Predictors of patient-related benefit, burden and feeling safe in relation to hospital admissions in palliative care: A cross-sectional survey

• Published in: Palliative medicine 2018-01, Vol.32 (1), p.167-171
• Main Authors: Robinson, Jackie, Gott, Merryn, Frey, Rosemary, Gardiner, Clare, Ingleton, Christine
• Format: Article
• Language: English
• Subjects: Cancer; Cross-sectional studies; Demography; Deprivation; Deprived areas; Ethnicity; Hospice care; Hospitalization; Oncology; Palliative care; Patient satisfaction; Patients; Preferences; Sociodemographics; Socioeconomic factors; Treatment preferences
• ISSN: 0269-2163; 1477-030X
• DOI: 10.1177/0269216317731991

Background: Research exploring patient experience of palliative care in the hospital setting has previously been limited to negative aspects of care. However, recent studies have shown that patients with palliative care needs experience benefits being in hospital. Little is known about how experiences of benefit and burden vary according to socio-demographic and illness-related factors and how these experiences influence patient preferences to return to hospital. Aim: To identify factors influencing experiences of benefit and burden and the predictors associated with a preference to return to hospital in palliative care. Design: Cross-sectional design using a questionnaire survey. Setting/participants: In total, 116 hospital inpatients admitted with palliative care needs in an urban hospital in New Zealand. Recruitment was from an oncology ward, four general medical wards and a respiratory ward. Results: Those living in more deprived areas experienced more benefit being in hospital (F(4, 109) = 3.15, p = 0.017), while younger people (F(4, 109) = 4.44, p = 0.00) and those from Asian or Pacific cultures (F(2, 111) = 7.78, p = 0.000) experienced more burden. Those with a non-cancer diagnosis felt less safe in hospital (p = 0.04). ‘Feeling safe’ was a significant (B = 0.14, p = 0.03) predictor for a preference to return to hospital. Conclusion: Deprivation, diagnosis, age and ethnicity influenced experiences of benefit and burden in hospital. ‘Feeling safe’ was a significant predictor for a preference to return to hospital. Further research is needed to understand why certain patient factors influence experiences of hospitalisation and how ‘feeling safe’ can be replicated in other care environments.