Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers
Abstract Background In Colombia, cancer incidence is increasing, as is the demand for end-of-life care. Understanding how patients who die from cancer experience this phase will allow the identification of factors associated with greater suffering and actions to improve end-of-life care. We aimed to...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-023-01148-x |
| _version_ | 1797840788259864576 |
|---|---|
| author | Angélica Arango-Gutiérrez Socorro Moreno Martín Rondón Lucía I Arroyo Liliana Ardila Fabián Alexander Leal Arenas José A Calvache Esther de Vries |
| author_facet | Angélica Arango-Gutiérrez Socorro Moreno Martín Rondón Lucía I Arroyo Liliana Ardila Fabián Alexander Leal Arenas José A Calvache Esther de Vries |
| author_sort | Angélica Arango-Gutiérrez |
| collection | DOAJ |
| description | Abstract Background In Colombia, cancer incidence is increasing, as is the demand for end-of-life care. Understanding how patients who die from cancer experience this phase will allow the identification of factors associated with greater suffering and actions to improve end-of-life care. We aimed to explore associations between the level of suffering of patients who died from cancer and were cared for in three Colombian hospitals with patient, tumor, treatment, and care characteristics and provided information. Methods Data on the last week of life and level of suffering were collected through proxies: Bereaved caregivers of patients who died from cancer in three participating Colombian hospitals. Bereaved caregivers participated in a phone interview and answered a series of questions regarding the last week of the patient’s life. An ordinal logistic regression model explored the relationship between the level of suffering reported by bereaved caregivers with the patient’s demographic and clinical characteristics, the bereaved caregivers, and the care received. Multivariate analyses were adjusted for place of death, treatments to prolong of life, prolongation of life during the dying process, suffering due to prolongation of life, type of cancer, age, if patient had partner, rural/urban residence of patient, importance of religion for the caregiver, caregivers´ relationship with the patient, and co-living with the patient. Results A total of 174 interviews were included. Median age of the deceased patients was 64 years (IQR 52–72 years), and 93 patients were women (53.4%). Most caregivers had rated the level of suffering of their relative as “moderately to extremely” (n = 139, 80%). In multivariate analyses, factors associated with a higher level of suffering were: unclear information about the treatment and the process before death Odds Ratio (OR) 2.26 (90% CI 1.21–4.19), outpatient palliative care versus home care OR 3.05 (90% CI 1.05–8.88), procedures inconsistent with the patient’s wishes OR 2.92 (90% CI 1.28–6.70), and a younger age (18–44 years) at death versus the oldest age group (75–93 years) OR 3.80 (90% CI 1.33–10.84, p = 0.04). Conclusion End-of-life care for cancer patients should be aligned as much as possible with patients´ wishes, needs, and capacities. A better dialogue between doctors, family members, and patients is necessary to achieve this. |
| first_indexed | 2024-04-09T16:20:23Z |
| format | Article |
| id | doaj.art-63c3341dd2d243ebbc31e2cc6b62bc2d |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-04-09T16:20:23Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-63c3341dd2d243ebbc31e2cc6b62bc2d2023-04-23T11:31:33ZengBMCBMC Palliative Care1472-684X2023-04-0122111210.1186/s12904-023-01148-xFactors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregiversAngélica Arango-Gutiérrez0Socorro Moreno1Martín Rondón2Lucía I Arroyo3Liliana Ardila4Fabián Alexander Leal Arenas5José A Calvache6Esther de Vries7MSc programme Clinical Epidemiology, Pontificia Universidad JaverianaDepartment of Clinical Epidemiology and Biostatistics, Pontificia Universidad JaverianaDepartment of Clinical Epidemiology and Biostatistics, Pontificia Universidad JaverianaDepartamento de Fonoaudiología, Universidad de CaucaNational Cancer Institute of ColombiaNational Cancer Institute of ColombiaDepartment of Anaesthesiology, Universidad del CaucaDepartment of Clinical Epidemiology and Biostatistics, Pontificia Universidad JaverianaAbstract Background In Colombia, cancer incidence is increasing, as is the demand for end-of-life care. Understanding how patients who die from cancer experience this phase will allow the identification of factors associated with greater suffering and actions to improve end-of-life care. We aimed to explore associations between the level of suffering of patients who died from cancer and were cared for in three Colombian hospitals with patient, tumor, treatment, and care characteristics and provided information. Methods Data on the last week of life and level of suffering were collected through proxies: Bereaved caregivers of patients who died from cancer in three participating Colombian hospitals. Bereaved caregivers participated in a phone interview and answered a series of questions regarding the last week of the patient’s life. An ordinal logistic regression model explored the relationship between the level of suffering reported by bereaved caregivers with the patient’s demographic and clinical characteristics, the bereaved caregivers, and the care received. Multivariate analyses were adjusted for place of death, treatments to prolong of life, prolongation of life during the dying process, suffering due to prolongation of life, type of cancer, age, if patient had partner, rural/urban residence of patient, importance of religion for the caregiver, caregivers´ relationship with the patient, and co-living with the patient. Results A total of 174 interviews were included. Median age of the deceased patients was 64 years (IQR 52–72 years), and 93 patients were women (53.4%). Most caregivers had rated the level of suffering of their relative as “moderately to extremely” (n = 139, 80%). In multivariate analyses, factors associated with a higher level of suffering were: unclear information about the treatment and the process before death Odds Ratio (OR) 2.26 (90% CI 1.21–4.19), outpatient palliative care versus home care OR 3.05 (90% CI 1.05–8.88), procedures inconsistent with the patient’s wishes OR 2.92 (90% CI 1.28–6.70), and a younger age (18–44 years) at death versus the oldest age group (75–93 years) OR 3.80 (90% CI 1.33–10.84, p = 0.04). Conclusion End-of-life care for cancer patients should be aligned as much as possible with patients´ wishes, needs, and capacities. A better dialogue between doctors, family members, and patients is necessary to achieve this.https://doi.org/10.1186/s12904-023-01148-xSufferingNeoplasmsCaregiversMedical futilityPalliative careEnd of life |
| spellingShingle | Angélica Arango-Gutiérrez Socorro Moreno Martín Rondón Lucía I Arroyo Liliana Ardila Fabián Alexander Leal Arenas José A Calvache Esther de Vries Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers BMC Palliative Care Suffering Neoplasms Caregivers Medical futility Palliative care End of life |
| title | Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers |
| title_full | Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers |
| title_fullStr | Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers |
| title_full_unstemmed | Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers |
| title_short | Factors associated with suffering from dying in patients with cancer: a cross-sectional analytical study among bereaved caregivers |
| title_sort | factors associated with suffering from dying in patients with cancer a cross sectional analytical study among bereaved caregivers |
| topic | Suffering Neoplasms Caregivers Medical futility Palliative care End of life |
| url | https://doi.org/10.1186/s12904-023-01148-x |
| work_keys_str_mv | AT angelicaarangogutierrez factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT socorromoreno factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT martinrondon factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT luciaiarroyo factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT lilianaardila factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT fabianalexanderlealarenas factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT joseacalvache factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers AT estherdevries factorsassociatedwithsufferingfromdyinginpatientswithcanceracrosssectionalanalyticalstudyamongbereavedcaregivers |