Factors influencing death or the cessation of palliative care in home-based setting among patients with cancer
10.2512/jspm.10.116
- VernacularTitle:在宅緩和ケアを受けた終末期がん患者の在宅診療中止の関連要因
- Author:
Kazuki Sato
;
Kotaro Hashimoto
;
Junko Uchiumi
;
Akira Demizu
;
Hajime Fujimoto
;
Masatoshi Morii
;
Yuzuru Nagasawa
;
Mitsunori Miyashita
;
Masao Suzuki
- Publication Type:Journal Article
- Keywords:
Home care;
palliative care;
terminal care;
home death;
neoplasm
- From:Palliative Care Research
2015;10(2):116-123
- CountryJapan
- Language:Japanese
-
Abstract:
Objectives:To determine the factors influencing death or the cessation of palliative care in home-based setting among patients with cancer. Methods:We included 352 terminally ill patients with cancer who received home-based palliative care from six specialized palliative care clinics. We reviewed the medical charts when patients died at home or chose to stop home care. Results:A total of 82％ of participants died at home, and 18％ chose to stop home care. Multiple logistic regression analysis revealed five independent factors that affected cessation of home-based palliative care:patient and informal caregiver preferences for the place of death not to be at home［odds ratio, 10.1（95％ Confidential interval, 2.5-40.9）and 51.9（11.9-226.6）, respectively］or uncertain preferences［5.0（1.3-19.4）, 10.8（2.3-50.5）］;anxiety and depression among informal caregiver［4.1（1.2-13.9）］;lower frequency of informal care［6.8（2.0-23.4）］;and history of admittance to hospital during home care［11.6（4.0-33.9）］. Conclusion:We revealed independent factors influencing death or the cessation of palliative care in home-based settings among patients with cancer. Our findings suggest the importance of providing support for decision making about the place of death and hospital admission, and psychosocial support for informal caregiver to ensure home death consistent with patient preference.
