A survey of over 9,000 people in seven different countries across Europe has shown that the majority would want to improve the quality of life in the time they had left, rather than extend it. The survey reveals attitudes across Europe for dealing with serious illnesses such as cancer, and issues raised when caring for a close friend of relative in the last few months of life. The research was carried out as part of an EU-funded project led by researchers from King's College London.
The telephone survey of 9,339 people was carried out to explore attitudes to end of life care in seven European countries: Germany, England, the Netherlands, Belgium (Flanders), Portugal, Spain and Italy. The survey showed that 71% of people said they would want to improve quality of life for the time they had left; 4% would like to extend life; and 25% said both quality and extending life was equally important. Across all countries in the survey, 'being in pain' was the symptom or problem that was of most concern, followed by 'being a burden to others'
The results of the survey will be discussed by policy makers, research funders and experts in palliative care on Thursday in Brussels at a symposium held by PRISMA - a consortium of experts from nine European and African countries, led by King's College London. The PRISMA group says greater attention must be paid to quality of life alongside potentially life-prolonging treatments, as the survey shows quality of life is important to people, often more so than extending it.
A group of leading researchers and clinicians, led by Professor Irene Higginson OBE at King's College London, will call for delivery of end-of-life care across Europe to be reviewed in the light of the results, and investment in research increased, in order to meet people's needs more effectively at the end of their lives.
Professor Irene Higginson OBE, scientific lead of PRISMA and Professor of Palliative Care and Policy at King's College London, said: 'There needs to be a fundamental shift in the approach to delivering end-of-life care across Europe. Although individuals' priorities and needs will differ, it is absolutely clear that people value highly the quality of the time they have left.
'What we need to see is a step-change in the way policy-makers and clinicians across Europe look at end-of-life care, and ensure that people's priorities and needs inform planning and delivery of these services. Together with an increased investment in scientific research into end-of-life care, this will really make a difference to the quality of people's lives as they face their last weeks and days.'
The PRISMA group is calling for a change in the way all health care professionals working with patients with advanced diseases measure things which are important to patients and their families. Currently, the focus is on physical tests such as x-rays, scans and monitoring bloods. But PRISMA warns that, although important, these routine tests may miss the effects of the illness on the person and their family. A move towards assessment of symptoms, psychological, social and spiritual needs is urgently required in order to ensure an adequate response to patient and family priorities.
PRISMA compared the survey results with the views of nearly 800 clinicians working in end-of-life care and recommended a five-pronged approach to tackle: symptom control; emotional well-being; family support; choice for where to be cared for; and information needs.
Professor Stein Kaasa, a member of PRISMA, Professor of Palliative Medicine and an oncologist at the Norwegian University of Science and Technology said: 'It is now the responsibility of all clinicians working with patients with life-threatening diseases such as advanced cancer, to measure and lead others to measure the outcomes of their work against what matters to patients, so they know they are on the right track to providing quality care.'
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King's College London
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Notes to editors:
Results of the survey by country are available on request.
The Palliative care Outcome Scale (POS) tool is freely available in ten languages through the website: http://www.
King's College London (www.kcl.ac.uk)
King's College London is one of the top 25 universities in the world (2010 QS international world rankings), The Sunday Times 'University of the Year 2010/11' and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,500 students (of whom more than 9,000 are graduate students) from nearly 140 countries, and some 6,000 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.
PRISMA: PRISMA is a major three year coordinating action project funded by the European Union under the Seventh Framework Programme (FP7). PRISMA is delivering an integrated programme coordinating research priorities and practice about end-of-life care across Europe and Africa through sharing practice, coordinating research and delivering research outputs, and identifying key priorities for end-of-life care. Scientific Director: Professor Irene J Higginson. Project Coordinator (Principal Investigator): Dr Richard Harding www.prisma.fp7.eu
Palliative care: Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is achievement of the best possible quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness. Palliative care (WHO definition) states that palliative care: affirms life and regards dying as a normal process; neither hastens nor postpones death; provides relief from pain and other distressing symptoms; integrates the psychological and spiritual aspects of patient care; offers a support system to help patients live as actively as possible until death; offers a support system to help the family cope during the patient's illness and in their own bereavement.
The Cicely Saunders Institute: The Cicely Saunders Institute is the first purpose built institute for research into palliative care offering palliative care courses and other resources relevant to palliative care. The Institute brings together academics, healthcare professionals, community organisations, patients and carers in one centre and acts as the hub for a network of international research. It offers high-quality palliative care solutions to patients, as well as providing education, patient information and support. The Cicely Saunders Institute of Palliative Care opened in May 2010, the result of a partnership between the King's College London and the charity Cicely Saunders International. http://www.