Associations between successful palliative trajectories, place of death and GP involvement

Scand J Prim Health Care. 2010 Sep;28(3):138-45. doi: 10.3109/02813432.2010.505316.

Abstract

Objective: General practitioner (GP) involvement may be instrumental in obtaining successful palliative cancer trajectories. The aim of the study was to examine associations between bereaved relatives' evaluation of palliative cancer trajectories, place of death, and GP involvement.

Design: Population-based, cross-sectional combined register and questionnaire study.

Setting: The former Aarhus County, Denmark.

Subjects: Questionnaire data on GPs' palliative efforts and relatives' evaluations of the palliative trajectories were obtained for 153 cases of deceased cancer patients.

Main outcome measures: A successful palliative trajectory as evaluated retrospectively by the relatives.

Results: Successful palliative trajectories were statistically significantly associated with home death (PR 1.48 (95% CI 1.04; 2.12)). No significant associations were identified between the evaluations of the palliative trajectory at home and GP involvement. "Relative living with patient" (PR 1.75 (95% CI: 0.87; 3.53)) and "GP having contact with relatives" (PR 1.69 (95% CI 0.55; 5.19)) were not significantly associated, but this may be due to the poor number of cases included in the final analysis.

Conclusion: This study indicates that home death is positively associated with a higher likelihood that bereaved relatives will evaluate the palliative trajectory at home as successful. No specific GP services that were statistically significantly associated with higher satisfaction among relatives could be identified, but contact between GPs and relatives seems important and the impact needs further investigation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude to Death
  • Cross-Sectional Studies
  • Denmark
  • Family Practice
  • Female
  • Home Care Services
  • House Calls
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / nursing
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Palliative Care* / methods
  • Physician's Role
  • Physicians, Family / psychology
  • Professional-Family Relations
  • Registries
  • Retrospective Studies
  • Surveys and Questionnaires
  • Terminal Care* / methods
  • Workforce