Factors influencing death at home in terminally ill patients with cancer: systematic review

摘要: Objectives To determine the relative influence of different factors on place death in patients with cancer. Data sources Four electronic databases—Medline (1966-2004), PsycINFO (1972-2004), CINAHL (1982-2004), and ASSIA (1987-2004); previous contacts key experts; hand search six relevant journals. Review methods We generated a conceptual model, against which studies were analysed. Included had original data risk for among patients, > 80% whom cancer. Strength evidence was assigned according to quantity quality consistency findings. Odds ratios home plotted high strength evidence. Results 58 included, over 1.5 million from 13 countries. There effect 17 death, strongly associated death: patients' low functional status (odds range 2.29-11.1), their preferences (2.19-8.38), care (1.37-5.1) its intensity (1.06-8.65), living relatives (1.78-7.85), extended family support (2.28-5.47). The covered all groups model: related illness, individual, environment (healthcare input social support), latter found be most important. Conclusions ne that where cancer die is complicated. Future policies clinical practice should focus ways empowering families public education, as well intensifying care, assessment, training practitioners end life care.