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Improved Symptom Change Enhances Quality of Dying in Patients With Advanced Cancer: An East Asian Cross-Cultural Study.
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- Author(s): Huang, Hsien-Liang; Chen, Ping-Jen; Mori, Masanori; Suh, Sang-Yeon; Wu, Chien-Yi; Peng, Jen-Kuei; Shih, Chih-Yuan; Yao, Chien-An; Tsai, Jaw-Shiun; Chiu, Tai-Yuan; Hiratsuka, Yusuke; Kim, Sun-Hyun; Morita, Tatsuya; Yamaguchi, Takashi; Tsuneto, Satoru; Hui, David; Cheng, Shao-Yi
- Source:
Oncologist; Apr2024, Vol. 29 Issue 4, pe553-e560, 8p- Subject Terms:
DEATH & psychology; STATISTICAL correlation; RESEARCH funding; EAST Asians; ETHNOLOGY research; MENTAL illness; MULTIPLE regression analysis; SYMPTOM burden; DESCRIPTIVE statistics; LONGITUDINAL method; METASTASIS; QUALITY of life; RESEARCH; DELIRIUM; TUMORS; CANCER patient psychology; TERMINAL care; DYSPNEA; COMPARATIVE studies; CONFIDENCE intervals; TERMINALLY ill - Source:
- Additional Information
- Subject Terms:
- Abstract: Background Symptom burdens tend to increase for patients with cancer and their families over the disease trajectory. There is still a lack of evidence on the associations between symptom changes and the quality of dying and death. In this context, this research investigated how symptom changes influence the quality of dying and death. Methods This international prospective cohort study (the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED), 2017-2019) included 22, 11, and 4 palliative care units across Japan, South Korea, and Taiwan. Eligible participants were adults (Japan and Korea, ≥18 years; Taiwan, ≥20 years) with locally advanced or metastatic cancer. Physical and psychological symptoms were assessed by physicians upon admission and within 3 days before death. Death quality was assessed using the Good Death Scale (GDS), developed in Taiwan. Univariate and multivariate regression analyses were used to identify correlations between symptom severity changes and GDS scores. Results Among 998 patients (542 [54.3%] men and 456 [45.7%] women; mean [SD] age = 70.1 [± 12.5] years), persistent dyspnea was associated with lower GDS scores when compared to stable dyspnea (β = −0.427, 95% CI = −0.783 to −0.071). Worsened (−1.381, −1.932 to −0.831) and persistent (−1.680, −2.701 to −0.659) delirium were also significantly associated with lower GDS scores. Conclusions Better quality of dying and death was associated with improved symptom control, especially for dyspnea and delirium. Integrating an outcome measurement for the quality of dying and death is important in the management of symptoms across the disease trajectory in a goal-concordant manner. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Oncologist is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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