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Context/Purpose <p>Promoting high-quality end-of-life (EOL) care is crucial for cancer patients. We investigated underexplored predictors associated with EOL quality and its domains during the last six months of life, as perceived by the patients themselves.</p> Methods <p>In this prospective longitudinal study, we followed 229 cancer patients (mean age 60.14&#xa0;years; 62.4% male; mean enrollment to death 96.86&#xa0;days) using a modified Quality of Dying and Death Questionnaire monthly. Multiple linear regression models with generalized estimating equations were used, adjusted for demographics and clinical characteristics.</p> Results <p>Physical symptom distress was negatively associated with total EOL quality (β [95% Confidence Interval] = –0.29 [–0.42, –0.15]) and with symptoms and personal control (–0.94 [–1.16, –0.71]). Depressive symptoms were negatively correlated with total EOL quality (–0.28 [–0.49, –0.08]), perceived time with family (–0.40 [–0.69, –0.10]), and whole-person wellbeing (–0.97 [–1.25, –0.69]). Anxiety severity was similarly associated with lower scores. Hospitalized patients reported poorer symptoms and personal control (–2.40 [–4.02, –0.78]) and lower whole-person wellbeing (–1.54 [–3.01, –0.07]) than outpatients, while hospice, palliative care, or preference-concordant care were associated with better fulfillment of treatment preferences (2.36 [0.22, 4.50]; 2.75 [1.03, 4.46]).</p> Conclusions <p>Patients’ physical and emotional symptoms were negatively associated with total EOL quality and related domains, while hospice care and preference-concordant care were linked to perceived treatment preference. To optimize EOL quality, healthcare professionals may address physical and emotional distress, initiate timely hospice referrals, and support care aligned with patient preferences.</p>

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Factors associated with end-of-life quality in terminally ill cancer patients’ last six months of life: a longitudinal study

  • 期刊论文

  • 发表日期：

    2025年11月5日

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  • Chen Hsiu Chen,
  • San Chi Chen,
  • Hsing Jung Lee

摘要

Context/Purpose

Promoting high-quality end-of-life (EOL) care is crucial for cancer patients. We investigated underexplored predictors associated with EOL quality and its domains during the last six months of life, as perceived by the patients themselves.

Methods

In this prospective longitudinal study, we followed 229 cancer patients (mean age 60.14 years; 62.4% male; mean enrollment to death 96.86 days) using a modified Quality of Dying and Death Questionnaire monthly. Multiple linear regression models with generalized estimating equations were used, adjusted for demographics and clinical characteristics.

Results

Physical symptom distress was negatively associated with total EOL quality (β [95% Confidence Interval] = –0.29 [–0.42, –0.15]) and with symptoms and personal control (–0.94 [–1.16, –0.71]). Depressive symptoms were negatively correlated with total EOL quality (–0.28 [–0.49, –0.08]), perceived time with family (–0.40 [–0.69, –0.10]), and whole-person wellbeing (–0.97 [–1.25, –0.69]). Anxiety severity was similarly associated with lower scores. Hospitalized patients reported poorer symptoms and personal control (–2.40 [–4.02, –0.78]) and lower whole-person wellbeing (–1.54 [–3.01, –0.07]) than outpatients, while hospice, palliative care, or preference-concordant care were associated with better fulfillment of treatment preferences (2.36 [0.22, 4.50]; 2.75 [1.03, 4.46]).

Conclusions

Patients’ physical and emotional symptoms were negatively associated with total EOL quality and related domains, while hospice care and preference-concordant care were linked to perceived treatment preference. To optimize EOL quality, healthcare professionals may address physical and emotional distress, initiate timely hospice referrals, and support care aligned with patient preferences.