Good home care for cancer patients

In addition to the support for physical and psychosocial problems, respect for the patient's autonomy and the right information plays a role. Patients with an incurable cancer often receive the care they need at home. However, general practitioners and district nurses may pay more attention to fatigue and the expected evolution of the disease. This is shown by Nivel's research among patients, general practitioners and district nurses.

Despite the improved detection and treatment of cancer, still a third of patients still die within five years of diagnosis. Many patients need intensive care before death. This care is usually provided at home by the general practitioner, sometimes in collaboration with community nurses.

Nivel's research shows that in case of symptoms of anxiety, anxiety or depression, about two-thirds of incurable cancer patients receive advice from the general practitioner. or district nurse. When patients experience pain, this percentage is considerably higher (87%). And patients who suffer from fatigue receive counseling in less than half of the cases. According to Gé Donker, general epidemiologist and senior researcher at Nivel, there is an explanation for this: "Fatigue is difficult to treat. GPs and nurses, however, can discuss with patients how they can handle this complaint.

Autonomy and Information
In addition to support for physical and psychosocial problems, respect for the autonomy of the patient. role. Almost all patients find these important aspects and general practitioners and district nurses find them even more important than patients.

Patients appear to be satisfied with perceived autonomy and the provision of information. However, a quarter of them indicate that they receive little or no information on the expected course of the disease, although they find it important. It may be because the course of the disease is difficult to predict. GPs could discuss possible care scenarios and treatment options and ask questions about pending cases, needs and issues. In this way, patients are better prepared

Research
The Nivel study was conducted among 72 patients with an incurable cancer, 87 general practitioners and 26 nurses in home care. They completed questionnaires based on the CQ palliative care index, in which they indicated the aspects of care that they deemed important. The patients also indicated whether they had received certain aspects of the care or not. The study was commissioned by the Stichting Stoffels-Hornstra. The results were recently published in BMC Palliative Care.