Characteristics and Quality of Life of Patients Who Choose Home Care at the End of Life
Accepted 31 October 2007. published online 09 April 2008.
Abstract
Cancer patients with advanced disease and short-survival expectancy were given hospital-based advanced home care (AHC) or conventional care (CC), according to their preference. The two groups were compared at baseline to investigate whether there were differences between the AHC and the CC patients that may help explain their choice of care. The patients were consecutively recruited over 2½ years. Sociodemographic and medical data, and the health-related quality of life (HRQL) of the two groups were compared. HRQL was assessed using a self-reporting questionnaire, including the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30), the Impact of Event Scale (IES), five questions about social support, and two items concerning general well-being. The AHC group showed significantly poorer functioning on all the EORTC QLQ-C30 scales and an overall higher symptom burden than the CC patients. Fewer of the AHC patients were receiving cancer treatment. The AHC patients had lived longer with their cancer diagnosis, had a significantly shorter survival after study enrollment, and a significantly poorer performance status. The major differences between the two groups seemed to be related to being at different stages in their disease. The results indicate that patients are reluctant to accept home care until absolutely necessary due to severity of functioning impairments and symptom burden. These findings should be taken into consideration in planning palliative care services.
fPalliative Medicine Unit, Department of Radiotherapy and Oncology, University Hospital of Trondheim, Trondheim, Norway
gCancer Unit, Innlandet Hospital Trust, Gjøvik, Norway
hPalliative Care Research Unit and Department of Radiation Oncology, The Norwegian Radium Hospital-Rikshospitalet Medical Centre, Montebello, Oslo, Norway
Address correspondence to: Marianne Ahlner-Elmqvist, RN, BEd, Department of Otorhinolaryngology, Malmö University Hospital, SE-20502 Malmö, Sweden.
The study was supported by grants from The Swedish Cancer Society (grant no. 3650-B95-01XAC), The Vardal Foundation for Health Care Sciences and Allergy Research (grant no. V98262), and The Association for Cancer and Traffic Victims (grant no. C24405).