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Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries

(2014) PALLIATIVE MEDICINE. 28(2). p.101-110
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Abstract
Background: Health-care costs are growing, with little population-based data about people's priorities for end-of-life care, to guide service development and aid discussions. Aim: We examined variations in people's priorities for treatment, care and information across seven European countries. Design: Telephone survey of a random sample of households; we asked respondents their priorities if faced with a serious illness, like cancer, with limited time to live' and used multivariable logistic regressions to identify associated factors. Setting/participants: Members of the general public aged 16 years residing in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. Results: In total, 9344 individuals were interviewed. Most people chose improve quality of life for the time they had left', ranging from 57% (95% confidence interval: 55%-60%, Italy) to 81% (95% confidence interval: 79%-83%, Spain). Only 2% (95% confidence interval: 1%-3%, England) to 6% (95% confidence interval: 4%-7%, Flanders) said extending life was most important, and 15% (95% confidence interval: 13%-17%, Spain) to 40% (95% confidence interval: 37%-43%, Italy) said quality and extension were equally important. Prioritising quality of life was associated with higher education in all countries (odds ratio = 1.3 (Flanders) to 7.9 (Italy)), experience of caregiving or bereavement (England, Germany, Portugal), prioritising pain/symptom control over having a positive attitude and preferring death in a hospice/palliative care unit. Those prioritising extending life had the highest home death preference of all groups. Health status did not affect priorities. Conclusions: Across all countries, extending life was prioritised by a minority, regardless of health status. Treatment and care needs to be reoriented with patient education and palliative care becoming mainstream for serious conditions such as cancer.
Keywords
quality of life, END-OF-LIFE, palliative care, life extension, cross-cultural comparison, Decision making, PALLIATIVE CARE, ADVANCED CANCER, RESPONSE RATES, ATTITUDES, PREFERENCES, DEATH, AWARENESS, PORTUGAL, QUALITY

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MLA
Higginson, Irene J, Barbara Gomes, Natalia Calanzani, et al. “Priorities for Treatment, Care and Information If Faced with Serious Illness: a Comparative Population-based Survey in Seven European Countries.” PALLIATIVE MEDICINE 28.2 (2014): 101–110. Print.
APA
Higginson, I. J., Gomes, B., Calanzani, N., Gao, W., Bausewein, C., Daveson, B. A., Deliens, L., et al. (2014). Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries. PALLIATIVE MEDICINE, 28(2), 101–110.
Chicago author-date
Higginson, Irene J, Barbara Gomes, Natalia Calanzani, Wei Gao, Claudia Bausewein, Barbara A Daveson, Luc Deliens, et al. 2014. “Priorities for Treatment, Care and Information If Faced with Serious Illness: a Comparative Population-based Survey in Seven European Countries.” Palliative Medicine 28 (2): 101–110.
Chicago author-date (all authors)
Higginson, Irene J, Barbara Gomes, Natalia Calanzani, Wei Gao, Claudia Bausewein, Barbara A Daveson, Luc Deliens, Pedro L Ferreira, Franco Toscani, Marjolein Gysels, Lucas Ceulemans, Steffen T Simon, Joachim Cohen, and Richard Harding. 2014. “Priorities for Treatment, Care and Information If Faced with Serious Illness: a Comparative Population-based Survey in Seven European Countries.” Palliative Medicine 28 (2): 101–110.
Vancouver
1.
Higginson IJ, Gomes B, Calanzani N, Gao W, Bausewein C, Daveson BA, et al. Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries. PALLIATIVE MEDICINE. 2014;28(2):101–10.
IEEE
[1]
I. J. Higginson et al., “Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries,” PALLIATIVE MEDICINE, vol. 28, no. 2, pp. 101–110, 2014.
@article{5770032,
  abstract     = {Background: Health-care costs are growing, with little population-based data about people's priorities for end-of-life care, to guide service development and aid discussions. 
Aim: We examined variations in people's priorities for treatment, care and information across seven European countries. 
Design: Telephone survey of a random sample of households; we asked respondents their priorities if faced with a serious illness, like cancer, with limited time to live' and used multivariable logistic regressions to identify associated factors. 
Setting/participants: Members of the general public aged 16 years residing in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. 
Results: In total, 9344 individuals were interviewed. Most people chose improve quality of life for the time they had left', ranging from 57% (95% confidence interval: 55%-60%, Italy) to 81% (95% confidence interval: 79%-83%, Spain). Only 2% (95% confidence interval: 1%-3%, England) to 6% (95% confidence interval: 4%-7%, Flanders) said extending life was most important, and 15% (95% confidence interval: 13%-17%, Spain) to 40% (95% confidence interval: 37%-43%, Italy) said quality and extension were equally important. Prioritising quality of life was associated with higher education in all countries (odds ratio = 1.3 (Flanders) to 7.9 (Italy)), experience of caregiving or bereavement (England, Germany, Portugal), prioritising pain/symptom control over having a positive attitude and preferring death in a hospice/palliative care unit. Those prioritising extending life had the highest home death preference of all groups. Health status did not affect priorities. 
Conclusions: Across all countries, extending life was prioritised by a minority, regardless of health status. Treatment and care needs to be reoriented with patient education and palliative care becoming mainstream for serious conditions such as cancer.},
  author       = {Higginson, Irene J and Gomes, Barbara and Calanzani, Natalia and Gao, Wei and Bausewein, Claudia and Daveson, Barbara A and Deliens, Luc and Ferreira, Pedro L and Toscani, Franco and Gysels, Marjolein and Ceulemans, Lucas and Simon, Steffen T and Cohen, Joachim and Harding, Richard},
  issn         = {0269-2163},
  journal      = {PALLIATIVE MEDICINE},
  keywords     = {quality of life,END-OF-LIFE,palliative care,life extension,cross-cultural comparison,Decision making,PALLIATIVE CARE,ADVANCED CANCER,RESPONSE RATES,ATTITUDES,PREFERENCES,DEATH,AWARENESS,PORTUGAL,QUALITY},
  language     = {eng},
  number       = {2},
  pages        = {101--110},
  title        = {Priorities for treatment, care and information if faced with serious illness: a comparative population-based survey in seven European countries},
  url          = {http://dx.doi.org/10.1177/0269216313488989},
  volume       = {28},
  year         = {2014},
}

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