Journal
CANCER NURSING
Volume 44, Issue 3, Pages 214-222Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NCC.0000000000000863
Keywords
Cancer; Home-based care; Home death; Palliative care; Place of death
Funding
- National Natural Science Foundation of China [71904011]
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This study examined the congruence between preferred and actualized home death among cancer patients receiving home-based palliative care in Canada. The study found that home was the most preferred place of death and increasing the intensity of home-based nursing visits and hours of care provided by personal support workers contributed to achieving a preferred home death. Conversely, a higher intensity of emergency department visits was associated with a lower likelihood of achieving a preferred home death.
Background Home is often deemed to be the preferred place of death for most patients. Knowing the factors related to the actualization of a preferred home death may yield evidence to enhance the organization and delivery of healthcare services. Objective The objectives of this study were to measure the congruence between a preferred and actualized home death among cancer patients in receipt of home-based palliative care in Canada and explore predictors of actualizing a preferred home death. Methods A longitudinal prospective cohort design was conducted. A total of 290 caregivers were interviewed biweekly over the course of patients' palliative care trajectory between July 2010 and August 2012. Cross-tabulations and multivariate analyses were used in the analysis. Results Home was the most preferred place of death, and 68% of patients who had voiced a preference for home death had their wish fulfilled. Care context variables, such as living with others and the intensity of home-based nursing visits and hours of care provided by personal support workers (PSW), contributed to actualizing a preferred home death. The intensity of emergency department visits was associated with a lower likelihood of achieving a preferred home death. Conclusions Higher intensity of home-based nursing visits and hours of PSW care contribute to the actualization of a preferred home death. Implications for Practice This study has implications for policy decision-makers and healthcare managers. Improving and expanding the provision of home-based PSW and nursing services in palliative home care programs may help patients to actualize a preferred home death.
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