Symptom-Related Distress among Indigenous Australians in Specialist End-of-Life Care: Findings from the Multi-Jurisdictional Palliative Care Outcomes Collaboration Data

John A. Woods, Claire E. Johnson, Hanh T. Ngo, Judith M. Katzenellenbogen, Kevin Murray and Sandra C. Thompson
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John A. Woods: Western Australian Centre for Rural Health, School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia
Claire E. Johnson: Eastern Health, Melbourne, VIC 3128, Australia
Hanh T. Ngo: Discipline of Emergency Medicine, Medical School, The University of Western Australia, Perth, WA 6009, Australia
Judith M. Katzenellenbogen: School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia
Kevin Murray: School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia
Sandra C. Thompson: Western Australian Centre for Rural Health, School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia

IJERPH, 2020, vol. 17, issue 9, 1-13

Abstract: Symptom relief is fundamental to palliative care. Aboriginal and Torres Strait Islander (Indigenous) Australians are known to experience inequities in health care delivery and outcomes, but large-scale studies of end-of-life symptoms in this population are lacking. We compared symptom-related distress among Indigenous and non-Indigenous Australian patients in specialist palliative care using the multi-jurisdictional Palliative Care Outcomes Collaboration dataset. Based on patient-reported rating scale responses, adjusted relative risks (aRRs) stratified by care setting were calculated for occurrence of (i) symptom-related moderate-to-severe distress and worsening distress during a first episode of care and (ii) symptom-related moderate-to-severe distress at the final pre-death assessment. The p -value significance threshold was corrected for multiple comparisons. First-episode frequencies of symptom-related distress were similar among Indigenous ( n = 1180) and non-Indigenous ( n = 107,952) patients in both inpatient and community settings. In final pre-death assessments (681 Indigenous and 67,339 non-Indigenous patients), both groups had similar occurrence of moderate-to-severe distress when care was provided in hospital. In community settings, Indigenous compared with non-Indigenous patients had lower pre-death risks of moderate-to-severe distress from overall symptom occurrence (aRR 0.78; p = 0.001; confidence interval [CI] 0.67–0.91). These findings provide reassurance of reasonable equivalence of end-of-life outcomes for Indigenous patients who have been accepted for specialist palliative care.

Keywords: Aboriginal; palliative care; terminal care; symptom assessment; pain; psychological distress (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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