title: Impact of palliative care consultative service on disease awareness for patients with terminal cancer.
abstract: OBJECTIVE
  Awareness of the status of disease among terminally ill cancer patients is an important part of the end-of-life care. We have evaluated how palliative care consultative service (PCCS) affects patient disease awareness and determined who may benefit from such services in Taiwan.
  
  
  METHODS
  In total, 2,887 terminally ill cancer patients consecutively received PCCS between January 2006 and December 2010 at a single medical center in Taiwan, after which they were evaluated for disease awareness. At the beginning of PCCS, 31 % of patients (n = 895) were unaware of their disease status. The characteristics of these 895 patients were analyzed retrospectively to determine variables pertinent to patient disease awareness after PCCS.
  
  
  RESULTS
  In total, 485 (50 %) of the 895 patients became aware of their disease at the end of PCCS. Factors significantly associated with higher disease awareness included a longer interval between the date of hospital admission and that of PCCS referral (>4 weeks versus ≤2 weeks), a longer duration of PCCS (>14 days versus ≤7 days), the male gender, divorced marital status (versus married), and family awareness (versus lack of family awareness). Lower disease awareness was associated with older age (age > 75 years versus age = 18-65 years), referral from non-oncology departments, and primary cancer localization (lung, colon-rectum, or urological versus liver).
  
  
  CONCLUSIONS
  Disease awareness is affected by multiple factors related to the patients, their families, and the clinicians. The promotion of PCCS increased disease awareness among terminally ill cancer patients in Taiwan.
authors: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, and College of Medicine, Chang Gung University, No.5 Fuxing Street, Guishan Township, Taoyuan, Taiwan, Republic of China.
authors: Wen-Chi
authors: WC
authors: Chou
authors: Yu-Shin
authors: YS
authors: Hung
authors: Chen-Yi
authors: CY
authors: Kao
authors: Po-Jung
authors: PJ
authors: Su
authors: Chia-Hsun
authors: CH
authors: Hsieh
authors: Jen-Shi
authors: JS
authors: Chen
authors: Chi-Ting
authors: CT
authors: Liau
authors: Yung-Chang
authors: YC
authors: Lin
authors: Chuang-Chi
authors: CC
authors: Liaw
authors: Hung-Ming
authors: HM
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods* / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration*; D013624:Taiwan; D013727:Terminal Care / Q000379:methods* / Q000458:organization & administration; D055815:Young Adult