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Table 3 Characteristics of communication processes at the end of life

From: Care provided and care setting transitions in the last three months of life of cancer patients: a nationwide monitoring study in four European countries

  Belgium (N = 595) The Netherlands (N = 335) Italy (N = 830) Spain (N = 277) p-valuea
Characteristics N(%) N(%) OR (95% C.I.) N(%) ORb(95% C.I.) N(%) ORb(95% C.I.)  
GP-patient conversations about:
Primary diagnosis 474(84.2) 303(95.0) 3.1(1.8-5.4) 505(66.4) 0.3(0.3-0.5) 157(70.7) 0.4(0.3-0.6) <.001
Incurability of illness 416(74.4) 298(94.6) 5.0(2.9-8.6) 345(46.2) 0.3(0.2-0.4) 95(45.0) 0.3(0.2-0.4) <.001
Life expectation 363(64.5) 282(89.5) 4.1(2.7-6.2) 277(37.0) 0.3(0.2-0.4) 56(27.1) 0.2(0.1-0.3) <.001
Possible medical complications 393(70.1) 267(86.4) 2.6(1.8-3.9) 441(58.7) 0.6(0.4-0.7) 137(62.8) 0.7(0.5-0.95) <.001
Physical complaints 514(90.7) 306(95.9) 2.3(1.2-4.4) 632(83.0) 0.5(0.4-0.7) 208(90.4) 0.9(0.5-1.6) <.001
Psychological problems 416(74.3) 272(86.9) 2.1(1.4-3.1) 442(59.1) 0.5(0.4-0.7) 146(66.2) 0.7(0.5-0.9) <.001
Social problems 284(56.5) 202(70.1) 1.8(1.3-2.6) 249(34.5) 0.4(0.3-0.5) 63(34.4) 0.4(0.3-0.6) <.001
Spiritual problems 169(32.4) 156(54.4) 2.1(1.5-2.9) 104(14.4) 0.3(0.3-0.5) 27(14.7) 0.3(0.2-0.5) <.001
Options for palliative care 389(70.0) 272(88.0) 2.7(1.8-4.0) 267(36.4) 0.2(0.2-0.3) 138(66.7) 0.8(0.5-1.1) <.001
Burden of treatments 397(72.6) 244(81.6) 1.6(1.1-2.3) 367(50.0) 0.4(0.3-0.5) 136(68.3) 0.8(0.5-1.1) <.001
Overall: One or more of these topics was discussed 447(94.1) 259(97.7) 2.2(0.9-5.4) 586(88.7) 0.5(0.3-0.7) 133(95.7) 1.2(0.5-2.9) <.001
End-of-lifepreferences----Patient everexpressed a preference:
For place of death 293(49.3) 245(73.8) 2.3(1.7-3.1) 267(32.2) 0.4(0.3-0.5) 85(34.0) 0.4(0.3-0.6) <.001
About a medical treatment 225(40.5) 198(65.1) 2.4(1.7-3.2) 118(18.2) 0.3(0.3-0.4) 29(14.3) 0.2(0.1-0.4) <.001
  1. Missing data:
  2. Prior to last month: Diagnosis, possible medical complication, psychosocial problems: n < 10%; incurability of illness, life expectancy: n < 11%; physical problems: n < 8%, social problems; n < 17%; spiritual problems, n < 16%; options of palliative care, n < 12%; Burden of treatment: n < 13%; one or more issues discussed: n < 23%.
  3. Preference for place of death: n < 13%; preference about medical treatment: n < 17%.
  4. aχ2test on cross-country differences.
  5. bOdds ratios from multivariate logistic regression models. For these analyses, we compared end-of-life care between patients with cancer in the four countries, with Belgium as the reference category, and adjusted differences in place of death, age, gender and the types of malignancy. Odds ratios in bold are statistically significant at p < 0.05.