Gaps between Supportive Care Needs and Services in Korea: Experiences and Preferences of Patients with Advanced Cancer and Their Caregivers in the Hospital and at Home

초록

Purpose With longer survivals in advanced cancer, the need for supportive care is increasing. However, in Korea, these services remain limited, and many patients rely on long-term care hospitals. We investigated the supportive care experiences of patients with advanced cancer and their caregivers, and preferred place of care (pPOC) by performance status (PS). Materials and Methods A cross-sectional survey was conducted at a tertiary hospital in Seoul, Korea, targeting patients hospitalized only for supportive care and their caregivers. PS was assessed using the Eastern Cooperative Oncology Group scale [good (0–1) or poor (2–4)]. Hospital and home care experiences and pPOC were compared by PS. Logistic regression analysis was used to identify factors associated with pPOC. Results This study included 200 participants (117 patients, 83 caregivers). Among patients, 72% had good PS and 28% had poor PS. Main reasons for hospitalization were symptom control (51.2%), assistance with daily living (36.5%), and device or wound management (22.5%). Overall, 60.5% of participants reported discomfort during hospitalization, mostly related to hospital life, and 34.5% noted that care was insufficient at home, particularly those in the poor PS group (27.1% vs. 53.6%). Concern about emergencies was the most common home-care difficulty. Despite these challenges, 60% of participants chose home as their future pPOC, with no significant differences by PS or other demographic/clinical factors. Conclusion Although most patients with advanced cancer and their caregivers preferred home for supportive care, many relied on hospitals. Structured home-based medical care programs are urgently required in South Korea.

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