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Hospice Use Down in Terminal Patients With Religious Support

For these patients, spiritual support from medical team ups hospice use, cuts interventions
THURSDAY, May 9 (HealthDay News) -- Terminally ill patients who are well supported by religious communities use less hospice care and receive more aggressive medical interventions near death, according to a study published online May 6 in JAMA Internal Medicine.
Tracy A. Balboni, M.D., M.P.H., from the Dana-Farber Cancer Institute in Boston, and colleagues conducted a multisite cohort study involving 343 patients with advanced cancer enrolled for a median duration of 116 days until death. The authors sought to examine whether spiritual support from religious communities influences medical care and quality of life near death.
The researchers found that patients reporting high spiritual support from religious communities were significantly less likely to receive hospice care (adjusted odds ratio [aOR], 0.37). In addition, these patients were significantly more likely to receive aggressive end of life measures and were more likely to die in the intensive care unit (ICU) (aOR, 2.62 and 5.22, respectively). High religious coping patients had significantly increased risks of receiving aggressive end of life interventions and ICU deaths (aOR, 11.02 and 22.02, respectively), as did racial/ethnic minority patients (aOR, 8.03 and 11.21, respectively). Receiving spiritual support from the medical team correlated with higher rates of hospice use, fewer aggressive interventions, and fewer ICU deaths (aOR, 2.37, 0.23, and 0.19, respectively) for patients who were well supported by religious communities. In addition, among these patients, end-of-life discussions correlated with fewer aggressive interventions (aOR, 0.12).
"Spiritual care and end-of-life discussions by the medical team may reduce aggressive treatment, highlighting spiritual care as a key component of end-of-life medical care guidelines," the authors write.
Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1685898#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1685898 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1685899 )
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