Evidence map›Paper›PMID 40652268›Full record

ArticleBMC palliative care2025

Factors that support home deaths for patients receiving at-home palliative and end-of-life care: a sequential mixed-methods explanatory study.

Kelley Kilpatrick, Émilie Allard, Mira Jabbour, Eric Tchouaket

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Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kelley KilpatrickSusan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. kelley.kilpatrick@mcgill.ca.
Émilie AllardFaculty of Nursing, Université de Montréal, Montreal, QC, Canada.
Mira JabbourCentre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Maisonneuve-Rosemont Hospital Site, Montreal, QC, Canada.
Eric TchouaketDepartment of Nursing, Université du Québec en Outaouais (UQO), St-Jérôme Campus, Saint-Jérôme, QC, Canada.

Funding

Canadian Research Chair Tier 2 in Economics of Infection Prevention and Control: ÉconoPCI grant number CRC-2021-00321Fonds de recherche du Québec-Santé award number 298573McGill University Faculty of Medicine and Health Sciences and the Newton Foundation via the Susan E. French Chair in Nursing Research and Innovative Practice N/AMinistère de la santé et des services sociaux du Québec reference number 19-MS-09068
6 · The paper itself

Abstract

backgroundSignificant knowledge gaps persist in understanding how to support patients receiving palliative and end-of-life care (PEoLC) who wish to die at home. This study aimed to identify factors associated with remaining at home and home death for patients receiving PEoLC.

methodsA sequential mixed-methods explanatory study (QUANT + QUAL) was conducted. Administrative data from a not-for-profit at-home palliative care organization in Québec Canada from 2015 to 2024 (n = 5931) and 73 semi-structured interviews with patients receiving PEoLC, caregivers, service providers and decision-makers were collected. Logistic and Cox regression models were completed for the quantitative data analysis. Content analysis was used for the qualitative data analysis. Data integration occurred following the quantitative analyses.

resultsThe mean age of patients requiring PEoLC was 77.97 (SD: 13.70) years. The sample included 50.3% men and 49.7% women. One quarter (25.8%) of patients receiving PEoLC lived alone. Most patients (93.5%) had cancer. Home death occurred in almost 30% of cases. Over 95% of deaths occurred within 365 days following admission to the at-home palliative care organization. Access to respite care (adjusted odds ratio: 2.699, p < 0.001), female sex, living alone, having been hospitalized, receiving psychological care, and volunteer and transportation support were associated with remaining at home and home deaths for patients receiving PEoLC. The interviews highlighted the importance of respecting the patients' wishes related to end of life and home death. All participants described several challenges to access timely and reliable services following the pandemic. Timely access to home care, nursing and hygiene and a palliative care approach facilitated remaining at home and home death for patients receiving PEoLC.

conclusionsRespite care more than doubles the odds of remaining at home and home death. Timely access to services that include home care, nursing care and hygiene and a palliative care approach is essential to support patients receiving PEoLC who wish to die at home. Stabilizing staffing of home care teams, standardizing PEoLC services offered across community health centers in the province, and optimal use of nurse practitioners would improve services offered to patients receiving PEoLC and their caregivers.

Indexed as

Home Care ServicesPalliative CareTerminal CareAgedAged, 80 and overFemaleHumansMaleMiddle AgedQualitative ResearchQuebecCaregiversEnd of life careHome careHome deathMixed methods studiesNursing carePalliative care approachQualitative descriptive studyRespite careSurvival analysis

Identifiers

PMID40652268
PMCPMC12255988

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.