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Trajectory of psychosocial symptoms among home care patients with cancer at end-of-life.

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Title: Trajectory of psychosocial symptoms among home care patients with cancer at end-of-life.
Authors: Seow, Hsien (AUTHOR), Stevens, Tara (AUTHOR), Barbera, Lisa C. (AUTHOR), Burge, Fred (AUTHOR), McGrail, Kimberlyn (AUTHOR), Chan, Kelvin K. W. (AUTHOR), Peacock, Stuart J. (AUTHOR), Sutradhar, Rinku (AUTHOR), Guthrie, Dawn M. (AUTHOR)
Source: Psycho-Oncology. Jan2021, Vol. 30 Issue 1, p103-110. 8p. 2 Charts, 1 Graph.
Subjects: Cancer patient care, Symptoms, Home care services, Psycho-oncology, Activities of daily living, Knowledge gap theory
Abstract: Purpose: Understanding the end-of-life psychosocial needs of cancer patients at home is a knowledge gap. This study describes the trajectory of psychosocial symptoms in the last 6 months of life among cancer decedents who were receiving home care.Methods: Observational population-based cohort study of cancer decedents who were receiving home care services between 2007 and 2014. Decedents had to have at least one home care assessment in the last 6 months of life for inclusion. Outcomes were the presence of psychosocial symptoms (i.e., anxiety, loneliness, depression, social decline, caregiver distress, and cognitive decline) at each week before death.Results: Our cohort included 27,295 unique cancer decedents (30,368 assessments), of which 58% died in hospital. Fifty-six percent were older than 74, and 47% were female. The prevalence of all symptoms increased approaching death, except loneliness. Social decline (48%-78%) was the most prevalent psychosocial symptom, though loneliness was reported in less than 10% of the cohort. Caregiver distress rose over time from 15%-27%. A third of the cohort reported issues with cognitive impairment. Multivariate regression showed that physical symptoms such as uncontrolled pain, impairment in independent activities of daily living, and a high level of health instability all significantly worsened the odds of having a psychosocial symptom in the last 3 months of life.Conclusion: In this large home care cancer cohort, trajectories of psychosocial symptoms worsened close to death. Physical symptoms, such as uncontrolled pain, were associated with having worse psychosocial symptoms at end of life. [ABSTRACT FROM AUTHOR]
Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Trajectory of psychosocial symptoms among home care patients with cancer at end-of-life.
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  Data: <searchLink fieldCode="AR" term="%22Seow%2C+Hsien%22">Seow, Hsien</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stevens%2C+Tara%22">Stevens, Tara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Barbera%2C+Lisa+C%2E%22">Barbera, Lisa C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Burge%2C+Fred%22">Burge, Fred</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McGrail%2C+Kimberlyn%22">McGrail, Kimberlyn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chan%2C+Kelvin+K%2E+W%2E%22">Chan, Kelvin K. W.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Peacock%2C+Stuart+J%2E%22">Peacock, Stuart J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sutradhar%2C+Rinku%22">Sutradhar, Rinku</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guthrie%2C+Dawn+M%2E%22">Guthrie, Dawn M.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psycho-Oncology%22">Psycho-Oncology</searchLink>. Jan2021, Vol. 30 Issue 1, p103-110. 8p. 2 Charts, 1 Graph.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Cancer+patient+care%22">Cancer patient care</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink><br /><searchLink fieldCode="DE" term="%22Home+care+services%22">Home care services</searchLink><br /><searchLink fieldCode="DE" term="%22Psycho-oncology%22">Psycho-oncology</searchLink><br /><searchLink fieldCode="DE" term="%22Activities+of+daily+living%22">Activities of daily living</searchLink><br /><searchLink fieldCode="DE" term="%22Knowledge+gap+theory%22">Knowledge gap theory</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Purpose: </bold>Understanding the end-of-life psychosocial needs of cancer patients at home is a knowledge gap. This study describes the trajectory of psychosocial symptoms in the last 6 months of life among cancer decedents who were receiving home care.<bold>Methods: </bold>Observational population-based cohort study of cancer decedents who were receiving home care services between 2007 and 2014. Decedents had to have at least one home care assessment in the last 6 months of life for inclusion. Outcomes were the presence of psychosocial symptoms (i.e., anxiety, loneliness, depression, social decline, caregiver distress, and cognitive decline) at each week before death.<bold>Results: </bold>Our cohort included 27,295 unique cancer decedents (30,368 assessments), of which 58% died in hospital. Fifty-six percent were older than 74, and 47% were female. The prevalence of all symptoms increased approaching death, except loneliness. Social decline (48%-78%) was the most prevalent psychosocial symptom, though loneliness was reported in less than 10% of the cohort. Caregiver distress rose over time from 15%-27%. A third of the cohort reported issues with cognitive impairment. Multivariate regression showed that physical symptoms such as uncontrolled pain, impairment in independent activities of daily living, and a high level of health instability all significantly worsened the odds of having a psychosocial symptom in the last 3 months of life.<bold>Conclusion: </bold>In this large home care cancer cohort, trajectories of psychosocial symptoms worsened close to death. Physical symptoms, such as uncontrolled pain, were associated with having worse psychosocial symptoms at end of life. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1002/pon.5559
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      – SubjectFull: Cancer patient care
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      – SubjectFull: Home care services
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      – SubjectFull: Activities of daily living
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              Text: Jan2021
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              Y: 2021
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