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Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries.

Publication ,  Journal Article
Malhotra, C; Krishnan, A; Yong, JR; Teo, I; Ozdemir, S; Ning, XH; Hapuarachchi, T; Palat, G; Bhatnagar, S; Joad, AK; Tuong, PN; Ssu, WM ...
Published in: Int J Equity Health
September 10, 2020

BACKGROUND: A systematic understanding of socio-economic inequalities in end-of-life (EOL) suffering among advanced cancer patients is required to inform efforts to reduce these inequalities as part of Universal Health Coverage goals. AIMS: To assess inequalities in multiple domains of EOL suffering among advanced cancer patients - physical, functional, psychological, social, and spiritual -, using two socio-economic status (SES) indicators, education and perceived economic status of the household. METHODS: We used cross-sectional data from surveys of stage IV cancer patients (n = 1378) from seven hospitals across five countries (China, Sri Lanka, India, Vietnam and Myanmar). We conducted separate multivariable linear regression models for each EOL suffering domain. We also tested interactions between the two SES indicators and between each SES indicator and patient age. RESULTS: Patients living in low economic status households /with fewer years of education reported greater suffering in several domains. We also found significant interaction effects between economic status of the household and years of education for all EOL suffering outcomes. Age significantly moderated the association between economic status of the household and social suffering and between years of education and psychological, social, and spiritual suffering (p < 0.05 for all). CONCLUSION: Results highlight that SES inequalities in EOL suffering vary depending on the suffering domain, the SES indicator assessed, and by patient age. Greater palliative care resources for patients with low SES may help reduce these inequalities.

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Published In

Int J Equity Health

DOI

EISSN

1475-9276

Publication Date

September 10, 2020

Volume

19

Issue

1

Start / End Page

158

Location

England

Related Subject Headings

  • Young Adult
  • Terminal Care
  • Stress, Psychological
  • Spirituality
  • Socioeconomic Factors
  • Social Support
  • Social Class
  • Public Health
  • Palliative Care
  • Pain
 

Citation

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Chicago
ICMJE
MLA
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Malhotra, C., Krishnan, A., Yong, J. R., Teo, I., Ozdemir, S., Ning, X. H., … Finkelstein, E. (2020). Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries. Int J Equity Health, 19(1), 158. https://doi.org/10.1186/s12939-020-01274-5
Malhotra, Chetna, Anirudh Krishnan, Jing Rong Yong, Irene Teo, Semra Ozdemir, Xiao Hong Ning, Thushari Hapuarachchi, et al. “Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries.Int J Equity Health 19, no. 1 (September 10, 2020): 158. https://doi.org/10.1186/s12939-020-01274-5.
Malhotra C, Krishnan A, Yong JR, Teo I, Ozdemir S, Ning XH, et al. Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries. Int J Equity Health. 2020 Sep 10;19(1):158.
Malhotra, Chetna, et al. “Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries.Int J Equity Health, vol. 19, no. 1, Sept. 2020, p. 158. Pubmed, doi:10.1186/s12939-020-01274-5.
Malhotra C, Krishnan A, Yong JR, Teo I, Ozdemir S, Ning XH, Hapuarachchi T, Palat G, Bhatnagar S, Joad AK, Tuong PN, Ssu WM, Finkelstein E. Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries. Int J Equity Health. 2020 Sep 10;19(1):158.
Journal cover image

Published In

Int J Equity Health

DOI

EISSN

1475-9276

Publication Date

September 10, 2020

Volume

19

Issue

1

Start / End Page

158

Location

England

Related Subject Headings

  • Young Adult
  • Terminal Care
  • Stress, Psychological
  • Spirituality
  • Socioeconomic Factors
  • Social Support
  • Social Class
  • Public Health
  • Palliative Care
  • Pain