Authors (including presenting author) :
NG KL (1)(2), NG KUG (1)(2), WONG WYT (1)(2)
Affiliation :
(1) Department of Medicine and Geriatrics, (2) Caritas Medical Centre
Introduction :
Department of Medicine and Geriatrics (M&G) has enhanced nurses’ skills and knowledge in end-of-life care (EOLC) in acute & rehabilitation wards since 2013. There is no prior study to explore any differences in EOLC among cancer deaths in palliative care unit (PCU) and general settings; a cross-sectional study was conducted in 2016.
Objectives :
To review patients’ profiles and nursing interventions during EOL for cancer patients in PCU and general settings.
Methodology :
Cohort study in case notes review on decreased cancer patients in PCU and general settings from 1 January 2016 to 30 June 2016. Descriptive statistics and Chi-square test were used for statistical analysis.
Result & Outcome :
217 cancer deaths were recruited, 66.4% (n=144) were cared in PCU, the remaining (33.6%, n=73) were in acute & rehabilitation wards. Time of deterioration before death were 4.19 ± 6.21 and 2.0 ± 2.22 respectively. 100% (n=141) of cancer patients in PCU had palliative care specialists and palliative nurse inputs, compared with those in general settings (61.6% & 56.2%). No cancer patients in PCU received non-invasive and or invasive mechanical ventilator (NIV+/- IMV) supports. 21.9% (n=16) of them with NIV+/- IMV supports in general wards. Deceased patients in both settings presented with dyspnoea were (47.9% vs. 43.8%), more pain were observed (54.2% vs. 17.8%), more nausea / vomiting (22.9% vs. 9.6%), and had fever (22.9% vs. 9.6%), all p<0.001. Both settings had facilitated families with flexible visiting (94.4% vs. 72.6%), accompanied by bedside (88.2% vs. 75.3%) and put on own stroud for last office (92.4% vs. 80.8%), all p<0.001. This Cohort study reveals differences remain in EOLC on cancer patients between PCU and general settings even after continuous efforts in promoting EOLC. PC specialists / nurses joint care provided significant inputs on symptoms management and quality EOLC
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