Comfort in the last 2 weeks of life: relationship to accessing palliative care services.

Introduction: Specialised palliative care services (SPCS) aim to address the needs of patients and caregivers confronting life-limiting illnesses but only half of the potential cohort are referred. Randomised controlled trials of SPCS provision can no longer be ethically justified so there is a need...

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Publicado en:Supportive Care in Cancer Vol. 16; no. 11; pp. 1255 - 1264
Autores principales: Currow DC, Ward AM, Plummer JL, Bruera E, Abernethy AP, Currow, David C, Ward, Alicia M, Plummer, John L, Bruera, Eduardo, Abernethy, Amy P
Formato: research Journal Article
Publicado: Springer Nature Nov2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2008
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00520-008-0424-2
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        atl: Comfort in the last 2 weeks of life: relationship to accessing palliative care services.
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          Currow DC
          Ward AM
          Plummer JL
          Bruera E
          Abernethy AP
          Currow, David C
          Ward, Alicia M
          Plummer, John L
          Bruera, Eduardo
          Abernethy, Amy P
        affil: Department of Palliative and Supportive Services, Flinders University, Daw Park, Adelaide, South Australia
      sug:
        subj:
          Adaptation, Psychological
          Health Services Accessibility
          Palliative Care Methods
          Quality of Health Care
          Confidence Intervals
          Cross Sectional Studies
          Logistic Regression
          Male
          Odds Ratio
          Pilot Studies
          Questionnaires
          South Australia
          Human
          Male
      ab: Introduction: Specialised palliative care services (SPCS) aim to address the needs of patients and caregivers confronting life-limiting illnesses but only half of the potential cohort are referred. Randomised controlled trials of SPCS provision can no longer be ethically justified so there is a need to develop new methods to evaluate the net impact of SPCS for the whole community, not just for those who access SPCS. The aim of this study was to assess whether perceived comfort in the last 2 weeks of life was associated with accessing SPCS.Methods: This study utilised a whole-of-population random survey (n = 4,366) in South Australia. A total of 802 respondents had someone close to them die within the last 5 years due to a terminal illness, and they had the complete data. A subsequent question was asked whether SPCS had been accessed. Perceived comfort levels for those who had used SPCS were compared with those who did not by using stereotype logistic regression, weighted to a standardised population.Results: Higher levels of comfort of the deceased having been assessed 'very comfortable' was associated with the use of SPCS (p = 0.04; odds ratio, 1.78; 95% confidence interval, 1.02-3.08). For people who accessed SPCS, 13.3% were reported as 'very comfortable' compared with 8.0% without SPCS. Almost one half of respondents (48.4%) reported that the deceased was considered 'uncomfortable' or 'very uncomfortable', irrespective of SPCS access.Discussion: While this study provides further incremental evidence of benefit from access to SPCS, there is much that still needs to be done to improve care for the whole community at the end of life.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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