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End of life care in high-grade glioma patients in three European countries: a comparative study

(2014) JOURNAL OF NEURO-ONCOLOGY. 120(2). p.303-310
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Abstract
Exploring cross-national differences is useful to evaluate whether different patterns of end of life (EOL) care meet patient's specific needs. This study aimed to (1) compare EOL care processes for high-grade glioma (HGG) patients in three European countries, (2) explore differences in perceived quality of care (QOC), and (3) identify aspects of good QOC in the EOL phase. We analyzed 207 questionnaires from relatives of deceased HGG patients, using a similar retrospective study design in three countries [The Netherlands (n = 83), Austria (n = 72) and the UK (n = 52)], and examined four subthemes: (1) organization of EOL care, (2) treatment preferences, (3) experiences with EOL care, (4) perceived QOC. Three months before death 75 % of patients were at home. In all countries, on average, 50 % were transferred to a hospital at least once and received effective symptom treatment during the last 3 months. In The Netherlands, Austria and UK, respectively, patients most often died at home (60 %), in a hospital (41 %) or hospice (41 %) (p < 0.001). Advance directives were present in 46 % of Dutch, 36 % of British and 6 % of Austrian patients (p < 0.001). Fifty-three percent of patients experienced good QOC, irrespective of country. Dying at the preferred place, satisfaction with information provided and effective symptom treatment were independently associated with good QOC. There are various cross-national differences in organization and experiences with EOL care for HGG, but patient's perceived QOC is similar in the three countries. As symptom treatment was considered effective in only half of HGG patients, and independently predicted good QOC, this particularly needs further improvement in all countries.
Keywords
End of life, Patient satisfaction, Advance directives, Supportive care, Brain tumor, Glioma, QUALITY-OF-LIFE, PALLIATIVE CARE, BRAIN-TUMOR, METASTATIC CANCER, DECISION-MAKING, PHASE, DEATH, NETHERLANDS, GLIOBLASTOMA, INDICATORS

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Citation

Please use this url to cite or link to this publication:

Chicago
Koekkoek, JAF, L Dirven, JC Reijneveld, EM Sizoo, HRW Pasman, TJ Postma, Luc Deliens, et al. 2014. “End of Life Care in High-grade Glioma Patients in Three European Countries: a Comparative Study.” Journal of Neuro-oncology 120 (2): 303–310.
APA
Koekkoek, J., Dirven, L., Reijneveld, J., Sizoo, E., Pasman, H., Postma, T., Deliens, L., et al. (2014). End of life care in high-grade glioma patients in three European countries: a comparative study. JOURNAL OF NEURO-ONCOLOGY, 120(2), 303–310.
Vancouver
1.
Koekkoek J, Dirven L, Reijneveld J, Sizoo E, Pasman H, Postma T, et al. End of life care in high-grade glioma patients in three European countries: a comparative study. JOURNAL OF NEURO-ONCOLOGY. 2014;120(2):303–10.
MLA
Koekkoek, JAF, L Dirven, JC Reijneveld, et al. “End of Life Care in High-grade Glioma Patients in Three European Countries: a Comparative Study.” JOURNAL OF NEURO-ONCOLOGY 120.2 (2014): 303–310. Print.
@article{5803699,
  abstract     = {Exploring cross-national differences is useful to evaluate whether different patterns of end of life (EOL) care meet patient's specific needs. This study aimed to (1) compare EOL care processes for high-grade glioma (HGG) patients in three European countries, (2) explore differences in perceived quality of care (QOC), and (3) identify aspects of good QOC in the EOL phase. We analyzed 207 questionnaires from relatives of deceased HGG patients, using a similar retrospective study design in three countries [The Netherlands (n = 83), Austria (n = 72) and the UK (n = 52)], and examined four subthemes: (1) organization of EOL care, (2) treatment preferences, (3) experiences with EOL care, (4) perceived QOC. Three months before death 75 % of patients were at home. In all countries, on average, 50 % were transferred to a hospital at least once and received effective symptom treatment during the last 3 months. In The Netherlands, Austria and UK, respectively, patients most often died at home (60 %), in a hospital (41 %) or hospice (41 %) (p < 0.001). Advance directives were present in 46 % of Dutch, 36 % of British and 6 % of Austrian patients (p < 0.001). Fifty-three percent of patients experienced good QOC, irrespective of country. Dying at the preferred place, satisfaction with information provided and effective symptom treatment were independently associated with good QOC. There are various cross-national differences in organization and experiences with EOL care for HGG, but patient's perceived QOC is similar in the three countries. As symptom treatment was considered effective in only half of HGG patients, and independently predicted good QOC, this particularly needs further improvement in all countries.},
  author       = {Koekkoek, JAF and Dirven, L and Reijneveld, JC and Sizoo, EM and Pasman, HRW and Postma, TJ and Deliens, Luc and Grant, R and McNamara, S and Grisold, W and Medicus, E and Stockhammer, G and Oberndorfer, S and Flechl, B and Marosi, C and Taphoorn, MJB and Heimans, JJ},
  issn         = {0167-594X},
  journal      = {JOURNAL OF NEURO-ONCOLOGY},
  keywords     = {End of life,Patient satisfaction,Advance directives,Supportive care,Brain tumor,Glioma,QUALITY-OF-LIFE,PALLIATIVE CARE,BRAIN-TUMOR,METASTATIC CANCER,DECISION-MAKING,PHASE,DEATH,NETHERLANDS,GLIOBLASTOMA,INDICATORS},
  language     = {eng},
  number       = {2},
  pages        = {303--310},
  title        = {End of life care in high-grade glioma patients in three European countries: a comparative study},
  url          = {http://dx.doi.org/10.1007/s11060-014-1548-5},
  volume       = {120},
  year         = {2014},
}

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