'Burden to others' as a public concern in advanced cancer: a comparative survey in seven European countries

被引：27

作者：

Bausewein, Claudia ^{[1
,2
,3
]}

Calanzani, Natalia ^{[1
]}

Daveson, Barbara A. ^{[1
]}

Simon, Steffen T. ^{[3
,4
,5
]}

Ferreira, Pedro L. ^{[6
]}

Higginson, Irene J. ^{[1
]}

Bechinger-English, Dorothee ^{[1
]}

Deliens, Luc ^{[7
,8
,12
]}

Gysels, Marjolein ^{[9
]}

Toscani, Franco ^{[10
]}

Ceulemans, Lucas ^{[11
]}

Harding, Richard ^{[1
]}

Gomes, Barbara ^{[1
]}

机构：

[1] Kings Coll London, Dept Palliat Care Policy & Rehabil, Cicely Saunders Inst, London WC2R 2LS, England

[2] Univ Hosp Munich, Interdisciplinary Ctr Palliat Med, Munich, Germany

[3] Deutsch Gesell Palliativmed, Berlin, Germany

[4] Inst Palliat Care IPAC, Oldenburg, Germany

[5] Univ Hosp Cologne, Dept Palliat Med, Cologne, Germany

[6] Univ Coimbra CEISUC, Ctr Hlth Studies & Res, Coimbra, Portugal

[7] Univ Ghent, End Of Life Care Res Grp, Brussels, Belgium

[8] Vrije Univ Brussel, Brussels, Belgium

[9] Univ Barcelona, Barcelona Ctr Int Hlth Res, CRESIB Hosp Clin, Barcelona, Spain

[10] Fdn Lino Maestroni ONLUS, Ist Ric Med Palliat, Cremona, Italy

[11] Univ Antwerp, B-2020 Antwerp, Belgium

[12] Vrije Univ Amsterdam, Palliat Care Ctr Expertise, Dept Publ & Occupat Hlth, EMGO Inst Hlth & Care Res,Med Ctr, Amsterdam, Netherlands

来源：

BMC CANCER | 2013年 / 13卷

关键词：

ISSUES SURROUNDING DEATH; TERMINALLY-ILL; LIFE; PAIN; CARE; END; PERSPECTIVES; PREFERENCES; PREVALENCE; ATTITUDES;

D O I：

10.1186/1471-2407-13-105

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Europe faces an enormous public health challenge with aging populations and rising cancer incidence. Little is known about what concerns the public across European countries regarding cancer care towards the end of life. We aimed to compare the level of public concern with different symptoms and problems in advanced cancer across Europe and examine factors influencing this. Methods: Telephone survey with 9,344 individuals aged >= 16 in England, Flanders, Germany, Italy, Netherlands, Portugal and Spain. Participants were asked about nine symptoms and problems, imagining a situation of advanced cancer with less than one year to live. These were ranked and the three top concerns examined in detail. As 'burden to others' showed most variation within and between countries, we determined the relative influence of factors on this concern using GEE and logistic regression. Results: Overall response rate was 21%. Pain was the top concern in all countries, from 34% participants (Italy) to 49% (Flanders). Burden was second in England, Germany, Italy, Portugal, and Spain. Breathlessness was second in Flanders and the Netherlands. Concern with burden was independently associated with age (70+ years, OR 1.50; 95%CI 1.24-1.82), living alone (OR 0.82, 95%CI 0.73-0.93) and preferring quality rather than quantity of life (OR 1.43, 95%CI 1.14-1.80). Conclusions: When imagining a last year of life with cancer, the public is not only concerned about medical problems but also about being a burden. Public education about palliative care and symptom control is needed. Cancer care should include a routine assessment and management of social concerns, particularly for older patients with poor prognosis.

引用

页数：11

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