Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective
Objectives To determine the factors influencing palliative care utilisation in patients with advanced cancer and to assess its association with the quality of death (QOD).Design A cross-sectional study.Setting This study was conducted in tumour hospitals in the Hunan and Sichuan provinces of China....
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/7/e081215.full |
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| author | Jun Ma Li Liang Siyuan Tang Jinfeng Ding Jiarui Chen Fang Xie Binbin Wen Qian Zeng |
| author_facet | Jun Ma Li Liang Siyuan Tang Jinfeng Ding Jiarui Chen Fang Xie Binbin Wen Qian Zeng |
| author_sort | Jun Ma |
| collection | DOAJ |
| description | Objectives To determine the factors influencing palliative care utilisation in patients with advanced cancer and to assess its association with the quality of death (QOD).Design A cross-sectional study.Setting This study was conducted in tumour hospitals in the Hunan and Sichuan provinces of China. In 2021, the country launched a ‘palliative care standard wards’ project, identifying 16 medical institutions as the first pilot sites.Participants Deceased patients who met the admission criteria for a standard palliative care unit were the study subjects, and their caregivers were recruited for questionnaires.Interventions No interventions were applied in this study.Primary and secondary outcome measures A self-reported questionnaire survey was administered to caregivers of deceased patients with advanced cancer in mainland China. Binary logistic regression was used to identify factors influencing palliative care utilisation. The association between utilisation of palliative care and the QOD was tested using an independent samples t-test.Results Of 947 patients, 342 (36.1%) received palliwiative care. Data were collected from 400 caregivers (42.2%). Palliative care utilisation was associate with intrusion operation (adjusted OR (aOR): 1.7, 95% CI: 1.05 to 2.92, p=0.032) and relationship with patients caregiver age (aOR=6.5, 95% CI: 3.6 to 12.7, p<0.001). Additionally, longer caregiving duration, high school or junioreducational level (aOR:=0.5, p=0.024), and caregiver retirement status were associated with palliative care utilisation. Patients receiving palliative care scored higher on the Good Death Inventory (96.2 (13.0) vs 107.22 (9.6), t = –9.8, p<0.000). The most significant differences were observed in the dimensions of ‘passing away in a place that meets the patient’s wishes,’ ‘unawareness of death’ and ‘remaining hopeful and happy.’Conclusions Patient and caregiver characteristics influence palliative care utilisation, and use of palliative care contributes positively to most dimensions of the QOD. Future research should further explore multiple factors influencing palliative care utilisation and examine whether they contribute to the QOD. |
| format | Article |
| id | doaj-art-a33d58bae4384e7b8799fd0d2d0d0cc5 |
| institution | Matheson Library |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-a33d58bae4384e7b8799fd0d2d0d0cc52025-07-12T03:40:17ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2023-081215Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspectiveJun Ma0Li Liang1Siyuan Tang2Jinfeng Ding3Jiarui Chen4Fang Xie5Binbin Wen6Qian Zeng7Xiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaXiangya School of Nursing, Central South University, Changsha, Hunan, ChinaObjectives To determine the factors influencing palliative care utilisation in patients with advanced cancer and to assess its association with the quality of death (QOD).Design A cross-sectional study.Setting This study was conducted in tumour hospitals in the Hunan and Sichuan provinces of China. In 2021, the country launched a ‘palliative care standard wards’ project, identifying 16 medical institutions as the first pilot sites.Participants Deceased patients who met the admission criteria for a standard palliative care unit were the study subjects, and their caregivers were recruited for questionnaires.Interventions No interventions were applied in this study.Primary and secondary outcome measures A self-reported questionnaire survey was administered to caregivers of deceased patients with advanced cancer in mainland China. Binary logistic regression was used to identify factors influencing palliative care utilisation. The association between utilisation of palliative care and the QOD was tested using an independent samples t-test.Results Of 947 patients, 342 (36.1%) received palliwiative care. Data were collected from 400 caregivers (42.2%). Palliative care utilisation was associate with intrusion operation (adjusted OR (aOR): 1.7, 95% CI: 1.05 to 2.92, p=0.032) and relationship with patients caregiver age (aOR=6.5, 95% CI: 3.6 to 12.7, p<0.001). Additionally, longer caregiving duration, high school or junioreducational level (aOR:=0.5, p=0.024), and caregiver retirement status were associated with palliative care utilisation. Patients receiving palliative care scored higher on the Good Death Inventory (96.2 (13.0) vs 107.22 (9.6), t = –9.8, p<0.000). The most significant differences were observed in the dimensions of ‘passing away in a place that meets the patient’s wishes,’ ‘unawareness of death’ and ‘remaining hopeful and happy.’Conclusions Patient and caregiver characteristics influence palliative care utilisation, and use of palliative care contributes positively to most dimensions of the QOD. Future research should further explore multiple factors influencing palliative care utilisation and examine whether they contribute to the QOD.https://bmjopen.bmj.com/content/15/7/e081215.full |
| spellingShingle | Jun Ma Li Liang Siyuan Tang Jinfeng Ding Jiarui Chen Fang Xie Binbin Wen Qian Zeng Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective BMJ Open |
| title | Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective |
| title_full | Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective |
| title_fullStr | Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective |
| title_full_unstemmed | Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective |
| title_short | Palliative care and its association with the quality of death in patients with advanced cancer in China: a cross-sectional study with a family caregivers’ perspective |
| title_sort | palliative care and its association with the quality of death in patients with advanced cancer in china a cross sectional study with a family caregivers perspective |
| url | https://bmjopen.bmj.com/content/15/7/e081215.full |
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