Rehabilitation for cancer patients in inpatient hospices / palliative care units and achievement of a good death : analyses of combined data from nationwide surveys among bereaved family members

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HASEGAWA, Takaaki | SEKINE, Ryuichi | AKECHI, Tatsuo | OSAGA, Satoshi | TSUJI, Tetsuya | OKUYAMA, Toru | SAKURAI, Haruka | MASUKAWA, Kento | AOYAMA, Maho | MORITA, Tatsuya | KIZAWA, Yoshiyuki | TSUNETO, Satoru | SHIMA, Yasuo | MIYASHITA, Mitsunori

Context: In end-of-life care, rehabilitation for cancer patients is considered to be an important means for improving patients’ quality of death and dying (QODD). Objectives: To determine whether the provision of rehabilitation for cancer patients in palliative care units is associated with the achievement of a good death. Methods: This study involved a cross-sectional, anonymous, self-report questionnaire survey of families of cancer patients who died in palliative care units in Japan. We evaluated the Good Death Inventory (GDI) short version on a 7-point scale. A logistic regression model was used to calculate the propensity score. Covariates included in this model were survey year, patients’ characteristics, and families’ characteristics. The associations between rehabilitation and GDI were tested using trend tests after propensity score matching adjustment. Results: Of the 1,965 family caregivers who received the questionnaires, available data was obtained from 1,008 respondents (51.2%). Among them, 285 (28.2%) cases received rehabilitation in palliative care units. There was no difference in total GDI score between the groups with and without rehabilitation. In exploratory analyses, patients receiving rehabilitation were significantly more likely to feel “maintaining hope and pleasure” (mean = 4.50 [standard error = 0.10] vs. 4.05 [0.11], respectively; effect size (ES)= 0.31; p-value = 0.003), “good relationships with medical staff,” (5.67 [0.07] vs. 5.43 [0.09], respectively; ES= 0.22; p-value = 0.035) and “being respected as an individual” (6.08 [0.06] vs. 5.90 [0.07], respectively; ES=0.19;p-value = 0.049) compared with patients not receiving rehabilitation. Conclusion: Rehabilitation in palliative care units may contribute to several domains of QODD, particularly “maintaining hope and pleasure”. Further research is needed to investigate whether palliative rehabilitation contribute to the achievement of a good death.

http://dx.doi.org/10.1016/j.jpainsymman.2020.06.031

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 60»

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