Page 43 - IJSA, Vol. 4, No 2, 2021

International Journal of Science Annals, Vol. 5, No. 1-2, 2022
рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa

increasing and improving the quality of life, not the life countries with Bulgaria as an example, western
extension. Focusing on pain control and symptom relief European countries with Germany as an example as well
become the primary goal of therapy (Cunningham & as more advanced world Asia countries, in particular
Schulick, 2007). Singapore and Japan.
Another very essential element of palliative medicine Lastly, we analyzed available statistics about incidence,
for patients with stomach cancer is communication with prevention, 5-year survival of stomach cancer in the
the seriously ill or dying patient and his relatives. selected countries.
Honesty in communication, delivering bad news, and
grief support are examples of this. Thirdly, the ability of Results and Discussion
the patient to lead as normal life as possible, such as Table 1 presents the results about place of where the
carrying out old habits that give him/her pleasure and death of patients occurred. The data is collected in an
maintaining contact with relatives, should be noted. own study conducted with gastric cancer patients. The
Although palliative care, as defined above, is not limited results show that 345 deaths (91.2%) did not occur at the
to the treatment of patients with incurable gastric cancer, hospital. In other words, the majority of the patients died
it should be noted that traditionally palliative care is in their homes or in hospices.
established in the field of tumor diseases. Palliative care Table 1
does not exclude chemotherapy, radiation therapy
and/or surgical therapy. A condition for the Place of Death of Patients with Stomach Cancer

implementation of these therapies is, however, that the
benefits of these measures are greater than their potential Parameters Patients
adverse impact for patients (Kelsen & Atiq, 1993; Scarpi people %
et al., 2019).
In summary, palliative medicine is characterized by the Death occurred at home 345 91.2
following points (Koizumi et al., 1999): or in a hospice
1. Comprehensive control of the patient’s pain and Death occurred in the
symptoms. hospital 33 8.7
2. Integrating the physical, social and spiritual needs of
patients, relatives and the treating team, both during and Total 378 100.0
after illness and death. Although the terms hospice care and palliative care are
3. Accepting death as a part of life. When life ends, often used interchangeably, the main difference between
death should neither be hastened nor delayed. Palliative the two should be noted. While palliative care has a
medicine rejects euthanasia. broader scope, including patients with various diseases
4. Competence on the important issues of and needing long-term specialized and active general
communication and ethics. care for their physical, psychosocial and spiritual
The task and aim of palliative medicine are to provide condition, hospice care is focused on patients in the
support to the patient suffering from stomach cancer so terminal phase of their illness. It can be summarized that
that he has the best possible quality of life until his end. hospice care is part of palliative care with the important
This is possible thanks to the cooperation of capable clarification that it includes the preparation of the patient
palliative bases with family doctors, social care and and his family on topics related to the end of life and
hospital departments, as their main goal is to ensure implies even more intensive care for the physical,
optimal round-the-clock treatment of palliative ill psycho-social and mental condition of the patient in the
patients. (Kilpatrick & Johnson, 1999; Kitzes & last months of his/her life. This clarification also
Anderson, 2003). constructs one of the important moral questions faced by
The aim of the study. To provide empirical data for the specialists caring for patients in a terminal stage, namely
significance of palliative care for patients with gastric – is it necessary for the patient to know about the
cancer. In particular, we focus on the analyses of the role approaching death (Kern at al., 2007; Klaschik, 2009).
of palliative care for improvement of the duration and According to the Law on Medical Institutions of the
quality of life of stomach cancer patients and discussed Republic of Bulgaria, a hospice is a medical institution
potential mitigation of the negative mental and social “in which medical and other specialists carry out long-
impacts of the disease. term medical monitoring, supporting treatment
prescribed by a doctor for a person with chronic
Materials and Methods debilitating diseases and medico-social problems”
To address the research question, we used various (Methodist Le Bonheur Healthcare, n. d.). In contrast, in
empirical data as well as literature review. countries with better-developed services for terminally
Firstly, we performed descriptive statistics of data from ill patients (USA, England, Austria, Germany, etc.), this
an own study conducted with a total sample of 378 definition focus on the concept of “hospice care”, which
gastric cancer patients at the University clinic in is aimed precisely at the nature of the care itself rather
Heidelberg in order to analyze place of death and than the physical location where it is provided. This can
potentially palliative care of stomach cancer patients. be the patient’s home or a specialist facility – the right
Secondly, we compared prevention approaches as well to decide is in their hands and/or in the hands of the
as hospice and palliative care in eastern European family when the patient is unable to decide for himself.

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