Non-cancer patients in specialized palliative care in Germany: What are the problems?

Abstract

To determine the role of non-cancer palliative care in inpatient services in Germany, data from the Hospice and Palliative Care Evaluation (HOPE) were analysed. Since 1999, a three-month census has been conducted annually in German palliative care units. Pooled data from 2002-2005 were tested for differences between non-cancer patients (NCs) and cancer patients (Cs). A total of 4182 patients (NC: 3.5%; C: 96.5%) were documented; functional status (using Eastern Cooperative Oncology Group (ECOG) measures) in NCs was lower compared to Cs (p ¼ 0.009). NCs suffered more often from dyspnoea (40%; C: 29%; p ¼ 0.004), weakness (92,3%; C: 84,5%; p ¼ 0.011) and tiredness (75.4%; C: 66.7%; p ¼ 0.03) and less from nausea (17.1%; C: 28.9%; p ¼ 0.002), vomiting (8.2%; C: 19.4%; p ¼ 0.001) or loss of appetite (55.5%; C: 67.9%; p ¼ 0.002). There were no differences in pain and constipation. Other problems (nursing, psychological) were more frequent for NCs, in particular the need for support in the activities of daily life (90.3%; C: 72.8%; p < 0.001) and disorientation/confusion (32.1%; C: 17.2%; p < 0.001). There were no differences in social problems. NCs are still rare in specialized inpatient palliative care institutions in Germany. The palliative care needs in patients with nonmalignant disease will challenge the health care system as the workload for these services will grow over proportionally.

Unmet Needs of Patients Feeling Severely Affected by Multiple Sclerosis in Germany: A Qualitative Study

“…2 Even though all patients with life limiting, progressive diseases are entitled to palliative care, only very few MS patients currently receive support from specialized palliative care. 3 Palliative care appears to remain a counterintuitive approach for MS patients. 4 Needs assessment in this patient group is essential for designing a concept of intertwined palliative and routine neurological care for severely affected MS patients.…”

Specific Characteristics of Patients with Advanced Genitourinary Cancer Receiving Specialized Inpatient Palliative Care

“…In these patients, the predominance of disorientation and confusion may have led to their impaired performance [7]. A significantly poorer functional status and higher needs for nursing support have also been described for non-cancer patients [9].…”

“…They also observed that these symptoms led to a higher risk of death. A more recent analysis compared a subgroup of palliative care patients with dyspnea with general palliative care patients, and demonstrated that patients with dyspnea present withern Cooperative Oncology Group (ECOG) performance status [8], and that this group suffered more frequently from dyspnea, weakness, and tiredness but less nausea and vomiting compared to cancer patients [9,10].…”

Physical and Psychospiritual Care Need by End-of-life Stages among Non-cancer Patient at Home: Based on the Importance and Difficulty of Care Need

“…예를 들어 Ostgathe 등(2010) (Ernstmann et al, 2009;Jenkins, Fallowfield, & Saul, 2001;Kwon & Eun, 1998;Longman, Atwood, Sherman, Benedict, & Shang, 1992;Mcillmurray et al, 2001;Morasso et al, 1999), 비 암 환자를 대상으로 실시된 연구도 있으나 (Fitzsimons et al, 2007;Lau et al, 2010;Luddington et al, 2001;Ostgathe et al, 2010) (Kamei, Shimanouchi, & Nakayama, 1999;Kwon & Eun, 1999;Sanders, Bantum, Owen, Thornton, & Stanton, 2010 …”