Evaluation of inpatient multidisciplinary palliative care unit on terminally ill cancer patients from providers' perspectives: A propensity score analysis
Journal
Japanese Journal of Clinical Oncology
Journal Volume
43
Journal Issue
2
Pages
161-169
Date Issued
2013
Author(s)
Abstract
Objective: The effectiveness of inpatient palliative care units, a complex intervention, is challenging to evaluate due to methodological and practical difficulties. We conducted a study to evaluate providers' perceived effectiveness of one such unit. Methods: A non-concurrent, prospective, controlled study using the Audit Scale for good death services as an indicator of process of care and the Good Death Scale as the outcome of provider assessment of quality of dying was conducted. Eighty of 212 terminally ill cancer patients were matched from a tertiary medical center in Taiwan. Patients in the unit served as the intervention group and patients in the oncology ward served as controls. Multiple logistic regression was applied to estimate the propensity of choosing the unit for each patient, and linear regression analysis was conducted to identify predictive factors for mean change scores of the Good Death Scale. Results: Male gender (P < 0.001, 95% confidence interval = 0.73-2.43) was associated with better quality of dying while having hepatocellular carcinoma (P < 0.004, 95% confidence interval = -2.22 to -0.44) was associated with worse quality. For those in the unit, higher total Audit Scale scores were positively related to the outcome of quality of dying. The unit (P < 0.001, 95% confidence interval = 8.67-12.97) and higher Good Death Scale at admission (P < 0.001, 95% confidence interval = 0.44-1.13) were predictors of Audit Scale scores. Conclusions: Admission to a palliative care unit was associated with higher provider assessments of quality of dying for terminally ill cancer patients. These units should be considered as options for hospitals looking for ways to improve the quality of dying for patients. ? The Author 2012. Published by Oxford University Press. All rights reserved.
SDGs
Other Subjects
adult; aged; article; audit scale score; breast cancer; cancer patient; clinical effectiveness; controlled study; dying; female; good death scale; health care personnel; health care quality; hospital admission; hospital patient; human; inpatient hospice palliative care unit; liver cell carcinoma; major clinical study; male; oncology ward; patient assessment; patient care; propensity score; rating scale; religion; Taiwan; terminally ill patient; tertiary health care; Adult; Carcinoma, Hepatocellular; Case-Control Studies; Death; Female; Hospice Care; Hospital Units; Humans; Inpatients; Interdisciplinary Communication; Linear Models; Liver Neoplasms; Logistic Models; Male; Middle Aged; Multivariate Analysis; Neoplasms; Palliative Care; Patient Admission; Patient Care Team; Prospective Studies; Sex Factors; Taiwan; Terminally Ill; Tertiary Care Centers
Type
journal article