Terminal care of cancer patients. 1. Frequency and clinical problems
Svendsen, I.; Stefansson, T.; Ostergaard, I.
Ugeskrift for Laeger 151(8): 492-495
1989
ISSN/ISBN: 0041-5782 PMID: 2922851 Document Number: 337958
The object of this work is to investigate how frequently and how long cancer patients receive terminal care (TP), where this care is given and the associated clinical problems. Data concerning terminal care of cancer patients during the first three months of 1986 in the County of Arhus [Denmark] was collected by means of a questionnaire sent to the health workers involved in this care: general practitioners, home nurses, nurses in charge of hospital departments and leaders of nursing homes. During this period, a total of 1,610 persons died. Review of the death certificates provided information about cancer in 404 of the cases. Information was available concerning the course of the terminal illness where 390 patients were concerned (97%). This investigation includes 254 cases in whom, according to at least one of the four categories of health workers, terminal care was administered. The average duration of terminal care was 77 days (quartiles: 30, 75, 138 days). 73% received all or part of the terminal care in their own homes and 61% were cared for in hospital. Among the patients who died in hospital, 73% had received terminal care in their own homes for varying periods of time. 27% were not hospitalized during the terminal phase. Moderate to severe pain was reported in two out of three patients receiving terminal care by the general practitioners and by home and hospital nurses. Only fatigue and loss of appetite were reported more frequently. On the basis of the results of the investigation, the frequency of terminal care of cancer patients in the entire country may be calculated to be approximately 10,000 cases annually. Of these approximately one quarter will receive all terminal care in their own homes, approximately one quarter in institutions and the remainder in both places.