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Quality of life trends in people with and without cancer referred to volunteer provided palliative care services (ELSA) : a longitudinal study
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CONTEXT: Trends in symptoms and functional ability are known towards the end of life, but less is understood about quality of life, particularly prospectively following service referral.
OBJECTIVES: This study compares quality of life trajectories of people with and without cancer, referred to volunteer provided palliative care services.
METHODS: A secondary analysis of the ELSA trial (n = 85 people with cancer and n = 72 without cancer). Quality of life data (WHOQOL-BREF) were collected at baseline (referral), 4, 8 and 12 weeks. Socio-demographic data were collected at baseline. We specified a series of joint models to estimate differences on quality of life trajectories between groups adjusting for participants who die earlier in the study.
RESULTS: People with cancer had a significantly better quality of life at referral to the volunteer provided palliative care services than those with non-malignant disease despite similar demographic characteristics (Cohen d's=.37 to .45). More people with cancer died during the period of the study. We observed significant differences in quality of life physical and environmental domain trajectories between groups (b = -2.35, CI -4.49, -0.21, and b = -4.11, CI -6.45, -1.76). People with cancer experienced a greater decline in quality of life than those with non-malignant disease.
CONCLUSION: Referral triggers for those with and without cancer may be different. People with cancer can be expected to have a more rapid decline in quality of life from the point of service referral. This may indicate greater support needs, including from volunteer provided palliative care services.
http://dx.doi.org/10.1016/j.jpainsymman.2018.07.020
Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
Autres numéros de la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»
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