Factors influencing death at home in terminally ill patients with cancer: systematic review

Title

Factors influencing death at home in terminally ill patients with cancer: systematic review

Creator

Gomes B; Higginson IJ

Publisher

Bmj (clinical Research Ed.)

Date

2006

Subject

Humans; Attitude to Death; Health Services Accessibility; Death; Risk Factors; Patient Satisfaction; Time Factors; Residence Characteristics; House Calls; social support; Hospitalization/statistics & numerical data; Terminally Ill/statistics & numerical data; location of death; Neoplasms/psychology/therapy; Home Care Services/standards/statistics & numerical data/utilization; Terminal Care/psychology/statistics & numerical data/utilization

Description

OBJECTIVES: To determine the relative influence of different factors on place of death in patients with cancer. DATA SOURCES: Four electronic databases-Medline (1966-2004), PsycINFO (1972-2004), CINAHL (1982-2004), and ASSIA (1987-2004); previous contacts with key experts; hand search of six relevant journals. REVIEW METHODS: We generated a conceptual model, against which studies were analysed. Included studies had original data on risk factors for place of death among patients, > 80% of whom had cancer. Strength of evidence was assigned according to the quantity and quality of studies and consistency of findings. Odds ratios for home death were plotted for factors with high strength evidence. RESULTS: 58 studies were included, with over 1.5 million patients from 13 countries. There was high strength evidence for the effect of 17 factors on place of death, of which six were strongly associated with home death: patients' low functional status (odds ratios range 2.29-11.1), their preferences (2.19-8.38), home care (1.37-5.1) and its intensity (1.06-8.65), living with relatives (1.78-7.85), and extended family support (2.28-5.47). The risk factors covered all groups of the model: related to illness, the individual, and the environment (healthcare input and social support), the latter found to be the most important. CONCLUSIONS: The ne of factors that influence where patients with cancer die is complicated. Future policies and clinical practice should focus on ways of empowering families and public education, as well as intensifying home care, risk assessment, and training practitioners in end of life care.
2006

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

515-521

Issue

7540

Volume

332

Citation

Gomes B; Higginson IJ, “Factors influencing death at home in terminally ill patients with cancer: systematic review,” Pediatric Palliative Care Library, accessed May 22, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13425.

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