,14,15]. Although there is not full consensus in the literature about what factors or qualities contribute to a good death, there are clear overlapping aspects to a good death, including “pain and symptom management, clear decision making, preparation for death, completion, contributing to others and affirmation of the whole person” [12] (p. 825).…”

Section: Introductionmentioning

confidence: 99%

Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective

Tenzek

Depner

2017

Behavioral Sciences

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The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member’s perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues. The second theme, (dis)continuity of care, includes categories of place of care, knowledge of family member dying and moment of death. Both of these themes lead to perceptions of either a good or bad death, which influences the bereavement process. We argue the main contribution of the model is the ability to identify moments throughout the interaction where family members can be present to the EOL process. Recommendations for healthcare participants, including patients, family members and clinical care providers are offered to improve the quality of experience throughout the EOL process and limitations of the study are discussed.

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Good death study of elderly patients with terminal cancer in Taiwan

Cited by 61 publications

References 21 publications

A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

Evaluation of Inpatient Multidisciplinary Palliative Care Unit on Terminally Ill Cancer Patients from Providers' Perspectives: A Propensity Score Analysis

Still Searching: A Meta-Synthesis of a Good Death from the Bereaved Family Member Perspective

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