title: End-of-life care among head and neck cancer patients.
abstract: OBJECTIVE
  This study is designed to (1) determine the perceived quality of care received by patients with head and neck cancer at the end of their lives, in order to (2) better anticipate and improve upon the experiences of future patients.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Single-institution, academic tertiary care medical center.
  
  
  METHODS
  A validated survey instrument, the Family Assessment of Treatment at the End of life (FATE), was administered to families of patients who died of head and neck cancer (n = 58). The primary outcome was the overall FATE score. Independent variables included clinical characteristics, treatments received, and the care provided at the time of death.
  
  
  RESULTS
  Overall FATE scores and the domains assessing management of symptoms and care at the time of death did not vary by disease status (logoregional vs distant metastasis) at the end of life (P = .989). The location of death in the home or in hospice (vs hospital) significantly improves scores in all 3 categories (P = .023). Involvement of a palliative care team improved the care at the time of death (P < .001), and palliative treatments (radiation and/or chemotherapy) improved scores in managing symptoms and care at the time of death (P = .011, P = .017).
  
  
  CONCLUSIONS
  The FATE survey is a useful measure of the end-of-life experience of head and neck cancer patients. Palliative treatments of head and neck cancer, death outside of the hospital, and palliative care team involvement all improve the end-of-life experience in this population.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. shumana@umich.edu
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Shuman
authors.forename: Ye
authors.initials: Y
authors.lastname: Yang
authors.forename: Jeremy M G
authors.initials: JM
authors.lastname: Taylor
authors.forename: Mark E
authors.initials: ME
authors.lastname: Prince
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013727:Terminal Care