End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

Meñaca, Arantza; Evans, Natalie; Andrew, Erin; Toscani, Franco; Finetti, Silvia; Gómez-Batiste, Xavier; Higginson, Irene J; Harding, Richard; Pool, Robert; Gysels, Marjolein

doi:10.1016/j.critrevonc.2011.06.002

Cited by 85 publications

(72 citation statements)

References 139 publications

(223 reference statements)

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“…In The Netherlands, in contrast to Austria, the differences in numbers of advance directives could be related to the patient's and physician's more open attitude towards EOL conversations [15,23,24]. Moreover, previous studies in both glioma and non-glioma patients show that non-treatment decisions, and in particular do-not-resuscitate orders, are relatively common in northern European countries, but less common in Austria and southern European countries [9,25,26].…”

Section: Discussionmentioning

confidence: 70%

End of life care in high-grade glioma patients in three European countries: a comparative study

et al. 2014

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Exploring cross-national differences is useful to evaluate whether different patterns of end of life (EOL) care meet patient's specific needs. This study aimed to (1) compare EOL care processes for high-grade glioma (HGG) patients in three European countries, (2) explore differences in perceived quality of care (QOC), and (3) identify aspects of good QOC in the EOL phase. We analyzed 207 questionnaires from relatives of deceased HGG patients, using a similar retrospective study design in three countries [The Netherlands (n = 83), Austria (n = 72) and the UK (n = 52)], and examined four subthemes: (1) organization of EOL care, (2) treatment preferences, (3) experiences with EOL care, (4) perceived QOC. Three months before death 75 % of patients were at home. In all countries, on average, 50 % were transferred to a hospital at least once and received effective symptom treatment during the last 3 months. In The Netherlands, Austria and UK, respectively, patients most often died at home (60 %), in a hospital (41 %) or hospice (41 %) (p < 0.001). Advance directives were present in 46 % of Dutch, 36 % of British and 6 % of Austrian patients (p < 0.001). Fifty-three percent of patients experienced good QOC, irrespective of country. Dying at the preferred place, satisfaction with information provided and effective symptom treatment were independently associated with good QOC. There are various cross-national differences in organization and experiences with EOL care for HGG, but patient's perceived QOC is similar in the three countries. As symptom treatment was considered effective in only half of HGG patients, and independently predicted good QOC, this particularly needs further improvement in all countries.

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Section: Discussionmentioning

confidence: 70%

End of life care in high-grade glioma patients in three European countries: a comparative study

et al. 2014

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“…[44][45][46] Suggested quality indicators for EOL cancer care also associate receipt of aggressive care near EOL with poorer quality. 47 In contrast, most respondents of this survey wanted "all possible care" till the end.…”

Section: Discussionmentioning

confidence: 98%

Preferences regarding disclosure of prognosis and end-of-life care: A survey of cancer patients with advanced disease in a lower-middle-income country

et al. 2016

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“…The NECPAL tool has incorporated some issues to be adapted to our cultural context, such as the inclusion of the family members (and team members) in the ‘choice question’, in a paternalistic context where the patients are less autonomous and families take responsibility for information and decision-making 26. The inclusion of the combination of severe and progressive frailty is due to its high prevalence (not necessarily linked to individual diseases) and the severe psychological distress (or difficulties in adjustment to the clinical condition) based on the assumption that these dimensions are also indicators of the need for PC interventions.…”

Section: Discussionmentioning

confidence: 99%

Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia

Gómez-Batiste

Martínez-Muñoz

Blay

et al. 2012

BMJ Support Palliat Care

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151

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Palliative care (PC) has focused on patients with cancer within specialist services. However, around 75% of the population in middle-income and high-income countries die of one or more chronic advanced diseases. Early identification of such patients in need of PC becomes crucial. In this feature article we describe the initial steps of the NECPAL (Necesidades Paliativas [Palliative Needs]) Programme. The focus is on development of the NECPAL tool to identify patients in need of PC; preliminary results of the NECPAL prevalence study, which assessed prevalence of advanced chronically ill patients within the population and all socio-health settings of Osona; and initial implementation of the NECPAL Programme in the region. As first measures of the Programme, we present the NECPAL tool. The main differences from the British reference tools on which NECPAL is based are highlighted. The preliminary results of the prevalence study show that 1.45% of the total population and 7.71% of the population aged over 65 are 'surprise question' positive, while 1.33% and 7.00%, respectively, are NECPAL positive, and surprise question positive with at least one additional positive parameter. More than 50% suffer from geriatric pluri-pathology conditions or dementia. The pilot phase of the Programme consists of developing sectorised policies to improve PC in three districts of Catalonia. The first steps to design and implement a Programme to improve PC for patients with chronic conditions with a public health and population-based approach are to identify these patients and to assess their prevalence in the healthcare system.

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End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal

Cited by 85 publications

References 139 publications

End of life care in high-grade glioma patients in three European countries: a comparative study

End of life care in high-grade glioma patients in three European countries: a comparative study

Preferences regarding disclosure of prognosis and end-of-life care: A survey of cancer patients with advanced disease in a lower-middle-income country

Identifying patients with chronic conditions in need of palliative care in the general population: development of the NECPAL tool and preliminary prevalence rates in Catalonia

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