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'Burden to others' as a public concern in advanced cancer : a comparative survey in seven European countries

(2013) BMC CANCER. 13.
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Organization
Abstract
Background: Europe faces an enormous public health challenge with aging populations and rising cancer incidence. Little is known about what concerns the public across European countries regarding cancer care towards the end of life. We aimed to compare the level of public concern with different symptoms and problems in advanced cancer across Europe and examine factors influencing this. Methods: Telephone survey with 9,344 individuals aged >= 16 in England, Flanders, Germany, Italy, Netherlands, Portugal and Spain. Participants were asked about nine symptoms and problems, imagining a situation of advanced cancer with less than one year to live. These were ranked and the three top concerns examined in detail. As 'burden to others' showed most variation within and between countries, we determined the relative influence of factors on this concern using GEE and logistic regression. Results: Overall response rate was 21%. Pain was the top concern in all countries, from 34% participants (Italy) to 49% (Flanders). Burden was second in England, Germany, Italy, Portugal, and Spain. Breathlessness was second in Flanders and the Netherlands. Concern with burden was independently associated with age (70+ years, OR 1.50; 95%CI 1.24-1.82), living alone (OR 0.82, 95%CI 0.73-0.93) and preferring quality rather than quantity of life (OR 1.43, 95%CI 1.14-1.80). Conclusions: When imagining a last year of life with cancer, the public is not only concerned about medical problems but also about being a burden. Public education about palliative care and symptom control is needed. Cancer care should include a routine assessment and management of social concerns, particularly for older patients with poor prognosis.
Keywords
TERMINALLY-ILL, LIFE, ISSUES SURROUNDING DEATH, PAIN, CARE, END, PERSPECTIVES, PREFERENCES, PREVALENCE, ATTITUDES

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MLA
Bausewein, Claudia, Natalia Calanzani, Barbara A Daveson, et al. “‘Burden to Others’ as a Public Concern in Advanced Cancer : a Comparative Survey in Seven European Countries.” BMC CANCER 13 (2013): n. pag. Print.
APA
Bausewein, Claudia, Calanzani, N., Daveson, B. A., Simon, S. T., Ferreira, P. L., Higginson, I. J., Bechinger-English, D., et al. (2013). “Burden to others” as a public concern in advanced cancer : a comparative survey in seven European countries. BMC CANCER, 13.
Chicago author-date
Bausewein, Claudia, Natalia Calanzani, Barbara A Daveson, Steffen T Simon, Pedro L Ferreira, Irene J Higginson, Dorothée Bechinger-English, et al. 2013. “‘Burden to Others’ as a Public Concern in Advanced Cancer : a Comparative Survey in Seven European Countries.” Bmc Cancer 13.
Chicago author-date (all authors)
Bausewein, Claudia, Natalia Calanzani, Barbara A Daveson, Steffen T Simon, Pedro L Ferreira, Irene J Higginson, Dorothée Bechinger-English, Luc Deliens, Marjolein Gysels, Franco Toscani, Lucas Ceulemans, Richard Harding, and Barbara Gomes. 2013. “‘Burden to Others’ as a Public Concern in Advanced Cancer : a Comparative Survey in Seven European Countries.” Bmc Cancer 13.
Vancouver
1.
Bausewein C, Calanzani N, Daveson BA, Simon ST, Ferreira PL, Higginson IJ, et al. “Burden to others” as a public concern in advanced cancer : a comparative survey in seven European countries. BMC CANCER. 2013;13.
IEEE
[1]
C. Bausewein et al., “‘Burden to others’ as a public concern in advanced cancer : a comparative survey in seven European countries,” BMC CANCER, vol. 13, 2013.
@article{5811087,
  abstract     = {Background: Europe faces an enormous public health challenge with aging populations and rising cancer incidence. Little is known about what concerns the public across European countries regarding cancer care towards the end of life. We aimed to compare the level of public concern with different symptoms and problems in advanced cancer across Europe and examine factors influencing this. 
Methods: Telephone survey with 9,344 individuals aged >= 16 in England, Flanders, Germany, Italy, Netherlands, Portugal and Spain. Participants were asked about nine symptoms and problems, imagining a situation of advanced cancer with less than one year to live. These were ranked and the three top concerns examined in detail. As 'burden to others' showed most variation within and between countries, we determined the relative influence of factors on this concern using GEE and logistic regression. 
Results: Overall response rate was 21%. Pain was the top concern in all countries, from 34% participants (Italy) to 49% (Flanders). Burden was second in England, Germany, Italy, Portugal, and Spain. Breathlessness was second in Flanders and the Netherlands. Concern with burden was independently associated with age (70+ years, OR 1.50; 95%CI 1.24-1.82), living alone (OR 0.82, 95%CI 0.73-0.93) and preferring quality rather than quantity of life (OR 1.43, 95%CI 1.14-1.80). 
Conclusions: When imagining a last year of life with cancer, the public is not only concerned about medical problems but also about being a burden. Public education about palliative care and symptom control is needed. Cancer care should include a routine assessment and management of social concerns, particularly for older patients with poor prognosis.},
  articleno    = {105},
  author       = {Bausewein, Claudia and Calanzani, Natalia and Daveson, Barbara A and Simon, Steffen T and Ferreira, Pedro L and Higginson, Irene J and Bechinger-English, Dorothée and Deliens, Luc and Gysels, Marjolein and Toscani, Franco and Ceulemans, Lucas and Harding, Richard and Gomes, Barbara},
  issn         = {1471-2407},
  journal      = {BMC CANCER},
  keywords     = {TERMINALLY-ILL,LIFE,ISSUES SURROUNDING DEATH,PAIN,CARE,END,PERSPECTIVES,PREFERENCES,PREVALENCE,ATTITUDES},
  language     = {eng},
  pages        = {11},
  title        = {'Burden to others' as a public concern in advanced cancer : a comparative survey in seven European countries},
  url          = {http://dx.doi.org/10.1186/1471-2407-13-105},
  volume       = {13},
  year         = {2013},
}

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