Referrals to palliative care often come too late to improve quality of life for patients with cancer, a new study has found. A survey of family members of people who have died of cancer in Japan found that nearly half of respondents believed that referrals to palliative care were given too late in the course of the illness. The study, which will be published online February 22 in the Journal of Clinical Oncology (JCO), is the first to investigate perceptions about referrals to end-of-life care among family members of cancer patients.
"Earlier referrals to palliative care are essential to alleviate suffering and improve treatment outcomes and quality of life for people with cancer," said Tatsuya Morita, MD, Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice in Shizuoka, Japan, and lead author of the study. "Patients and their families should feel comfortable discussing end of life care with their physicians and each other so that palliative care services can be given at the most appropriate moment for the patient."
Palliative care treats the physical, spiritual, psychological, and social needs of a person with cancer, both during cancer treatment and at the end of life.
Researchers in Japan gave detailed questionnaires to 318 family members of cancer patients who had received end-of-life palliative care services. The survey asked respondents about their perception of the timing of referral to care, as well as their perceptions of the quality of palliative care.
The greatest proportion of respondents believed that palliative care referrals were given late (30%) or very late (19%). Forty-eight percent of families thought that referral timing was appropriate, while only 3.8% said that it was early or very early.
A number of factors determined the timing of palliative care referrals. Families who reported late or very late referrals were significantly less likely to report having discussions with physicians about end of life care (55%), compared to those who thought referral time was appropriate (79%). Of the families who did not have such conversations, factors included family unwillingness (14%), patient unwillingness (18%), and physician unwillingness (57%).
Families who reported late or very late referrals were two times more likely to believe before admission that palliative care shortens patient lives. They were also more likely to report feeling unprepared for changes in the patient’s condition as he or she neared the end of life.
Researchers found, however, that families’ perceptions of palliative care changed significantly once patients were admitted to palliative care units. Among 257 families who had low expectations before admission, 101 (39%) reported that the care was much better than expected, 76 families (30%) said it was better, while only 12 (4.7%) reported that care was worse.
An accompanying editorial by Betty Ferrell, PHD, FAAN, research scientist, City of Hope National Medical Center, notes that this study has great significance for people living with cancer in all countries.
"There is international recognition about the need to ease what is an incredibly difficult decision for patients and families about palliative care and increase earlier referrals to such programs," Dr. Ferrell said. "This study supports closer collaboration between oncologists and palliative care specialists, rather than simply a swift transfer from one provider to the other as the patient’s condition declines."
Danielle Potuto | Source: EurekAlert!
Further information: www.asco.org
More articles from Statistics:
More than 400,000 higher education graduates in 2012
17.09.2013 | Statistisches Bundesamt
Share of women among professors increases to over 20% in 2012
11.07.2013 | Statistisches Bundesamt
The Light: Global study gets underway with online user survey
Light has a fundamental impact on our sense of well-being and performance. In cooperation with Zumtobel, a supplier of lighting solutions, Fraunhofer IAO has launched a global user survey of lighting quality in offices. The objective is to identify the best lighting conditions for a variety of spaces and lighting ...
Quantum entanglement, a perplexing phenomenon of quantum mechanics that Albert Einstein once referred to as “spooky action at a distance,” could be even spookier than Einstein perceived.
Physicists at the University of Washington and Stony Brook University in New York believe the phenomenon might be intrinsically linked with wormholes, hypothetical features of space-time that in popular science fiction can provide a much-faster-than-light shortcut from one part of the universe to another.
But here’s the catch: One couldn’t actually ...
A star is formed when a large cloud of gas and dust condenses and eventually becomes so dense that it collapses into a ball of gas, where the pressure heats the matter, creating a glowing gas ball – a star is born.
New research from the Niels Bohr Institute, among others, shows that a young, newly formed star in the Milky Way had such an explosive growth, that it was initially about 100 times brighter than it is now. The results are published in the scientific journal, Astrophysical Journal Letters.
The young ...
EPFL scientists have shown how to achieve a dramatic increase in the capacity of optical fibers; Their simple, innovative solution reduces the amount of space required between the pulses of light that transport data
Optical fibers carry data in the form of pulses of light over distances of thousands of miles at amazing speeds. They are one of the glories of modern telecommunications technology.
However, their capacity is limited, because the pulses of light need to be lined up one after the other in ...
NASA's Hurricane and Severe Storms Sentinel airborne mission known as HS3 wrapped up for the 2013 Atlantic Ocean hurricane season at the end of September, and had several highlights. HS3 will return to NASA’s Wallops Flight Facility in Wallops Island, Va., for the 2014 Atlantic hurricane season.
During the 2013 mission, two unmanned Global Hawks flew from Wallops for the first time. The mission highlights included studying the Saharan Air Layer, following the genesis of a tropical storm, finding a unique hybrid core or center circulation in a redeveloped storm, obtaining measurements on the strongest side of ...
05.12.2013 | Health and Medicine
05.12.2013 | Ecology, The Environment and Conservation
05.12.2013 | Information Technology
05.12.2013 | Event News
04.12.2013 | Event News
12.11.2013 | Event News