Abstract
Context
In end-of-life care, rehabilitation for patients with cancer is considered to be an
important means for improving patients' quality of death and dying.
Objectives
To determine whether the provision of rehabilitation for patients with cancer in palliative
care units is associated with the achievement of a good death.
Methods
This study involved a cross-sectional, anonymous, and self-report questionnaire survey
of families of patients with cancer who died in palliative care units in Japan. We
evaluated the short version of Good Death Inventory (GDI) on a seven-point scale.
A logistic regression model was used to calculate the propensity score. Covariates
included in this model were survey year, patients' characteristics, and families'
characteristics. The associations between rehabilitation and GDI were tested using
trend tests after propensity score matching adjustment.
Results
Of the 1965 family caregivers who received the questionnaires, available data were
obtained from 1008 respondents (51.2%). Among them, 285 (28.2%) cases received rehabilitation
in palliative care units. There was no difference in total GDI score between the groups
with and without rehabilitation. In exploratory analyses, patients receiving rehabilitation
were significantly more likely to feel maintaining hope and pleasure (mean 4.50 [SE
0.10] vs. 4.05 [0.11], respectively; effect size [ES] 0.31; P = 0.003), good relationships with medical staff (mean 5.67 [SE 0.07] vs. 5.43 [0.09],
respectively; ES 0.22; P = 0.035), and being respected as an individual (mean 6.08 [SE 0.06] vs. 5.90 [0.07],
respectively; ES 0.19; P = 0.049) compared with patients not receiving rehabilitation.
Conclusion
Rehabilitation in palliative care units may contribute to several domains of quality
of death and dying, particularly maintaining hope and pleasure. Further research is
needed to investigate whether palliative rehabilitation contributes to the achievement
of a good death.
Key Words
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Article info
Publication history
Published online: June 29, 2020
Accepted:
June 20,
2020
Identification
Copyright
© 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
