Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 3;12(2):e0171365.
doi: 10.1371/journal.pone.0171365. eCollection 2017.

The Effects of Hospice-Shared Care for Gastric Cancer Patients

Affiliations
Free PMC article

The Effects of Hospice-Shared Care for Gastric Cancer Patients

Kun-Siang Huang et al. PLoS One. .
Free PMC article

Abstract

Background: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients.

Methods: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81).

Results: Among the 174 patients, 84% had advanced stage (stage III or stage IV) cancer. The females and the patients cared by medical oncologists had a higher percentage of hospice-shared care than the males (71% vs 44%, p = 0.001) and those cared by other physicians (63% vs 41%, p = 0.004). Compared to the control group, the hospice-shared care group underwent lower incidence of life sustaining or aggressive medical treatments, including intensive care unit admission (2% vs 26%, p<0.001), intubation (1% vs 27%, p<0.001), cardiopulmonary-cerebral resuscitation (0% vs 11%, p = 0.001), ventilator use (1% vs 27%, p<0.001), inotropic agent use (8% vs 46%, p<0.001), total or partial parenteral nutrition use (38% vs. 58%, p = 0.029), and blood transfusion (45% vs 74%, p<0.001). Besides, the hospice-shared care group had a higher percentage of palliative treatments than the control group, including signed Do-Not-Resuscitate (DNR) orders (95% vs 37%, p<0.001), receiving home hospice care (16% vs 1%, p<0.001), and indicating home as the realistically preferred place of death (41% vs 19%, p = 0.001). The hospice ward admission rate in the hospice-shared care group increased from 30% to 53% from 2012 to 2014.

Conclusion: The use of hospice-shared care for gastric cancer patients could increase the rate of signed DNR orders, decrease the use of life sustaining and aggressive/palliative treatments, and improve quality of life.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The hospice ward admission rates of the gastric cancer patients who received hospice care.

Similar articles

See all similar articles

Cited by 2 articles

References

    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108. 10.3322/caac.21262 - DOI - PubMed
    1. Ministry of Health and Welfare T. http://www.mohw.gov.tw/CHT/DOS/DisplayStatisticFile.aspx?d=49775.
    1. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA. 2003;289(18):2387–92. 10.1001/jama.289.18.2387 - DOI - PubMed
    1. Hong JH, Rho SY, Hong YS. Trends in the Aggressiveness of End-of-Life Care for Advanced Stomach Cancer Patients. Cancer Res Treat. 2013;45(4):270–5. 10.4143/crt.2013.45.4.270 - DOI - PMC - PubMed
    1. Liu CN, Yang MC. National health insurance expenditure for adult beneficiaries in Taiwan in their last year of life. J Formos Med Assoc. 2002;101(8):552–9. - PubMed

Grant support

The authors received no specific funding for this work.
Feedback