Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T05:29:14.941Z Has data issue: false hasContentIssue false

Palliative care among adult cancer survivors: Knowledge, attitudes, and correlates

Published online by Cambridge University Press:  22 June 2021

Julia Stal*
Affiliation:
Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
Mary Baron Nelson
Affiliation:
Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Medical Education, Keck School of Medicine of the University of Southern California, Los Angeles, CA
Erin M. Mobley
Affiliation:
Department of Surgery, College of Medicine, University of Florida, Jacksonville, FL
Carol Y. Ochoa
Affiliation:
Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
Joel E. Milam
Affiliation:
School of Medicine, Department of Epidemiology and Biostatistics, Chao Family Comprehensive Cancer Center, University of California, Irvine, CA
David R. Freyer
Affiliation:
Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CA USC Norris Comprehensive Cancer Center, Los Angeles, CA Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA
Kimberly A. Miller
Affiliation:
Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
*
Author for correspondence: Julia Stal, Department of Preventive Medicine, Keck School of Medicine of USC, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA 90032, USA. E-mail: [email protected]

Abstract

Objective

Palliative care (PC) is patient and family-centered supportive care intended to improve symptom management, reduce caregiver burden, coordinate care, and improve quality of life for patients diagnosed with serious illness. Optimally, PC is begun close to initial diagnosis and delivered in synchrony with disease-specific treatment until symptom relief or patient death. The purpose of this study was to examine cancer survivors’ knowledge and perceptions of PC using a nationally representative sample of US adults from the Health Information National Trends Survey (HINTS).

Method

A total of 593 HINTS respondents reported a personal history of cancer and were included in the sample (55.56% female; mean age of 65.88 years, SD = 18.21; mean time from diagnosis 13.83 years, SD = 18.21). Weighted logistic regression models were conducted to identify correlates of PC knowledge.

Results

Of the 593 cancer survivors in the sample, 66% (N = 378) reported that they had never heard of PC, 18% (N = 112) reported knowing a little bit about PC, and 17% (N = 95) reported knowing what PC is and could explain it to someone else. In multivariable analysis, survivors of color (Hispanic/Latino, Black, Asian, American Indian, and Pacific Islander), males, and those less educated were significantly less likely to report knowledge of PC. Among survivors who did report knowledge of PC, a lack of distinction between differing modes of supportive care exists.

