DETERMINANTS OF DEATH IN AN INPATIENT HOSPICE FOR TERMINALLY ILL CANCER PATIENTS

2.50
Hdl Handle:
http://hdl.handle.net/10755/164671
Category:
Abstract
Type:
Presentation
Title:
DETERMINANTS OF DEATH IN AN INPATIENT HOSPICE FOR TERMINALLY ILL CANCER PATIENTS
Author(s):
Tzuh, Siew; Tang, Stephanie; McCorkle, Ruth
Author Details:
Siew Tzuh, Yang-Ming University, Taipei City United Hospital, Taipei, Taiwan, Republic of China; Stephanie Tang, RN, DNSc; Ruth McCorkle, PhD, FAAN
Abstract:
Despite the strong emphasis on home-based end-of-life care in the United States and the recognition of dying at home as a gold standard of quality of care, hospice home care is not a panacea and death at home may not be feasible for every terminally ill cancer patient. However, factors predisposing death in an inpatient hospice were under-explored from the existing studies. To investigate the determinants of death in an inpatient hospice for terminally ill cancer patients. Mor and Hiris’s (1983) framework of determinants of place of death: (a) sociodemographics, (b) support network, (c) clinical condition/ care needs, and (d) health-system factors. Research Design: Prospective cohort study. Measurements: Preferred/actual place of death, functional dependency, symptom distress, availability/utilization of health care resources. Data Analysis: Determinants of death in an inpatient hospice were identified by survival analysis with Cox proportional hazards model. Results: A total of 180 terminal cancer patients were enrolled (87% response rate). Approximately two-fifths (40.8%) of terminally ill cancer patients in this study died in an inpatient hospice over the two-year study period. Results from Cox proportional hazards model with adjustment for covariates indicated that cancer patients who received hospice care before death (hazard ratio (HR)=7.32, 95% confidence interval (CI): 3.21-16.67), with a preference to die in an inpatient hospice (HR= 4.86, 95% CI: 2.24-10.51), resided in New Haven County (HR=1.70, 95% CI:1.00-2.93), or who experienced higher levels of functional dependency (HR=1.05, 95% CI: 1.02-1.08) were at significantly higher likelihood to die in an inpatient hospice. Implications: The high prevalence of inpatient hospice death for terminally ill cancer patients in this study was related to the local health care system characteristics, health care needs at the end of life, and personal preference of place of death. Findings from this study make a valuable contribution to our currently limited understanding of how inpatient hospice care influences place of death. Available and ease access to inpatient hospice services facilitate a death in a place that is in accord with some terminally ill cancer patients wishes. An important component of a good death as defined by Institute of Medicine.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Sponsors:
Funding Sources: ONS Foundation through an unrestricted grant from the Roxanne Laboratories, Inc. and Mary Lewis, Manager Palliative Care Education.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDETERMINANTS OF DEATH IN AN INPATIENT HOSPICE FOR TERMINALLY ILL CANCER PATIENTSen_GB
dc.contributor.authorTzuh, Siewen_US
dc.contributor.authorTang, Stephanieen_US
dc.contributor.authorMcCorkle, Ruthen_US
dc.author.detailsSiew Tzuh, Yang-Ming University, Taipei City United Hospital, Taipei, Taiwan, Republic of China; Stephanie Tang, RN, DNSc; Ruth McCorkle, PhD, FAANen_US
dc.identifier.urihttp://hdl.handle.net/10755/164671-
dc.description.abstractDespite the strong emphasis on home-based end-of-life care in the United States and the recognition of dying at home as a gold standard of quality of care, hospice home care is not a panacea and death at home may not be feasible for every terminally ill cancer patient. However, factors predisposing death in an inpatient hospice were under-explored from the existing studies. To investigate the determinants of death in an inpatient hospice for terminally ill cancer patients. Mor and Hiris’s (1983) framework of determinants of place of death: (a) sociodemographics, (b) support network, (c) clinical condition/ care needs, and (d) health-system factors. Research Design: Prospective cohort study. Measurements: Preferred/actual place of death, functional dependency, symptom distress, availability/utilization of health care resources. Data Analysis: Determinants of death in an inpatient hospice were identified by survival analysis with Cox proportional hazards model. Results: A total of 180 terminal cancer patients were enrolled (87% response rate). Approximately two-fifths (40.8%) of terminally ill cancer patients in this study died in an inpatient hospice over the two-year study period. Results from Cox proportional hazards model with adjustment for covariates indicated that cancer patients who received hospice care before death (hazard ratio (HR)=7.32, 95% confidence interval (CI): 3.21-16.67), with a preference to die in an inpatient hospice (HR= 4.86, 95% CI: 2.24-10.51), resided in New Haven County (HR=1.70, 95% CI:1.00-2.93), or who experienced higher levels of functional dependency (HR=1.05, 95% CI: 1.02-1.08) were at significantly higher likelihood to die in an inpatient hospice. Implications: The high prevalence of inpatient hospice death for terminally ill cancer patients in this study was related to the local health care system characteristics, health care needs at the end of life, and personal preference of place of death. Findings from this study make a valuable contribution to our currently limited understanding of how inpatient hospice care influences place of death. Available and ease access to inpatient hospice services facilitate a death in a place that is in accord with some terminally ill cancer patients wishes. An important component of a good death as defined by Institute of Medicine.en_GB
dc.date.available2011-10-27T12:04:54Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:04:54Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.sponsorshipFunding Sources: ONS Foundation through an unrestricted grant from the Roxanne Laboratories, Inc. and Mary Lewis, Manager Palliative Care Education.-
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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