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BMJ. 1990 Aug 4; 301(6746): 277–281.
PMCID: PMC1663479

Palliative care: views of patients and their families.


OBJECTIVE--To investigate the current problems and needs of terminally ill cancer patients and their family members, and to discover their views of hospital, community, and support team services. DESIGN--Prospective study of patients and families by questionnaire interviews in the patients' homes. SETTING--Inner London and north Kent (London suburbs). SUBJECTS--65 Patients, each with a member of their family or a career. MAIN OUTCOME MEASURES--Ratings of eight current problems and ratings and comments on three services-hospital doctors and nurses, general practitioners and district nurses, and the support team staff-obtained after a minimum of two weeks' care from palliative care support teams. RESULTS--Effect of anxiety on the patient's nearest career. and symptom control were rated as the most severe current problems by both patients and families; a few patients and families identified other severe problems. Families' ratings of pain control, symptom control, and effect of anxiety on the patient were significantly worse than the patients' ratings (p less than 0.05). Support teams received the most praise, being rated by 58 (89%) patients and 59 (91%) of family members as good as excellent. General practitioners and district nurses were rated good or excellent by 46 (71%) patients and 46 (71%) family members, but six (9%) in each group rated the service as poor or very bad, and ratings in the inner London district were significantly worse than those in the outer London district. Hospital doctors and nurses were rated good or excellent by 22 (34%) patients and 35 (54%) of family members, and 14 (22%) patients and 15 (23%) family members rated this service as poor or very bad. Negative comments referred to communication (especially at diagnosis), coordination of services, the attitude of the doctor, delays in diagnosis, and difficulties in getting doctors to visit at home. Family members were more satisfied with the services than were patients. CONCLUSIONS--Palliative care needs to include both the patient and family because the needs of the family may exceed those of the patient. Support teams and some hospital and community doctors and nurses met the perceived needs of dying patients and families, but better education and organisation of services are needed.

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Selected References

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  • Haines A, Booroff A. Terminal care at home: perspective from general practice. Br Med J (Clin Res Ed) 1986 Apr 19;292(6527):1051–1053. [PMC free article] [PubMed]
  • Seale CF. What happens in hospices: a review of research evidence. Soc Sci Med. 1989;28(6):551–559. [PubMed]
  • Copperman H. Domiciliary hospice care: a survey of general practitioners. J R Coll Gen Pract. 1988 Sep;38(314):411–413. [PMC free article] [PubMed]
  • Lunt B. Terminal cancer care services: recent changes in regional inequalities in Great Britain. Soc Sci Med. 1985;20(7):753–759. [PubMed]
  • Hinton J. Comparison of places and policies for terminal care. Lancet. 1979 Jan 6;1(8106):29–32. [PubMed]
  • Parkes CM, Parkes J. 'Hospice' versus 'hospital' care--re-evaluation after 10 years as seen by surviving spouses. Postgrad Med J. 1984 Feb;60(700):120–124. [PMC free article] [PubMed]
  • Higginson I, McCarthy M. Measuring symptoms in terminal cancer: are pain and dyspnoea controlled? J R Soc Med. 1989 May;82(5):264–267. [PMC free article] [PubMed]
  • Parkes CM. Home or hospital? Terminal care as seen by surviving spouses. J R Coll Gen Pract. 1978 Jan;28(186):19–30. [PMC free article] [PubMed]
  • Gilley J. Intimacy and terminal care. J R Coll Gen Pract. 1988 Mar;38(308):121–122. [PMC free article] [PubMed]
  • Maguire P, Faulkner A. Communicate with cancer patients: 2. Handling uncertainty, collusion, and denial. BMJ. 1988 Oct 15;297(6654):972–974. [PMC free article] [PubMed]

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