BACKGROUND:
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.
Source: 'Burden to others' as a public concern in advanced
cancer: a comparative survey in seven European countries. Bausewein C (claudia.bausewein@kcl.ac.uk),
Calanzani N, Daveson BA, Simon ST, Ferreira PL, Higginson IJ, Bechinger-English
D, Deliens L, Gysels M, Toscani F, Ceulemans L, Harding R, Gomes B. BMC Cancer.
2013 Mar 8;13(1):105.
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