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Table 4 Circumstances of the dying process

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
Variable N(%) N(%) ORb(95% C.I.) N(%) ORb(95% C.I.) N(%) ORb(95% C.I.)  
Physical symptom distress in last week of life
GP could make estimationc 520(87.4) 285(85.1) 0.2(0.1-0.3) 702(84.6) 0.5(0.4-0.8) 231(83.4) 0.8(0.5-1.3) .355
Distress from at least one physical symptom 412(91.6) 215(91.9) 1.1(0.6-1.9) 571(88.4) 0.7(0.4-1.1) 134(98.5) 5.8(1.4-24.8) .002
Lack of appetite 280(60.1) 120(49.6) 0.7(0.5-1.0) 299(47.8) 0.6(0.4-0.8) 67(49.6) 0.7(0.4-0.992) .001
Lack of energy 344(72.0) 186(73.5) 1.1(0.8-1.7) 482(73.8) 1.0(0.8-1.3) 83(56.8) 0.5(0.3-0.8) .001
Pain 93(23.7) 56(26.8) 1.4(0.9-2.2) 236(38.2) 2.0(1.5-2.8) 46(48.4) 3.2(2.0-5.2) <.001
Feeling drowsy 142(32.9) 60(29.0) 1.0(0.7-1.5) 182(29.4) 0.9(0.7-1.2) 18(25.0) 0.6(0.3-1.1) .438
Constipation 57(17.8) 22(13.8) 0.7(0.4-1.3) 158(27.7) 1.7(1.2-2.4) 26(32.1) 2.1(1.2-3.8) <.001
Dry mouth 73(20.4) 44(22.6) 1.1(0.7-1.7) 177(30.9) 1.6(1.1-2.2) 34(39.5) 2.3(1.3-3.8) <.001
Difficulty breathing 140(36.2) 58(32.8) 1.1(0.7-1.6) 243(40.6) 1.3(1.0-1.8) 40(60.6) 2.5(1.4-4.4) <.001
Psychological symptom distress in last week of life
GP could make estimationc 487(81.8) 258(77.0) 0.2(0.1-0.3) 649(78.2) 0.6(0.3-1.1) 208(75.1) 0.7(0.5-1.1) 0.096
Distress from at least one psychological symptom 241(63.9) 75(48.4) 0.5(0.4-0.8) 341(87.2) 4.2(2.8-6.3) 90(100) Notestim. <.001
Feeling sad 143(38.0) 42(25.1) 0.7(0.4-1.0) 247(58.9) 2.6(1.9-3.6) 57(67.1) 3.4(2.0-5.8) <.001
Worrying 162(41.9) 50(29.9) 0.7(0.4-1.0) 164(41.7) 1.0(0.7-1.3) 54(63.5) 2.2(1.3-3.7) <.001
Feeling irritable 87(25.9) 11(8.7) 0.3(0.1-0.6) 145(42.0) 2.1(1.5-3.0) 18(54.5) 3.5(1.6-7.5) <.001
Feeling nervous 116(33.0) 16(11.8) 0.3(0.2-0.5) 146(42.6) 1.6(1.2-2.3) 22(46.8) 1.7(0.9-3.3) <.001
Died at the place of wish d 221(75.4) 214(87.3) 1.8(1.1-2.9) 176(65.9) 0.6(0.4-0.8) 67(78.8) 1.2(0.6-2.1) <.001
  1. Missing data:
  2. Physical symptoms were measured on five levels in the original questionnaire (not at all, a little bit, somewhat, quite a bit or very much), variables were later recoded into two categories: quite a bit and very much vs all others; Missing values for physical symptoms Distress from at least one physical symptom: n < 29%; Physical symptoms: lack of appetite: n < 28%; lack of energy: n < 26%; pain: n < 17%; drowsy: n < 19%; constipation: n < 21%; dry mouth: n < 22%; difficulty breathing: n < 19%.
  3. Psychological symptoms were measured on four levels in the original questionnaire (rarely, occasionally, frequently or almost constantly), variables were later recoded into two categories: frequently and almost constantlyvs all others; Distress from at least one psychosocial symptom: n < 51%; Psychosocial symptoms: feeling sad: n < 49%, worry: n < 50%, irritable: n < 59%, nervous: n < 57%.
  4. Died at the preferred place of wish: information available for 44% of the patients.
  5. aχ2test on cross-country differences.
  6. bFrom 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, types of malignancy and the number of GPs contact in the last week of life. Odds ratios in bold are statistically significant at p < 0.05.
  7. cFor at least one symptom.
  8. dIf the wish of the patient was known to the GP. For the death at the place of wish, we adjusted differences in the longest place of residence, number of GPs contact in the last week of life, age, sex and types of malignancy.