title: Routine assessment of performance status during palliative chemotherapy when approaching end-of-life.
abstract: OBJECTIVE
  Palliative chemotherapy treatment (PCT) offered late in the cancer disease trajectory may be problematic. It is not easy to accurately calculate whether the potential benefits will outweigh the side-effects. This study investigates whether routine use of the Performance Status in Palliative Chemotherapy questionnaire (PSPC) affects the proportions of patients receiving PCT during the last month of life, care utilization, and documentation routines. A secondary aim was to gather registered nurses' experiences of the PSPC in routine use.
  
  
  METHODS
  Eighty incurable patients with cancer who had used the PSPC before PCT were compared to 160 matched controls, using non-parametric tests. Nurses' reflections on the PSPC were collected and reviewed.
  
  
  RESULTS
  No significant differences were found between users and non-users of the PSPC in terms of proportions receiving PCT during the last month of life. Higher proportions of patients older than 74 years received PCT than in previous studies (40% versus 17%). Nurses considered the questionnaires to be a valuable complement to verbal information when trying to acquire an accurate picture of patients' performance status.
  
  
  CONCLUSIONS
  At this point in the development of the PSPC we did not find any significant decreases in the proportion of patients receiving PCT during the last month in life. However, as the nurses valued the PSPC, it can be used as a complementary tool in assessment of performance status until further research is conducted.
authors.affiliation: Department of Radiation Sciences/Centre of Surgery - Östersund, Umeå University, S-901 87 Umeå, Sweden; Department of Nursing, Umeå University, S-901 87 Umeå, Sweden. Electronic address: ulla.nappa@regionjh.se.
authors.forename: Ulla
authors.initials: U
authors.lastname: Näppä
authors.affiliation: Department of Nursing, Umeå University, S-901 87 Umeå, Sweden; Department of Learning, Informatics, Management and Ethics/Medical Management Centre, Karolinska Institutet, S-171 77 Stockholm, Sweden. Electronic address: olav.lindqvist@ki.se.
authors.forename: Olav
authors.initials: O
authors.lastname: Lindqvist
authors.affiliation: Institute of Palliative Care, Lund University and Skåne Regional Council, Department of Health Sciences, Lund University, Box 117, S-221 00 Lund, Sweden. Electronic address: birgit.rasmussen@med.lu.se.
authors.forename: Birgit H
authors.initials: BH
authors.lastname: Rasmussen
authors.affiliation: Department of Radiation Sciences, Unit of Clinical Research Centre - Östersund, Umeå University, S-901 87 Umeå, Sweden. Electronic address: bertil.axelsson@regionjh.se.
authors.forename: Bertil
authors.initials: B
authors.lastname: Axelsson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D010166:Palliative Care; D062072:Patient Acuity; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden; D013727:Terminal Care
keywords: Cancer; Case-control study; Chemotherapy; Decision-making; Palliative care; Questionnaire; Rural hospitals