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The end-of-life phase of high-grade glioma patients: dying with dignity?

(2013) ONCOLOGIST. 18(2). p.198-203
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Organization
Abstract
Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. Methods. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) healthrelated quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. Results. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. Conclusions. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life.
Keywords
Quality of life, Quality of care, End of life, Dignity, High grade glioma, DECISION-MAKING, PALLIATIVE CARE, TERMINALLY ILL, BRAIN-TUMORS, DEATH, COMMUNICATION, FACILITATORS, ASSOCIATIONS, PREFERENCES, DISCUSSIONS

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Citation

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MLA
Sizoo, Eefje M, Martin JB Taphoorn, Bernard Uitdehaag, et al. “The End-of-life Phase of High-grade Glioma Patients: Dying with Dignity?” ONCOLOGIST 18.2 (2013): 198–203. Print.
APA
Sizoo, E. M., Taphoorn, M. J., Uitdehaag, B., Heimans, J. J., Deliens, L., Reijneveld, J. C., & Pasman, H. R. W. (2013). The end-of-life phase of high-grade glioma patients: dying with dignity? ONCOLOGIST, 18(2), 198–203.
Chicago author-date
Sizoo, Eefje M, Martin JB Taphoorn, Bernard Uitdehaag, Jan J Heimans, Luc Deliens, Jan C Reijneveld, and H Roeline W Pasman. 2013. “The End-of-life Phase of High-grade Glioma Patients: Dying with Dignity?” Oncologist 18 (2): 198–203.
Chicago author-date (all authors)
Sizoo, Eefje M, Martin JB Taphoorn, Bernard Uitdehaag, Jan J Heimans, Luc Deliens, Jan C Reijneveld, and H Roeline W Pasman. 2013. “The End-of-life Phase of High-grade Glioma Patients: Dying with Dignity?” Oncologist 18 (2): 198–203.
Vancouver
1.
Sizoo EM, Taphoorn MJ, Uitdehaag B, Heimans JJ, Deliens L, Reijneveld JC, et al. The end-of-life phase of high-grade glioma patients: dying with dignity? ONCOLOGIST. 2013;18(2):198–203.
IEEE
[1]
E. M. Sizoo et al., “The end-of-life phase of high-grade glioma patients: dying with dignity?,” ONCOLOGIST, vol. 18, no. 2, pp. 198–203, 2013.
@article{5811182,
  abstract     = {Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as perceived by their relatives and (b) identify disease and care factors correlated with dying with dignity in HGG patients. 
Methods. We approached relatives of a cohort of 155 deceased HGG patients for the study. Participants completed a questionnaire concerning the EOL phase of the patient, covering several subthemes: (a) symptoms and signs, (b) healthrelated quality of life, (c) decision making, (d) place and quality of EOL care, and (e) dying with dignity. 
Results. Relatives of 81 patients participated and 75% indicated that the patient died with dignity. These patients had fewer communication deficits, experienced fewer transitions between health care settings in the EOL phase, and more frequently died at their preferred place of death. Relatives were more satisfied with the physician providing EOL care and reported that the physician adequately explained treatment options. Multivariate analysis identified satisfaction with the physician, the ability to communicate, and the absence of transitions between settings as most predictive of a dignified death. 
Conclusions. Physicians caring for HGG patients in the EOL phase should timely focus on explaining possible treatment options, because patients experience communication deficits toward death. Physicians should strive to allow patients to die at their preferred place and avoid transitions during the last month of life.},
  author       = {Sizoo, Eefje M and Taphoorn, Martin JB and Uitdehaag, Bernard and Heimans, Jan J and Deliens, Luc and Reijneveld, Jan C and Pasman, H Roeline W},
  issn         = {1083-7159},
  journal      = {ONCOLOGIST},
  keywords     = {Quality of life,Quality of care,End of life,Dignity,High grade glioma,DECISION-MAKING,PALLIATIVE CARE,TERMINALLY ILL,BRAIN-TUMORS,DEATH,COMMUNICATION,FACILITATORS,ASSOCIATIONS,PREFERENCES,DISCUSSIONS},
  language     = {eng},
  number       = {2},
  pages        = {198--203},
  title        = {The end-of-life phase of high-grade glioma patients: dying with dignity?},
  url          = {http://dx.doi.org/10.1634/theoncologist.2012-0247},
  volume       = {18},
  year         = {2013},
}

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