ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Factors associated with end-of-life quality in terminally ill cancer patients' last six months of life: a longitudinal study.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
context/purposePromoting 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.
methodsIn 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.
resultsPhysical 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]).
conclusionsPatients' 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.
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