TY - JOUR
T1 - Patients' and relatives' perspectives on the quality of end-of-Life care in advanced cancer
T2 - From the final months to bereavement
AU - Versluis, Moyke A J
AU - van der Linden, Yvette M
AU - van Leeuwen-Snoeks, Lobke
AU - van den Beuken-van Everdingen, Marieke H J
AU - Hendriks, Mathijs P
AU - van den Borne, Ben E E M
AU - Sommeijer, Dirkje
AU - van Basten, Jean-Paul A
AU - van der Padt-Pruijsten, Annemieke
AU - de Graeff, Alexander
AU - Hunting, Jarmo C B
AU - Kuip, Evelien J M
AU - van Lindert, Anne S R
AU - Youssef-El Soud, Magdolen
AU - Thijs-Visser, Martine F
AU - Vreugdenhil, Art
AU - van Laarhoven, Hanneke W M
AU - de Jong, Wouter K
AU - Mandigers, Caroline
AU - van Zuylen, Lia
AU - Kloover, Jeroen
AU - Smilde, Tineke J
AU - van de Poll-Franse, Lonneke V
AU - Raijmakers, Natasja J H
N1 - Publisher Copyright:
© 2026 Versluis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2026/2/9
Y1 - 2026/2/9
N2 - BACKGROUND: End-of-life care affects both patients with advanced cancer and their relatives but is often assessed from only one perspective, namely that of bereaved relatives. This study aimed to gain insight into the quality of care as experienced by patients with advanced cancer and their relatives.METHODS: A total of 367 patients with stage IV cancer, 242 relatives and 163 bereaved relatives were included from a large prospective, longitudinal study (eQuiPe), which ran from November 2017 until March 2020. Patients and their relatives completed a questionnaire during the last 3 months of the patient's life. Bereaved relatives completed a questionnaire within six months after the patient's death.RESULTS: At the end of life, patients reported a mean satisfaction with care score of 72/100 (SD 21), and relatives a mean score of 59/100 (SD 28) for the care they received themselves. Continuity with care, the extent to which the care received from different healthcare professionals was coordinated, was associated with higher satisfaction with care in patients (β 2.1, 95% CI 1.6-2.6). Bereaved relatives reported that most patients died peacefully (87%) and at home (73%). Most bereaved relatives (66%) were contacted by a healthcare professional after the patient's death, but over half were not informed about grief (52%) or the available options for bereavement support (58%), with about 20% reporting they would have appreciated this.CONCLUSIONS: Quality of end-of-life care was generally perceived as good. This study highlights the importance of good continuity of care as it is associated with higher satisfaction with care in patients. Also, one-fifth of the bereaved relatives reported that they had not been informed about bereavement care despite desiring it, which emphasizes the need for better care for relatives before and after the patient's death.
AB - BACKGROUND: End-of-life care affects both patients with advanced cancer and their relatives but is often assessed from only one perspective, namely that of bereaved relatives. This study aimed to gain insight into the quality of care as experienced by patients with advanced cancer and their relatives.METHODS: A total of 367 patients with stage IV cancer, 242 relatives and 163 bereaved relatives were included from a large prospective, longitudinal study (eQuiPe), which ran from November 2017 until March 2020. Patients and their relatives completed a questionnaire during the last 3 months of the patient's life. Bereaved relatives completed a questionnaire within six months after the patient's death.RESULTS: At the end of life, patients reported a mean satisfaction with care score of 72/100 (SD 21), and relatives a mean score of 59/100 (SD 28) for the care they received themselves. Continuity with care, the extent to which the care received from different healthcare professionals was coordinated, was associated with higher satisfaction with care in patients (β 2.1, 95% CI 1.6-2.6). Bereaved relatives reported that most patients died peacefully (87%) and at home (73%). Most bereaved relatives (66%) were contacted by a healthcare professional after the patient's death, but over half were not informed about grief (52%) or the available options for bereavement support (58%), with about 20% reporting they would have appreciated this.CONCLUSIONS: Quality of end-of-life care was generally perceived as good. This study highlights the importance of good continuity of care as it is associated with higher satisfaction with care in patients. Also, one-fifth of the bereaved relatives reported that they had not been informed about bereavement care despite desiring it, which emphasizes the need for better care for relatives before and after the patient's death.
KW - Humans
KW - Terminal Care/psychology
KW - Male
KW - Female
KW - Neoplasms/psychology
KW - Bereavement
KW - Middle Aged
KW - Family/psychology
KW - Aged
KW - Surveys and Questionnaires
KW - Longitudinal Studies
KW - Quality of Health Care
KW - Prospective Studies
KW - Adult
KW - Patient Satisfaction
KW - Aged, 80 and over
UR - https://www.scopus.com/pages/publications/105029398476
U2 - 10.1371/journal.pone.0342068
DO - 10.1371/journal.pone.0342068
M3 - Article
C2 - 41662270
SN - 1932-6203
VL - 21
JO - PLoS ONE
JF - PLoS ONE
IS - 2 February
M1 - e0342068
ER -