End-of-life caregivers' perception of medical and psychological support during the final weeks of glioma patients: A questionnaire-based survey

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Oliver Heese - , University of Hamburg, Ludwig Maximilian University of Munich (Author)
  • Eva Vogeler - , University of Hamburg (Author)
  • Tobias Martens - , University of Hamburg (Author)
  • Oliver Schnell - , Ludwig Maximilian University of Munich (Author)
  • Jörg Christian Tonn - , Ludwig Maximilian University of Munich (Author)
  • Matthias Simon - , University of Bonn (Author)
  • Johannes Schramm - , University of Bonn (Author)
  • Dietmar Krex - , Department of Neurosurgery, TUD Dresden University of Technology (Author)
  • Gabriele Schackert - , TUD Dresden University of Technology (Author)
  • Thomas Reithmeier - , University of Freiburg (Author)
  • Guido Nikkhah - , University of Freiburg (Author)
  • Michael Sabel - , Heinrich Heine University Düsseldorf (Author)
  • Hans Jakob Steiger - , Heinrich Heine University Düsseldorf (Author)
  • Uwe Schlegel - , Ruhr University Bochum (Author)
  • Markus Löffler - , Leipzig University (Author)
  • Michael Weller - , University of Zurich (Author)
  • Manfred Westphal - , University of Hamburg (Author)

Abstract

BackgroundThe prognosis for glioma remains dismal, and little is known about the final disease phase. To obtain information about this period, we surveyed caregivers of patients who were registered in the German Glioma Network and who died from the disease.MethodsA questionnaire with 15 items, focusing on medical, logistic, and mental health support and symptom control during the final 4 weeks, was sent to caregivers. For some of the questions, a scale from 1 (inadequate) to 10 (excellent) was used.ResultsOf 1655 questionnaires, 605 were returned (36.6%) and evaluated. We found that 67.9% of the patients were taken care of at home for the last 4 weeks; 47.7% died at home, 22.6% died in hospitals, and 19.3% died in hospice facilities. Medical support was provided by general practitioners in 72.3% of cases, by physicians affiliated with a nursing home or hospice in 29.9%, and by general oncologists in 17%. Specialized neuro-oncologists were involved in 6%. The caregivers ranked the medical support with a mean of 7.2 (using a 10-point scale), nursing service with 8.1, and mental health support with 5.5. In 22.9% of cases, no support for the caregivers themselves was offered by medical institutions.ConclusionsAlthough these data reflect the caregivers' subjective views, they are useful in understanding and improving current patterns of care. While patients and their caregivers are supported mainly by neuro-oncologists for most of the disease phase, the end-of-life phase is managed predominantly by general practitioners and specialists in palliative care. Close cooperation between these specialties is necessary to meet the specific needs of glioma patients.

Details

Original languageEnglish
Pages (from-to)1251-1256
Number of pages6
JournalNeuro-oncology
Volume15
Issue number9
Publication statusPublished - Sept 2013
Peer-reviewedYes

External IDs

PubMed 23814266

Keywords

Sustainable Development Goals

Keywords

  • glioma, palliative care, supportive therapy