Hospice Care's Influence on Pain, Sleep, Anxiety, and Depression: A Focus on Elderly Survivors of Cancer Chemotherapy

Abstract

Background: With population ageing, the number of elderly cancer chemotherapy survivors has been increasing. In addition, the elderly often face problems, such as pain, sleep disorders, anxiety and depression, which seriously affect their quality of life. We explored the effects of hospice care on pain, sleep quality, anxiety, depression, quality of life, chemotherapy-related adverse reactions and readmission rate in elderly cancer survivors after chemotherapy to supply evidence for the clinical promotion of this nursing model.

Methods: A total of 240 elderly cancer survivors who completed at least 4 cycles of chemotherapy (January 2022–June 2024) and had a 3-month follow-up were retrospectively enrolled. They were divided into the observation (hospice care + routine nursing, n = 124) and control (routine nursing, n = 116) groups. After 1:1 propensity score matching, 98 cases per group were analysed. Core (Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Short Form-36 Health Survey (SF-36)) and extended indicators (chemotherapy-related adverse reactions, 3-month readmission rate and nursing satisfaction) were compared pre- and postintervention.

Results: Pre-intervention, no significant differences were found between groups (p > 0.05). Post-intervention, the observation group had significantly lower VAS (2.08 ± 0.85), PSQI (5.25 ± 1.32), SAS (38.15 ± 4.15) and SDS (38.86 ± 4.40) scores than the control group (4.68 ± 1.33, 8.92 ± 1.65, 49.32 ± 5.40 and 50.65 ± 5.80, respectively; all p < 0.05). The observation group showed significant improvements in all eight dimensions of SF-36 (p < 0.05), with a larger improvement range than the control group. In addition, the observation group had lower incidence of chemotherapy-related adverse reactions (nausea and vomiting: 8.16%, fatigue: 16.33%), lower readmission rate (7.14%) and higher nursing satisfaction (95.92%) than the control group (24.49%, 31.63%, 19.39% and 82.65%, respectively; all p < 0.05).

Conclusions: Hospice care can effectively alleviate pain, sleep disorders, anxiety and depression in elderly cancer chemotherapy survivors, improve their quality of life, reduce adverse reactions and readmission rate and enhance nursing satisfaction and is thus worthy of clinical promotion.