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Insights into the factors associated with achieving the preference of home death in terminal cancer: A national population-based study

Published online by Cambridge University Press:  23 November 2017

Finian Bannon ,
Victoria Cairnduff ,
Deirdre Fitzpatrick ,
Janine Blaney ,
Barbara Gomes ,
Anna Gavin  and
Conan Donnelly
Finian Bannon*
Affiliation:
Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
Victoria Cairnduff
Affiliation:
Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, United Kingdom
Deirdre Fitzpatrick
Affiliation:
Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, United Kingdom
Janine Blaney
Affiliation:
Physiotherapy Department, Cancer Centre, Belfast City Hospital, Belfast, United Kingdom
Barbara Gomes
Affiliation:
Faculty of Medicine, University of Coimbra, Coimbra, Portugal Department of Palliative Care, Policy, and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom
Anna Gavin
Affiliation:
Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, United Kingdom
Conan Donnelly
Affiliation:
Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, United Kingdom
*
Address correspondence and reprint requests to: Finian Bannon, Centre for Public Health, Queen's University Belfast, Centre for Public Health, Institute of Clinical Sciences Building, Grosvenor Road, Belfast BT12 6BJ, United Kingdom. E-mail: [email protected].
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Abstract

Objectives:

Most terminally ill cancer patients prefer to die at home, yet only a minority are able to achieve this. Our aim was to investigate the factors associated with cancer patients achieving their preference to die at home.

Methods:

This study took the form of a mortality followback, population-based, observational survey of the relatives of deceased cancer patients in Northern Ireland. Individuals who registered the death of a friend or relative (aged ≥ 18 years) between 1 December 2011 and 31 May 2012, where the primary cause of death was cancer (ICD10: C00–D48), who were invited to take part. Preferred and actual place of death, and patient, service, and clinical data were collected using the QUALYCARE postal questionnaire. Multivariable logistic regression was employed to investigate the factors associated with achieving a home death when preferred.

Results:

Some 467 of 1,493 invited informants completed the survey. The 362 (77.5%) who expressed a preference for dying at home and spent time at home in their final 3 months were included in our analysis. Of these, 53.4% achieved their preference of a home death. Factors positively associated with achieving a home death were: living in an affluent area, receipt of good and satisfactory district nurse care, discussing place of death with health professionals, and the caregiver's preference for a home death. Being older than 80 years of age, being a Presbyterian, and being unconscious most of the time during their final week were negatively associated with achieving a home death.

Significance of Results:

Communication, care satisfaction, and caregiver preferences were all associated with home death. Our findings will help inform the design of future interventions aimed at increasing the proportion of patients achieving their preferred place of death at home, for example, by targeting interventions toward older patients and those from the most deprived communities.

Keywords

BereavementCommunicationHome care servicesCancerPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 6 , December 2018 , pp. 749 - 755
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

*

Joint first authors.

α

Joint last authors.

References

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