[Health care and communication with the terminal cancer patient and his family in a health area].

OBJECTIVES

To know the clinical, essential and communication characteristics of the terminal cancer patient care in a health district.

DESIGN

Cross-sectional descriptive study. PLACEMENT: Vth health district of Asturias (Spain).

PATIENTS AND PARTICIPANTS

107 cancer patients dead in the first term of 1995 and their families.

MEASUREMENT AND MAIN RESULTS

Revision of hospital and primary care health centres clinical records and personal interview with the patient's main carer by closed questionnaire, taken place between August and October of 1996. We revised 107 clinical records interviewing 54 relatives. 50% of the patients died at home, 17% in a palliative care partially dedicated hospital. 81% of patients suffered from pain in some moment of their process, being controlled in 69%, using morphine in 66% of cases with pain (mode and median of dose 60 mg/24 hours VO). Pain evaluation scales were registered in 32% of cases, improving the pain control (p < 0.01). 30% of carers were told of their relative cancer diagnosis in a corridor. 57% of carers were advised on symptoms that the patient could suffer; these patients were interned in hospital in a smaller proportion (p = 0.02) and attended less the casualty department (p = 0.02). 19% of patients were informed about their diagnosis, using less health resources (less hospitalizations, p = 0.06).

CONCLUSIONS

We use low doses of morphine. There is a low register of pain valoration scales, although they improve its control. Two thirds of patients dye in an proper place. Communication with the patients and their families is insufficient. Among other factors, the patient who knows his diagnosis uses less health resources.