In the week before their death, patients treated at in intensive care unit (ICU) were more nervous and troubled by their symptoms than others who prayed or meditated, or had a good rapport with their doctor.

“Maybe the best medicine for patients who are dying is developing a therapeutic alliance between doctors and patients – that is, an emotional connection, a feeling that there are shared goals,” said the lead author, Dr Holly G. Prigerson of the Dana-Farber Cancer Institute and the Harvard Medical School in Boston.

The research, published in the Archives of Internal Medicine, adds to a growing body of evidence suggesting that potent drugs and aggressive medical care may end up doing more harm than good for patients with only months left to live.

Prigerson and colleagues used data from the ‘€˜Coping With Cancer’€™ study, which followed nearly 400 terminally ill cancer patients from across the US. The patients were interviewed and completed a questionnaire about their relationship with their physician – including whether they trusted their doctors and felt they were being treated as a whole person.

Their caregivers also were interviewed at the outset and again after the death of the patient – on average four months after enrolment in the study.

Based on the caregivers’ assessment of each patient’s quality of life during their last week, the researchers then created statistical models to see what factors mattered most.

Ending their lives at a hospital or in the ICU was tied to a lower quality of life during the patients’ last week, as was having a feeding tube or receiving chemotherapy. The same was true for worry at the outset of the study.

Religious activities like praying or meditating, however, were linked to a higher quality of life at the end, as were pastoral care and a sense of “therapeutic alliance.”

Source: Reuters Health