Prospective Study of Preferred Versus Actual Place of Death Among Swedish Palliative Cancer Patients.
Jonas Nilsson, Stefan Bergström, Hampus Hållberg and 3 others
PMID 37933153WHAT IT FOUND
Most Swedish palliative cancer patients wanted to die at home, and 80% of those who wanted home actually died at home.
When relatives were involved, wanting home was 96% versus 74% alone, but actual place did not differ.
Key findings
01Most included patients preferred to die at home (79%), and most actually died at home (76%).
02Of the 190 patients who wanted to die at home, 148 (80%) died at home.
03When the choice was made together with relatives, 96% wanted home versus 74% when decided alone; actual place of death did not differ.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Of 663 patients evaluated, 421 were excluded, mainly because of cognitive impairment, so the sample may not represent all palliative cancer patients. The study was done in only three Swedish municipalities with palliative home-care teams, so results may not apply elsewhere. Very few patients preferred hospital or nursing home, only 6 and 9 respectively, so the study cannot say much about how to support those preferences. The study was largely conducted during the COVID-19 pandemic, which may have made home seem safer and influenced preferences. The study did not assign treatments or compare palliative home care with another setting, so it cannot show that any part of the care changed where patients died.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by a grant from Stiftelsen Gävle Cancerfond.
The easy way to misread this
Do not read the 80% home death rate among patients who wanted home as proof that palliative home care causes home death. This was an observational study of patients already enrolled in palliative home care, and it did not compare that care with another setting.