Table 4.
The differences between models for the delivery of PCO, symptomatic management, communication with patients and family and end-of-life care before and after PCO integration
| Mean | SD | Z | P value | |
|---|---|---|---|---|
| III. What are models for the delivery of simultaneous oncology and PC at your oncology center? | ||||
| a) Inpatient PC consultation service | 0.81548 | 0.52071 | -10.934 | < 0.001 |
| b) Regular palliative care outpatient clinic | 0.57396 | 0.55273 | -9.377 | < 0.001 |
| c) On-demand joint oncology-palliative care outpatient clinic | 0.76331 | 0.51485 | -10.788 | < 0.001 |
| d) Palliative care unit | 0.89412 | 0.30860 | -8.899 | < 0.001 |
| e) Weekends and holidays PMT inpatient ward round | 0.57059 | 0.49645 | -12.329 | < 0.001 |
| f) 24/7 phone calls for continuity of care | 0.29412 | 0.45699 | -9.849 | < 0.001 |
| g) Standalone PCC with 24 h services | 0.26627 | 0.46941 | -7.071 | < 0.001 |
| h) Community-based palliative care or home health care | 0.49112 | 0.52461 | -6.429 | < 0.001 |
| IV. Do you agree with the following statements about the symptomatic management of cancer patients before and after PCO integration? | ||||
| a) Physical, psychological, social and spiritual pain was properly managed | 1.26471 | 1.12815 | -9.681 | < 0.001 |
| b) Dyspnea and other respiratory symptoms were easy to manage | 1.08824 | 1.14529 | -9.069 | < 0.001 |
| c) Difficult cases of nausea and vomiting were well controlled | 0.92941 | 1.15424 | -8.159 | < 0.001 |
| d) Constipation and other GIT symptoms were underestimated and under treated | 0.92353 | 1.35438 | -7.401 | < 0.001 |
| e) Psychological issues (e.g. depression, insomnia and anxiety) were routinely assessed and properly managed | 1.22353 | 1.18048 | -9.349 | < 0.001 |
| f) Delirium was easily identified and managed | 1.08235 | 1.28452 | -8.432 | < 0.001 |
| g) Opioids initiation, titration, rotation and related side effects were properly managed | 1.38235 | 1.92484 | -9.683 | < 0.001 |
| h) Symptoms were adequately controlled on discharge | 1.08235 | 1.15857 | -9.026 | < 0.001 |
| i) Allowing for more effective delivery of oncological treatments through control of symptoms | 1.00000 | 1.18671 | -8.331 | < 0.001 |
| V. Do you agree with the following statements about communication with patients and family before and after PCO integration? | ||||
| a) Repeated honest and accurate communication in a sensitive manner. | 0.98824 | 1.11466 | -8.699 | < 0.001 |
| b) Goals of care were discussed. | 0.87647 | 1.05023 | -8.171 | < 0.001 |
| c) Dealing more effectively with issues of ending active treatments. | 0.90000 | 1.06393 | -8.525 | < 0.001 |
| d) Conflicts among patient, family and medical team were resolved | 0.81765 | 1.13926 | -7.344 | < 0.001 |
| e) Higher patients’ and families’ acceptance of PC policy of transfer. | 0.75294 | 0.99592 | -7.593 | < 0.001 |
| VI. Do you agree with the following statements about end-of-life care before and after the PCO? | ||||
| a) End of life symptoms were effectively managed (e.g. delirium, pain, upper respiratory secretions) | 1.27059 | 1.22487 | -9.419 | < 0.001 |
| b) Prognosis was communicated clearly to the family. | 0.78235 | 3.31301 | -8.473 | < 0.001 |
| c) Compassionate communication was regularly delivered to patient, family and medical staff | 0.87647 | 1.00415 | -8.582 | < 0.001 |
| d) Bereavement support was provided | 2.12941 | 1.22873 | -10.610 | < 0.001 |
| e) Limitation of the role of life sustaining measures were discussed | 1.62941 | 0.99005 | -10.591 | < 0.001 |
| f) Patient and family values, preferences and goals were discussed and incorporated into PC plan | 1.45882 | 0.89115 | -10.720 | < 0.001 |
| g) Managing the place of death based on patient/family preference were discussed and declared (e.g.: ICU, home.) | 0.81765 | 1.06961 | -7.810 | < 0.001 |
Mean of the differences of each item before and after PCO