Prognostic awareness in advanced cancer patients and their caregivers: A longitudinal cohort study

2021 ◽  
Author(s):  
Martin Loučka ◽  
Karolína Vlčková ◽  
Anna Tučková ◽  
Kristýna Poláková ◽  
Adam Houska ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Longitudinal Cohort Study ◽  
Advanced Cancer Patients ◽  
Longitudinal Cohort

Symptom clusters (SCs) in advanced cancer patients (ACPs): A prospective cohort study.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e20664-e20664
Author(s):  
Pedro Miguel Coecho Barata ◽  
Sonia Margarida Duarte De Oliveira ◽  
Filipa Santos ◽  
Frederico Filipe ◽  
Maria Paula Custódio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Symptom Clusters ◽  
Advanced Cancer Patients

Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: a longitudinal cohort study

2011 ◽  
Vol 20 (8) ◽  
pp. 1679-1685 ◽  
Author(s):  
Mai-Britt Guldin ◽  
Peter Vedsted ◽  
Robert Zachariae ◽  
Frede Olesen ◽  
Anders Bonde Jensen
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Complicated Grief ◽  
Professional Support ◽  
Longitudinal Cohort Study ◽  
Longitudinal Cohort

A prospective cohort study of stability in preference for place of death among patients with stage IV cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24148-e24148
Author(s):  
Ling En Koh ◽  
Chetna Malhotra ◽  
Eric Finkelstein ◽  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Relative Risk ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Patient Preference ◽  
Place Of Death ◽  
Advanced Cancer Patients ◽  
Baseline Preference ◽  
Over Time

e24148 Background: Advanced care planning (ACP) involves discussion and documentation of patients’ care preferences including their preference for place of death. This process assumes that patients’ preference will not change over time; yet evidence for this is inconclusive. The primary aim of this study was to test whether patient preference for place of death changes over time and to identify factors associated with this change. We also assessed whether patients who do not change their preference for place of death during the study duration have greater congruence between actual and baseline preference for place of death. Methods: As part of an ongoing cohort study, we surveyed 466 advanced cancer patients every 6 months in Singapore for a period of two years. We asked patients their preference for place of death (home/ institution/ unclear). We assessed proportion of patients who changed their preference from baseline and at every time point. We ran univariable and multivariable multinomial logistic regression models to assess the association between change in preference for place of death and patient socio-demographics (gender, race, education, housing, marital status) as well as time varying variables (quality of life (Functional Assessment of Cancer Therapy- General), pain severity (Brief Pain Inventory), psychological distress (Hospital Anxiety and Depression Scale), any intervening hospitalization). We used a logistic regression model to assess if no change in preference during the study period was associated with congruence between actual and baseline preference for place of death. Results: More than a quarter of patients changed their preference for place of death every 6 months with 55% changing their preference at least once within 2 years. There was no clear trend in direction of change in preference. Patients who were psychologically distressed at the time of survey had a greater relative risk of changing their preferred place of death to home (Relative Risk Ratio (RRR) 1.81; 95% Confidence Interval (CI): 1.16-2.82) and to institution (RRR 2.00; 95% CI: 1.17-3.42) relative to no change in preference. Having no change in preference for place of death during the study period was not associated with congruence between actual and baseline preference for place of death. Conclusions: The study provides evidence of instability in advanced cancer patients’ preference for place of death. It calls into question the validity of patient preference for place of death recorded on ACP documents and suggests that we should regularly re-evaluate these documents.

scholarly journals What Determines the Final Place of Care of Advanced Cancer Patients Receiving Integrated Home-based Palliative Care?: a Retrospective Cohort Study

2021 ◽  
Author(s):  
RiYin Tay ◽  
Rozenne WK Choo ◽  
WahYing Ong ◽  
Allyn YM Hum
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Terminal Care ◽  
Retrospective Cohort ◽  
Advanced Cancer Patients ◽  
Home Death ◽  
Home Based

Abstract Background Meeting patients' preferences for place of care at the end-of-life is an indicator of quality palliative care. Understanding the elements required for terminal care within an integrated model may inform policy and practice to increase the likelihood of meeting preferences. Hence, this study aims to identify factors associated with the final place of care of advanced cancer patients receiving integrated home-based palliative care.MethodsThis retrospective cohort study included deceased adult advanced cancer patients enrolled into the home-based service from January 2016-December 2018. Patients with <2 weeks enrolment or ≤1-week duration at the final place of care were excluded. Independent variables included patients’ and families’ characteristics, care preferences, healthcare utilization, functional status and symptom severity assessed using the Palliative Performance Scale (PPSv2) and the Edmonton Symptom Assessment System respectively. The dependent variable was the final place of care. Multivariate logistic regression identified independent determinants and Kappa value evaluated goal-concordance.ResultsOf the 359 eligible patients, home was the most common final place of care (58.2%), followed by inpatient hospice (23.7%) and hospital (16.7%). Single or divorced patients with older family caregivers had a 5.5 (95% CI:1.1-27.8) and 3.1 (95% CI:1.1-8.8) odds respectively of receiving terminal care in inpatient hospice. A PPSv2≥40% and pain score ≥2 increased the odds by 9.1 (95% CI:3.3-24.8) and 3.6 (95% CI:1.3-9.8) times respectively, while non-home death preference increased it by 23.8 (95% CI:5.4-105.1) times. In predicting hospitalization, males had a 3.2 (95% CI:1.0-9.9) odds while a PPSv2≥40% and pain score ≥2 increased the odds by 8.6 (95% CI:2.9-26.0) and 3.5 (95% CI:1.2-10.3) times respectively. Non-home death preference increased it by 9.8 (95% CI:2.1-46.3) times, all p<0.05. Goal-concordance was fair (72.6%, kappa=0.39).ConclusionsHigher functional status, greater pain intensity and non-home death preference predicted institutionalization as the final place of care. Additionally, single or divorced patients with older family caregivers were more likely to receive terminal care in inpatient hospice while males were more likely to be hospitalized. Despite an integrated care model, goal-concordance was suboptimal. More comprehensive community networks and resources, better pain control and personalized care planning discussions are recommended. Future research could examine factors in non-cancer patients.

A Multicenter Cohort Study to Explore Differentiating Factors between Tumor Fever and Infection among Advanced Cancer Patients

2019 ◽  
Vol 22 (11) ◽  
pp. 1331-1336
Author(s):  
Takuya Odagiri ◽  
Tatsuya Morita ◽  
Hiroki Sakurai ◽  
Hirohide Yamada ◽  
Naoki Matsuo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort
Sign in / Sign up

Export Citation Format

Share Document