Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study

Abstract

Background Non-cancer patients experience the chronic process of disease that increases the patients’ suffering as well as families’ care burden. Although two-thirds of deaths are caused by non-cancer diseases, there is a lack of studies on palliative care for non-cancer patients. This study identified the palliative care needs and satisfaction, anxiety and depression, and health-related quality of life (HRQOL) of non-cancer patients and identified the factors influencing their HRQOL. Methods A cross-sectional survey design was employed. Participants were 114 non-cancer patients with chronic heart failure, stroke, end-stage renal disease, or end-stage liver disease who were admitted to the general ward of a tertiary hospital in South Korea. Measures included the Palliative Care Needs and Satisfaction Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcome Study 36-items Short Form Health Survey version 2. Data were analysed with descriptive statistics, independent t-tests, analyses of variance, Pearson’s correlations, and multiple linear regression analyses. Results The average score of palliative care needs was 3.66 ± 0.62, which falls between ‘moderate’ and ‘necessary’. Among the four domains, the average score of palliative care needs in the psychosocial domain was the highest: 3.83 ± 0.67. Anxiety was nearly in the normal range (7.48 ± 3.60; normal range = 0–7) but depression was higher than normal (9.17 ± 3.71; normal range = 0–7). Similar to patients with cancer, physical HRQOL (38.89 ± 8.69) and mental HRQOL (40.43 ± 11.19) were about 80% of the general population’s score (50 points). Duration of disease and physical performance were significant factors associated with physical HRQOL, whereas physical performance, anxiety, and depression were significant factors associated with mental HRQOL. Conclusion It is necessary to maintain non-cancer patients’ physical performance and assess and manage their mental health in advance for effective palliative care. This study provides relevant information that can be used to develop a tailored palliative care model for non-cancer patients.

Place of Death for Adults Receiving Specialist Palliative Care in Their Last 3 Months of Life: Factors Associated With Preferred Place, Actual Place, and Place of Death Congruence

“…It may also reflect the fact that SPC supports have traditionally been more focused on cancer diagnoses, and there is greater capacity to manage care needs at home. 20 , 33 Cancer diagnosis may be capturing some of the system-level influence in our data.…”

“…It may also reflect the fact that SPC supports have traditionally been more focused on cancer diagnoses, and there is greater capacity to manage care needs at home. 20,33 Cancer diagnosis may be capturing some of the systemlevel influence in our data. -The significant association between prior hospital use and hospital death, and between prior hospital use and noncongruence, could be capturing residual complexity of need.…”

A questionnaire survey on the implementation of palliative care in the emergency department in China

“…Part 2 evaluated health-related quality of life (HRQOL). HRQOL was measured using the Chinese version of the Medical Outcome Study 36-item Short Form Health Survey (MOS SF-36) [9,10]. The MOS SF-36 consists of 36 items covering 8 areas, namely, physical function, physical roles, physical pain, overall health status, vitality, social function, emotional roles, and mental health.…”

A systematic review of needs-based triggers for palliative care for early referral of older people with non-cancer conditions

“…Most older adults severely affected by noncancer conditions experience progressive functional disability and subsequent health decline during the course of their disease. Moreover, some studies reported that functional status is significantly associated with health-related QOL (HRQOL) in people with noncancer conditions [118,119]. Although disease-specific functional assessment measures can be available in some noncancer diseases, the Australia-modified Karnofsky Performance Status (AKPS) is a modified version for palliative care that is widely used and appropriate for multiple care settings in palliative care populations [120].…”