Where Do Cancer Patients in Receipt of Home-Based Palliative Care Prefer to Die and What Are the Determinants of a Preference for a Home Death?

Cai, Jiaoli; Zhang, Li; Guerriere, Denise N.; Fan, Hongli; Coyte, Peter C.

doi:10.3390/ijerph18010235

Cited by 27 publications

(33 citation statements)

References 36 publications

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“…Finally, in relation to environmental factors, higher levels of congruence have been found when the family's choice coincided with that of the patient in line with previous studies (Raziee et al, 2017 ; Cai et al, 2021 ). In addition, variables directly related to the availability of health services and palliative care have also been positively associated with congruence in many of the studies included in this review.…”

Section: Discussionsupporting

confidence: 87%

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

et al. 2022

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Introduction: Congruence, understood as the agreement between the patient's preferred place of death and their actual place of death, is emerging as one of the main variables indicating the quality of end-of-life care. The aim of this research was to conduct a systematic literature review on levels and determinants of congruence in palliative patients over the period 2010–2021.Method: A systematic review of the literature in the databases of PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cuiden, the Cochrane Library, CSIC Indexes, and IBECS. Information was extracted on research characteristics, congruence, and associated factors.Results: A total of 30 studies were identified, mainly of retrospective observational design. The congruence values varied substantially between the various studies, ranging from 21 to 100%. The main predictors of congruence include illness-related factors (functional status, treatments and diagnosis), individual factors (age, gender, marital status, and end of life preferences), and environmental factors (place of residence, availability of health, and palliative care services).Conclusion: This review, in comparison with previous studies, shows that treatment-related factors such as physical pain control, marital status, having a non-working relative, age, discussing preferred place of death with a healthcare professional, and caregiver's preference have been associated with higher levels of congruence. Depending on the study, other factors have been associated with either higher or lower congruence, such as the patient's diagnosis, gender, or place of residence. This information is useful for designing interventions aimed towards greater congruence at the end of life.

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Section: Discussionsupporting

confidence: 87%

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

et al. 2022

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“…Hence, emotion can be examined as a coping strategy against the pandemic on an exploratory basis. In fact, a recent study has employed the construct of emotional and cognitive responses, and behavioral coping in the COVID-related study (Cai et al, 2020 ). Given the lack of COVID-related theorizing of coping strategies, the present study constructed a pandemic-specific framework of coping strategies, namely, cognitive, emotional, and behavioral coping, on the basis of the stress and coping model to highlight the eminently situational nature of the functionality of coping strategies.…”

Section: Introductionmentioning

confidence: 99%

Relationship between social support, coping strategy against COVID-19, and anxiety among home-quarantined Chinese university students: A path analysis modeling approach

Peng

Tao

2021

Curr Psychol

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With the continued spread of the COVID-19 pandemic and the strict implementation of quarantine policy, the levels of anxiety among university students surged in the lockdown period. Previous studies confirmed the effectiveness of social support in mitigating anxiety, so offering social support should be of high priority in COVID-19, especially in quarantine. However, various coping strategies against the pandemic may explain the link between social support and anxiety. The purpose of this study was to investigate the associations of social support, coping strategy against COVID-19, and anxiety, identifying the potential mediating effect of coping strategy between social support and anxiety during the COVID-19 quarantine. Home-quarantined Chinese university students ( N = 2640; 68.79% female) completed online ratings of social support, coping, and anxiety from February 21st to 24th, 2020, when they had been confined to their homes in the peak of the pandemic. Sex and academic attainment being covariates, path analysis with parallel mediation were conducted using “lavaan” package in R environment. Anxiety was significantly negatively related to subjective support and counselor support, while family support did not demonstrate substantive associations with anxiety. The mediating role of cognitive coping was found between all the three social support sources and anxiety. Emotional coping and behavioral coping were found to partially mediate the relationship between subjective support and anxiety, fully mediate the associations of family support and anxiety. However, the impact of counselor support on anxiety was not found to be mediated by emotional coping and behavioral coping. This large-scale online study provides initial evidence that various coping strategies may mediate the relationship between three sources of social support and anxiety in quarantine to some extent. Given that coping against COVID-19 is a valuable reasearch goal upon the global ongoing challenge, the findings will shed more light on the mechanism in the link between coping, social support, and anxiety.

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“…Moreover, this suggests that palliative care teams were increasingly effective at facilitating a safe transition from the hospital to home or hospice centers, a practice consistent with guidelines recommending palliative care [ 26 ] and supported by the Affordable Care Act (ACA) [ 27 ]. Home death has been documented in prospective cohort studies to be preferred by the majority of cancer patients as long as their family caregivers did not have a high burden [ 28 ]. Thus, health managers and policymakers should develop policies that honor those preferences.…”

Section: Discussionmentioning

confidence: 99%

Inpatient Palliative Care Is Less Utilized in Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective

Mojtahedi

Yoo

Callahan

et al. 2021

IJERPH

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Background—Extrahepatic cholangiocarcinoma (ECC) is a rare, morbid, fatal cancer with distressing symptoms. Maintaining a high quality of life while reducing hospital charges and length of stay (LOS) for the end-of-life period remains a major challenge for the healthcare system. Palliative care utilization has been shown to address these challenges; moreover, its use has increased in recent years among cancer patients. However, the utilization of palliative care in rare cancers, such as ECC, has not yet been explored. Objectives—To investigate palliative care utilization among ECC patients admitted to US hospitals between 2007 and 2016 and its association with patient demographics, clinical characteristics, hospital charges, and LOS. Methods—De-identified patient data of each hospitalization were retrieved from the National Inpatient Sample (NIS) database. Codes V66.7 (ICD-9-CM) or Z51.5 (ICD-10-CM) were used to find palliative care utilization. Multivariate adjusted logistic regression analyses were conducted to assess factors associated with palliative care use, LOS, hospital charges, and in-hospital death. Results—Of 4426 hospitalizations, only 6.7% received palliative care services. Palliative care utilization did not significantly increase over time (p = 0.06); it reduced hospital charges by USD 25,937 (p < 0.0001) and LOS by 1.3 days (p = 0.0004) per hospitalization. Palliative care was positively associated with female gender, severe disease, and age group ≥80 (p ≤ 0.05). The average LOS was 8.5 days for each admission. Conclusions—Hospital admissions with palliative care utilization had lower hospital charges and LOS in ECC. However, ECC patients received less palliative care compared with more common cancers sharing similar symptoms (e.g., pancreatic cancer). ECC patients also had longer LOS compared with the national average. Further research is warranted to develop interventions to increase palliative care utilization among ECC hospital patients.

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Where Do Cancer Patients in Receipt of Home-Based Palliative Care Prefer to Die and What Are the Determinants of a Preference for a Home Death?

Cited by 27 publications

References 36 publications

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review

Relationship between social support, coping strategy against COVID-19, and anxiety among home-quarantined Chinese university students: A path analysis modeling approach

Inpatient Palliative Care Is Less Utilized in Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective

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