Where do Brazilian cancer patients prefer to die? Agreement between patients and caregivers.
J Pain Symptom Manage
; 64(2): 186-204, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35398168
ABSTRACT
CONTEXT Preferred place-of-death (PPoD) is considered an important outcome for the development of appropriate models of care and for improving health policies in countries with underdeveloped palliative care (PC) OBJECTIVES:
To determine the concordance between the PPoD of a sample of Brazilian seriously-ill cancer patients and their caregivers, and its associated factors under four different end-of-life (EOL) scenarios 1) health deterioration in the overall context; 2) health deterioration with severe and uncomfortable symptoms; 3) health deterioration receiving home-based visits as needed; 4) health deterioration receiving home-based visits as needed, when suffering severe and uncomfortable symptomsMETHODS:
Cross-sectional study at a large Brazilian cancer center, between February 2019 and July 2021. 190 adult cancer patients and their caregivers (n = 190) were analyzedRESULTS:
Patient and/or caregiver PPoD concordance for EOL scenario one 64% vs. 43% for death at home, 22% vs. 30% for death in a PC unit, 14% vs. 27% for death in hospital. Higher patient and/or caregiver PPoD concordance was found for death in hospital (41%; 49%) in EOL scenario two, and for death at home for scenario three (77%; 74%). Agreement coefficient was moderate for scenario two (k = 0.430; P < 0.001), and fair for EOL scenarios one, three and four (k = 0.237, P < 0.001; k = 0.296, P < 0.001; k = 0.307, P < 0.001, respectively). Associated disagreement factors were performance status (OR3.03), self-perceived health (OR 6.99), marital status (OR2.92), and hospital and/or emergency room proximity (OR4.11). The presence of relevant persons (42.3% vs. 44.2%), followed by spirituality (38.5% vs. 27.9%) and the place-of-death (14.0% vs. 18.4%), were the most important factors in the EOL, when comparing patients and care givers opinions, respectivelyCONCLUSION:
Low agreement between patients and caregivers on PPoD was identified. EOL clinical factors and deterioration, and PC support seem to influence PPoD.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Cuidado Terminal
/
Neoplasias
Tipo de estudio:
Observational_studies
/
Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
/
Humans
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
J Pain Symptom Manage
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPEUTICA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Brasil