To determine which symptoms, signs, and characteristics that define the patient's functional status predict the survival time in terminally ill cancer patients, a prospective longitudinal study was conducted with terminally ill cancer patients followed by a Home Care Support Team. Patients were followed up with at least weekly visits until death, collecting variables at each visit. A Cox multivariate regression analysis took into account all the follow-ups in the same patient. Ninety-eight patients were studied, and 250 evaluations were done. The mean age was 72 years. The median survival was 32 days. In the multivariate analysis, three independent variables were identified: Palliative Performance Score of 50 or under, heart rate of 100/minute or more, and respiratory rate of 24/minute or more. The variables that were found to be prognostic in our study are objective, easy, and quick to measure, and do not require that the professional have special training or experience. The prediction of survival time may be improved by considering these variables.
Primary care doctors are aware of the need to estimate a global cardiovascular risk, recognize the usefulness of the tables but find problems in their practical application. In order to make their application feasible, tables should be simplified and unified, and their format should be improved.
Data from patients with HF followed up in PC indicate that their survival is better than that obtained in other countries, supporting the argument of a better evolution of HF in Mediterranean countries.
The training needs expressed by doctors and nurses are mainly clinical in content, whereas those of office staff are mainly computer-related. The most highly valued training options are the courses/workshops in the area's continuing education programme. The main difficulty for attending courses is the lack of cover for their job.
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