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Praying, Avoiding Hospitalization, Improve Qulaity of Life for Dying Cancer Patients, Study

Praying, Avoiding Hospitalization, Improve Qulaity of Life for Dying Cancer Patients, Study

(ePharmaNews) – A new report published in the Archives of Internal Medicine suggests that better quality of life at the end of life for patients with advanced cancer was associated with avoiding hospitalizations and the intensive care unit, worrying less, praying or meditating, being visited by a pastor in a hospital or clinic, and having a therapeutic alliance with their physician.

Doctors often shift the focus from extending life to improving the quality of life (QOL) at the end of life (EOL) when treatments to cure a patient’s cancer are no longer an option.

“The aim of this study was to identify the best set of predictors of QOL of patients in their final week of life. By doing so, we identify promising targets for health care interventions to improve QOL of dying patients,” the authors note.

The study, conducted by Baohui Zhang, M.S., formerly of the Dana-Farber Cancer Institute, Boston, and colleagues, included 396 patients with advanced cancer and their caregivers as part of the Coping with Cancer study. The average age of patients was almost 59 years.

“Two of the most important determinants of poor patient quality QOL at the EOL were dying in a hospital and ICU stays in the last week of life. Therefore, attempts to avoid costly hospitalizations and to encourage transfer of hospitalized patients to home or hospice might improve patient QOL at the EOL,” the authors said.

The authors focused their attention on nine factors in the patients’ lives: intensive care stays in the final week, hospital deaths, patient worry at baseline, religious prayer or meditation at baseline, site of cancer care, feeding tube use in the final week, pastoral care within the hospital or clinic, chemotherapy in the final week, and a patient-physician therapeutic alliance where the patient felt they were treated as a “whole person”.

“One of the most influential predictors of worse QOL at the EOL,” the authors noted, was patient worry at baseline.

“By reducing patient worry, encouraging contemplation, integrating pastoral care within medical care, fostering a therapeutic alliance between patient and physician that enables patients to feel dignified, and preventing unnecessary hospitalizations and receipt of life-prolonging care, physicians can enable their patients to live their last days with the highest possible level of comfort and care,” the authors conclude.

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Prepared by: Laila Nour

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