Symptom Prevalence and Place of Death Preference in Advanced Cancer Patients: Factors Associated With the Achievement of Home Death.
Julia Fee Voon Ho, Nur Syafiqah Marzuki, Nur Syuhadah Monica Meseng and 4 others
PMID 34657488WHAT IT FOUND
In advanced cancer patients, a high symptom burden did not prevent most from dying where they preferred.
Older age was linked to choosing and achieving home death, while nausea, vomiting, and constipation were associated with hospital death.
Key findings
01Overall, 91.7% of patients with a known actual place of death achieved their preference for where they wanted to die.
02Older age was significantly associated with both preferring and achieving a home death in the multivariate analysis.
03Symptoms of nausea, vomiting, and constipation were associated with a preference for hospital death and actually dying in hospital.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in a single private tertiary hospital in a large city with well-developed community palliative care and private nursing services, so results may not apply to rural areas or settings with fewer resources. The sample was predominantly Malaysian Chinese, limiting generalizability to other ethnic or cultural groups. Symptom data was staff-proxy reported at the first consultation, which may not reflect the symptom burden immediately prior to death. For 68.8% of patients, the preference for place of death was expressed by next-of-kin rather than the patient themselves.
Declared interests
The research was not funded, but the publication of the article was sponsored by Sunway Medical Centre, where the study was conducted.
The easy way to misread this
Do not assume that a high symptom burden automatically forces a hospital death. In this setting, most patients achieved their preferred place of death despite having multiple symptoms, provided there was adequate community support and early referral.