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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.
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BMC Cancer

ISSN: 1471-2407

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