palliative care

A recent study published in Journal of Pain and Symptom Management has examined the attitudes of men and women towards accepting palliative care in in terminal stages of cancer.

Palliative care is a multidisciplinary combination of specialized medical and nursing interventions aimed to reduce the pain and suffering in patients suffering with terminal diseases. It is usually recommended when clinicians agree that medical interventions alone will not cure or benefit the patient at a particular stage of the disease.

Palliative care professionals strive to improve the patient’s overall quality of life by reducing pain and providing spiritual and social comfort. They also counsel patients and their relatives in dealing with stress and anguish that comes with combating terminal diseases.

This type of care is provided by a multidisciplinary team of people which include professionals such as physicians, nurses, physiotherapists, occupational therapists, health professionals, and other spiritual and motivational guidance counselors. This type of care is particularly important in advanced stages of cancer where unfortunately no care or clinical intervention can reduce diseases severity or prevent the inevitable demise of the patients.

The authors of a recent study published in the Journal of Pain and Symptom Management conducted a study on the premise that men are more reluctant towards cancer-related palliative care than women. Another goal of the study was to assess if educational background plays a role in shaping patients attitude towards accepting cancer associated palliative care. The overarching hypothesis here was that patients with lower educational backgrounds would be less receptive towards palliative care.

The clinical trial termed Values and Option in Cancer Care (VOICE) included 383 patients with advanced cancers in patients that came from Rochester, New York, Buffalo, New York, and Sacramento, California areas in the United States.

The VOICE platform was designed as a survey with questions that asked patients about their preferences towards receiving palliative care, provided that medical interventions would not provide any benefit to the patient. They categorized the responses into five categories which included “definitely no”, “possibly no”, “unsure”, “possibly yes”, and “definitely yes”.

Other variables that were correlated with these outcomes included age (less than or more than 65), educational background (college education vs. no college education), aggressiveness of cancer (aggressive vs. non-aggressive), race (white vs. non-white), perceived financial strain (present vs. absent) and insurance status (no insurance or Medicaid vs. Medicare or private party). Other variables like marital status (married vs. single), living situations (living alone vs. with someone) and other clinical variables measuring preferences towards palliative care added to the study as well.

A majority (79.1%) of patients responded that they would like to avail palliative care. Interestingly about 14.1% patients were reluctant towards accepting this type of care. Results of the study indicated that women were far more receptive than men in towards receiving palliative care. Men, on the other hand, were significantly more reluctant in accepting palliative care.

The authors hinted that societal norms that shape men’s attitude towards being more stoic in adversity could be a possible reason for this outcome. On the other hand, educational background did not seem to have any correlation to patients’ attitude towards accepting palliative care.

The study strongly suggested that educational aids would promote acceptance of palliative care in men. The authors also hinted that it is important that clinicians consider the gender of the patients when counseling patients regarding available palliative care options.

Written by Vinayak Khattar, Ph.D., M.B.A.

Reference: Saeed, F., Hoerger, M., Norton, S. A., Guancial, E., Epstein, R. M., & Duberstein, P. R. (2018). Preference for Palliative Care in Cancer Patients: Are Men and Women Alike? J Pain Symptom Manage, 56(1), 1-6 e1. doi:10.1016/j.jpainsymman.2018.03.014

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