Finian Bannon1, Victoria Cairnduff2, Deirdre Fitzpatrick2, Janine Blaney3, Barbara Gomes4, Anna Gavin2, Conan Donnelly2. 1. Centre for Public Health,Queen's University Belfast,Belfast,United Kingdom. 2. Northern Ireland Cancer Registry,Centre for Public Health,Queen's University Belfast,United Kingdom. 3. Physiotherapy Department,Cancer Centre,Belfast City Hospital,Belfast,United Kingdom. 4. Faculty of Medicine,University of Coimbra,Coimbra,Portugal.
Abstract
ABSTRACT Objectives: Most terminally ill cancer patients prefer to die at home, yet only a minority are able to achieve this. Our aim was to investigate the factors associated with cancer patients achieving their preference to die at home. METHODS: This study took the form of a mortality followback, population-based, observational survey of the relatives of deceased cancer patients in Northern Ireland. Individuals who registered the death of a friend or relative (aged ≥ 18 years) between 1 December 2011 and 31 May 2012, where the primary cause of death was cancer (ICD10: C00-D48), who were invited to take part. Preferred and actual place of death, and patient, service, and clinical data were collected using the QUALYCARE postal questionnaire. Multivariable logistic regression was employed to investigate the factors associated with achieving a home death when preferred. RESULTS: Some 467 of 1,493 invited informants completed the survey. The 362 (77.5%) who expressed a preference for dying at home and spent time at home in their final 3 months were included in our analysis. Of these, 53.4% achieved their preference of a home death. Factors positively associated with achieving a home death were: living in an affluent area, receipt of good and satisfactory district nurse care, discussing place of death with health professionals, and the caregiver's preference for a home death. Being older than 80 years of age, being a Presbyterian, and being unconscious most of the time during their final week were negatively associated with achieving a home death. SIGNIFICANCE OF RESULTS: Communication, care satisfaction, and caregiver preferences were all associated with home death. Our findings will help inform the design of future interventions aimed at increasing the proportion of patients achieving their preferred place of death at home, for example, by targeting interventions toward older patients and those from the most deprived communities.
ABSTRACT Objectives: Most terminally ill cancerpatients prefer to die at home, yet only a minority are able to achieve this. Our aim was to investigate the factors associated with cancerpatients achieving their preference to die at home. METHODS: This study took the form of a mortality followback, population-based, observational survey of the relatives of deceased cancerpatients in Northern Ireland. Individuals who registered the death of a friend or relative (aged ≥ 18 years) between 1 December 2011 and 31 May 2012, where the primary cause of death was cancer (ICD10: C00-D48), who were invited to take part. Preferred and actual place of death, and patient, service, and clinical data were collected using the QUALYCARE postal questionnaire. Multivariable logistic regression was employed to investigate the factors associated with achieving a home death when preferred. RESULTS: Some 467 of 1,493 invited informants completed the survey. The 362 (77.5%) who expressed a preference for dying at home and spent time at home in their final 3 months were included in our analysis. Of these, 53.4% achieved their preference of a home death. Factors positively associated with achieving a home death were: living in an affluent area, receipt of good and satisfactory district nurse care, discussing place of death with health professionals, and the caregiver's preference for a home death. Being older than 80 years of age, being a Presbyterian, and being unconscious most of the time during their final week were negatively associated with achieving a home death. SIGNIFICANCE OF RESULTS: Communication, care satisfaction, and caregiver preferences were all associated with home death. Our findings will help inform the design of future interventions aimed at increasing the proportion of patients achieving their preferred place of death at home, for example, by targeting interventions toward older patients and those from the most deprived communities.
Entities:
Keywords:
Bereavement; Cancer; Communication; Home care services; Palliative care
Authors: Joanna M Davies; Katherine E Sleeman; Javiera Leniz; Rebecca Wilson; Irene J Higginson; Julia Verne; Matthew Maddocks; Fliss E M Murtagh Journal: PLoS Med Date: 2019-04-23 Impact factor: 11.069
Authors: Sofía García-Sanjuán; Manuel Fernández-Alcántara; Violeta Clement-Carbonell; Concepción Petra Campos-Calderón; Núria Orts-Beneito; María José Cabañero-Martínez Journal: Front Psychol Date: 2022-01-13