Abstract
This study aimed to explore the effectiveness of an inpatient hospice palliative care unit (PCU) and palliative consultation service (PCS) on comprehensive quality of life outcome (CoQoLo) among terminally ill cancer patients. This was a prospective longitudinal study. Terminally ill cancer patients who met the inclusion criteria and received PCU or PCS in a northern Taiwanese medical center were recruited. The CoQoLo Inventory was used to measure CoQoLo level pre- and seven days following hospice care between August 2018 and October 2019. A total of 90 patients completed the study. No significant differences were found in CoQoLo levels between the PCU and PCS groups pre- and seven days following care. However, the CoQoLo level of patients significantly improved seven days following care in both PCU and PCS groups, compared with pre-hospice care. Patients’ age, religious belief, marital status, closeness with family, palliative prognostic index (PPI), and symptom severity were significant concerning CoQoLo levels after adjusting for patients’ baseline characteristics. PCU and PCS showed no difference in CoQoLo levels, but both of them can improve CoQoLo among terminally ill cancer patients. These patients could receive PCU or PCS to achieve a good CoQoLo at the end-of-life stage.
Highlights
No significant differences in baseline characteristics were noticed between the two groups
We found that there were no significant differences in the levels of comprehensive quality of life outcome (CoQoLo) between the palliative care unit (PCU) and palliative consultation service (PCS) groups
In Taiwan, our government has been actively promoting PCS due to the limited number of beds with regard to PCU. We expected that this policy could lead to more terminally ill patients receiving PCU or PCS in order to achieve a good CoQoLo in the end stage
Summary
Cancer was still the second leading cause of death in the United States in 2018 [1]. A statistical survey estimated 1,806,590 new cancer cases and 606,520 related deaths in the United States in 2020 [2]. Cancer has been ranked as the tenth cause of death in Taiwan for over 35 years [3]. To enhance the quality of life of terminally ill patients, hospice palliative care (HPC) has been advocated by the Ministry of Health and Welfare of Taiwan since 1996 [4], and the country’s legislative body passed the Hospice 4.0/).
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