[Domiciliary care of the terminal cancer patient: evaluation and proposals by physicians and nurses]

OBJECTIVE

To detect problems that terminal cancer patients pose to primary health care (PHC) professionals.

DESIGN

Cross-sectional study.

SETTING

PHC professionals of the Manresa (province of Barcelona) health Sector of the National Health System.

PARTICIPANTS

151 professionals (87 physicians and 64 nurses).

MEASUREMENTS AND RESULTS

Self-responded anonymous questionnaire. Dates: 10-20 December, 1990; response rate: 89%. Most participants said in the previous year they were responsible for 3 or more home terminal cancer patients. 35.6% said emergencies were handled in a hospital; professionals working in non-urban areas and in the non-reformed Primary Care system less often used hospitals. Access to consultants was deemed difficult by most interviewees, but most said consultants' reports were good or excellent; physicians valued reports higher than nurses (odds ratio [OR] = 5.43, P < 0.001). Most participants reported continuous education to be scarce or nonexistent. Also, most said care given to terminal cancer patients was inadequate; younger professionals (p = 0.001) y and those working in the reformed Primary Care system (P = 0.003) were more critical.

CONCLUSIONS

Interest of primary care professionals in terminal cancer patients was higher in less populated areas, among those having a permanent contract and in the reformed system.