Significance of results

These findings suggest a need to increase PC knowledge among cancer survivors with the ultimate goal of addressing disparities in PC acceptance and utilization.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Albano, JD, Ward, E, Jemal, A, et al. (2007) Cancer mortality in the United States by education level and race. Journal of the National Cancer Institute 99(18), 13841394. doi:10.1093/jnci/djm127CrossRefGoogle Scholar
Campesino, M, Saenz, DS, Choi, M, et al. (2012) Perceived discrimination and ethnic identity among breast cancer survivors. Oncology Nursing Forum 39(2), E91E100. doi:10.1188/12.onf.e91-e100CrossRefGoogle ScholarPubMed
Fadul, N, Elsayem, A, Palmer, J, et al. (2009) Supportive versus palliative care: What's in a name?: A survey of medical oncologists and midlevel providers at a comprehensive cancer center. Cancer 115(9), 20132021. doi:10.1002/cncr.24206CrossRefGoogle Scholar
Ferrell, BR, Temel, JS, Temin, S, et al. (2016) Integration of palliative care into standard oncology care: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology 35(1), 96112. doi:10.1200/JCO.2016.70.1474CrossRefGoogle ScholarPubMed
Fletcher, K, Prigerson, HG, Paulk, E, et al. (2013) Gender differences in the evolution of illness understanding among patients with advanced cancer. Journal of Clinical Oncology 11(3), 126132.Google ScholarPubMed
Gupta, S, Wilejto, M, Pole, JD, et al. (2014) Low socioeconomic status is associated with worse survival in children with cancer: A systematic review. PLoS ONE 9(2). doi:10.1371/journal.pone.0089482Google ScholarPubMed
Health Information National Trends Survey 5 (HINTS 5) (2018) Cycle 2 Methodology Report. Available at: https://hints.cancer.gov/docs/methodologyreportsGoogle Scholar
Kumar, P, Casarett, D, Corcoran, A, et al. (2012) Utilization of supportive and palliative care services among oncology outpatients at one academic cancer center: Determinants of use and barriers to access. Journal of Palliative Medicine 15(8), 923930. doi:10.1089/jpm.2011.0217CrossRefGoogle ScholarPubMed
Lane, T, Ramadurai, D and Simonetti, J (2019) Public awareness and perceptions of palliative and comfort care. The American Journal of Medicine 132(2), 129131. doi:10.1016/j.amjmed.2018.07.032CrossRefGoogle ScholarPubMed
LeMond, L and Allen, L (2011) Palliative care and hospice in advanced heart failure. Progress in Cardiovascular Diseases 54(2), 168178. doi:10.1016/j.pcad.2011. 03.012CrossRefGoogle ScholarPubMed
National Cancer Institute (NCI) (2020) Adolescents and Young Adults with Cancer. Available at: https://www.cancer.gov/types/ayaGoogle Scholar
National Comprehensive Cancer Network (NCCN) (2020) NCCN Clinical Practice Guidelines in Oncology-Palliative Care. Available at: https://www.nccn.org/professionals/physician_gls/pdf/palliative.pdfGoogle Scholar
National Quality Forum (NQF) (2006) A National Framework and Preferred Practices for Palliative and Hospice Care Quality. Available at: https://www.qualityforum.org/PublicationsGoogle Scholar
Nitecki, R, Diver, E, Kamdar, M, et al. (2018) Patterns of palliative care referral in ovarian cancer: A single institution 5 year retrospective analysis. Gynecologic Oncology 148(3), 521526. doi:10.1016/j.ygyno.2018.01.018CrossRefGoogle Scholar
Parsons, H, Schmidt, S, Harlan, L, et al. (2014) Young and uninsured: Insurance patterns of recently diagnosed adolescent and young adult cancer survivors in the AYA HOPE study. Cancer 120(15), 23522360. doi:10.1002/cncr.28685CrossRefGoogle Scholar
Richter, D, Mehnert, A, Forstmeyer, D, et al. (2019) Health literacy in adolescent and young adult cancer patients and its association with health outcomes. Journal of Adolescent and Young Adult Oncology 8(4), 451457. doi:10.1089/jayao.2018.0118CrossRefGoogle Scholar
SAS Institute Inc. SAS/STAT® 9.4 User's Guide, Cary, NC, USA.Google Scholar
Shen, M and Wellman, J (2019) Evidence of palliative care stigma: The role of negative stereotypes in preventing willingness to use palliative care. Palliative and Supportive Care 17(4), 374380. doi:10.1017/S1478951518000834CrossRefGoogle ScholarPubMed
Slomka, J, Prince-Paul, M, Webel, A, et al. (2016) Palliative care, hospice, and advance care planning: Views of people living with HIV and other chronic conditions. Journal of the Association of Nurses in AIDS Care 27(4), 476484. doi:10.1016/j.jana.2016.02.003CrossRefGoogle ScholarPubMed
Snyder, S, Hazelett, S, Allen, K, et al. (2013) Physician knowledge, attitude, and experience with advance care planning, palliative care, and hospice: Results of a primary care survey. American Journal of Hospice and Palliative Medicine 30(5), 419424. doi:10.1177/1049909112452467CrossRefGoogle ScholarPubMed
Stanbury, JF, Baade, PD, Yu, Y, et al. (2016) Cancer survival in New South Wales, Australia: Socioeconomic disparities remain despite overall improvements. BMC Cancer 16(51) doi:10.1186/s12885-016-2065-zCrossRefGoogle ScholarPubMed
Taber, JM, Ellis, EM, Reblin, M, et al. (2019) Knowledge of and beliefs about palliative care in a nationally-representative U.S. sample. PLoS ONE 14(8). doi:10.1371/journal.pone.0219074CrossRefGoogle Scholar
Temel, J, Greer, J, Muzikansky, A, et al. (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine 363(8), 733742. doi:10.1056/nejmoa1000678CrossRefGoogle ScholarPubMed
Trivedi, N, Peterson, EB, Ellis, EM, et al. (2019) Awareness of palliative care among a nationally representative sample of U.S. adults. Journal of Palliative Medicine 22(12). doi:10.1089/jpm.2018.0656CrossRefGoogle ScholarPubMed
U.S. Department of Health and Human Services Health Care Financing Administration (2001) Clarification of physician certification requirements for Medicare Hospice. Program memorandum. Intermediaries/Carriers. Transmittal AB-01-09.Google Scholar
van den Berg, I, Büttner, S, van den Braak, RC, et al. (2019) Low socioeconomic status is associated with worse outcomes after curative surgery for colorectal cancer: Results from a large, multicenter study. Journal of Gastrointestinal Surgery 24(11). doi:10.1007/s11605-019-04435-2Google ScholarPubMed
Ware, JE, Kosinski, M and Keller, SD (1996) A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care 34(3), 220233. doi:10.1097/00005650-199603000-00003CrossRefGoogle ScholarPubMed
Zhou, J and Wang, C (2019) Improving cancer survivors’ e-health literacy via online health communities (OHCs): A social support perspective. Journal of Cancer Survivorship 14(2), 244252. doi:10.1007/s11764-019-00833-2CrossRefGoogle ScholarPubMed