Influence of telling patients chemotherapeutic endpoints on quality of terminal care

ABSTRACT

<b>Purpose</b> The aim of this study was to evaluate the influence of informing patients of the endpoints of palliative chemotherapy on the quality of care for terminally ill cancer patients. <b>Methods</b> Of 85 advanced cancer patients who died at our hospital during the last 2 years, 53 patients who received palliative chemotherapy were recruited for this study. The patients were divided into three groups based on whether disease status and treatment endpoints were explained to the patient before the chemotherapy group A; both the disease status and treatment endpoint were explained, group B; only the disease status was explained, and group C; neither were explained.Japanese version of Support Team Assessment Schedule (STAS-J) was used to evaluate the quality of care for the patients. <b>Results</b> Of the 53 patients, 17, 22, and 14 cases were assigned to group A, group B, and group C, respectively. Changing gear, that is, stopping palliative chemotherapy followed by palliative care, was well accepted by 88%, 41%, and 0% of group A, B, and C patients, respectively (p<0.01). By using the STAS-J, it was revealed that there were no significant differences in either symptom control or in anxiety among the groups, but there were significant differences in insight of advanced disease and communication to others (p<0.001). <b>Conclusion</b> When performing palliative chemotherapy in advanced cancer patients, they should be informed of its endpoint before beginning the chemotherapy. This will lead to successful ′changing gear, ′ and improvement of the quality of care for terminally ill cancer patients.