Home-based hospice care alleviates the burden of mental disorders in older patients with advanced cancer

doi:10.5498/wjp.119705

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Sep 19, 2026; 16(9): 119705
Published online Sep 19, 2026. doi: 10.5498/wjp.119705

Table 1 Comparison of baseline data between the two groups, mean ± SD/n (%)

Baseline data	Group A (n = 126)	Group B (n = 126)	t/χ² value	P value
Male/female	67/59	65/61	0.064	0.801
Age (years)	71.14 ± 5.36	70.48 ± 5.89	0.930	0.353
Clinical stage			0.398	0.528
Stage III	57 (45.24)	62 (49.20)
Stage IV	69 (54.76)	64 (50.79)
Cancer type			0.886	0.971
Lung cancer	32 (25.40)	29 (23.02)
Gastric cancer	26 (20.63)	30 (23.81)
Liver cancer	23 (18.25)	21 (16.67)
Colorectal cancer	31 (24.60)	34 (26.98)
Breast cancer	10 (7.94)	8 (6.35)
Esophageal cancer	4 (3.17)	4 (3.17)
Living situation			0.941	0.816
Living alone	10 (7.94)	8 (6.35)
Living with spouse only	51 (40.48)	58 (46.03)
Living with spouse and children	53 (42.06)	50 (39.68)
Other	12 (9.52)	10 (7.94)
Education level			0.862	0.835
Illiterate	12 (9.52)	15 (11.90)
Primary school	44 (34.92)	43 (34.13)
Junior high school	36 (28.57)	39 (30.95)
High school or above	34 (26.98)	29 (23.02)
Comorbidities
Hyperlipidemia	57 (45.24)	52 (41.27)	0.404	0.525
Hypertension	46 (36.51)	53 (42.06)	0.815	0.367
Type 2 diabetes	31 (24.60)	36 (28.57)	0.508	0.476
Coronary heart disease	19 (15.08)	22 (17.46)	0.262	0.609

Group A (control) received conventional care; group B (observation) received home-based hospice care.

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Table 2 Comparison of Hamilton Anxiety scale and Hamilton Depression scale scores between the two groups, mean ± SD

Group	n	HAMA		HAMD
Group	n	Before intervention	After intervention	Before intervention	After intervention
Group A	126	18.85 ± 2.96	14.24 ± 2.12^a	17.11 ± 3.42	12.74 ± 2.69^a
Group B	126	19.01 ± 2.87	11.78 ± 1.63^a	17.05 ± 3.56	10.15 ± 2.21^a
t value		-0.436	10.326	0.136	8.351
P value		0.663	0.000	0.892	0.000

^aP < 0.05.

P compared with before the intervention. Group A (control) received conventional care; group B (observation) received home-based hospice care. HAMA: Hamilton Anxiety Scale; HAMD: Hamilton Depression Scale.

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Table 3 Comparison of Revised Piper Fatigue Scale scores between the two groups, mean ± SD

Group	n	Cognition		Sense		Emotion		Behavior
Group	n	Before intervention	After intervention	Before intervention	After intervention	Before intervention	After intervention	Before intervention	After intervention
Group A	126	6.36 ± 0.74	5.14 ± 0.52^a	5.93 ± 0.78	4.86 ± 0.64^a	6.47 ± 0.69	5.42 ± 0.59^a	5.67 ± 0.65	4.02 ± 0.42^a
Group B	126	6.29 ± 0.81	4.55 ± 0.68^a	6.02 ± 0.74	4.47 ± 0.60^a	6.52 ± 0.71	4.60 ± 0.61^a	5.59 ± 0.71	3.54 ± 0.50^a
t value		0.716	7.737	-0.940	4.990	-0.567	10.846	0.933	8.251
P value		0.475	0.000	0.348	0.000	0.571	0.000	0.352	0.000

^aP < 0.05.

P compared with before the intervention. Group A (control) received conventional care; group B (observation) received home-based hospice care.

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Table 4 Comparison of Edmonton Symptom Assessment System scores between the two groups, mean ± SD

Dimension	Time	Group A (n = 126)	Group B (n = 126)	t value	P value
Drowsiness	Before intervention	5.92 ± 0.74	6.01 ± 0.74	-0.965	0.335
	After intervention	3.45 ± 0.50^a	3.07 ± 0.38^a	6.792	0.000
Weakness	Before intervention	5.98 ± 0.78	5.87 ± 0.82	1.091	0.276
	After intervention	4.56 ± 0.64^a	3.98 ± 0.27^a	9.373	0.000
Nausea	Before intervention	4.54 ± 0.63	4.46 ± 0.67	0.976	0.330
	After intervention	2.91 ± 0.77^a	2.44 ± 0.61^a	5.371	0.000
Pain	Before intervention	6.15 ± 0.77	6.05 ± 0.70	1.079	0.282
	After intervention	4.41 ± 0.62^a	3.95 ± 0.40^a	6.998	0.000
Shortness of breath	Before intervention	3.57 ± 0.63	3.59 ± 0.60	-0.258	0.797
	After intervention	2.02 ± 0.31^a	1.62 ± 0.49^a	7.744	0.000
Anxiety	Before intervention	6.40 ± 0.92	6.33 ± 0.86	0.624	0.533
	After intervention	3.43 ± 0.60^a	2.42 ± 0.50^a	14.516	0.000
Depression	Before intervention	6.37 ± 0.94	6.44 ± 0.98	-0.579	0.563
	After intervention	3.59 ± 0.62^a	2.92 ± 0.40^a	10.193	0.000
Insomnia	Before intervention	6.48 ± 0.92	6.56 ± 0.93	-0.686	0.493
	After intervention	4.54 ± 0.62^a	4.00 ± 0.36^a	8.455	0.000
Poor appetite	Before intervention	5.93 ± 0.65	5.99 ± 0.75	-0.679	0.498
	After intervention	4.52 ± 0.60^a	4.03 ± 0.40^a	7.627	0.000
Impaired overall well-being	Before intervention	5.54 ± 0.63	5.50 ± 0.58	0.524	0.601
	After intervention	4.49 ± 0.50^a	3.96 ± 0.41^a	9.201	0.000

^aP < 0.05.

P compared with before the intervention. Group A (control) received conventional care; group B (observation) received home-based hospice care.

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Table 5 Comparison of Pittsburgh Sleep Quality Index scale scores between the two groups, mean ± SD

Dimension	Time	Group A (n = 126)	Group B (n = 126)	t value	P value
Sleep quality	Before intervention	2.42 ± 0.50	2.54 ± 0.50	-1.905	0.058
	After intervention	1.51 ± 0.62^a	1.00 ± 0.47^a	7.358	0.000
Sleep latency	Before intervention	2.01 ± 0.37	1.99 ± 0.37	0.429	0.668
	After intervention	1.05 ± 0.42^a	0.57 ± 0.50^a	8.251	0.000
Sleep duration	Before intervention	2.49 ± 0.50	2.48 ± 0.50	0.159	0.874
	After intervention	1.42 ± 0.61^a	1.06 ± 0.34^a	5.786	0.000
Sleep efficiency	Before intervention	2.46 ± 0.50	2.52 ± 0.50	-0.952	0.342
	After intervention	1.95 ± 0.40^a	1.53 ± 0.64^a	7.734	0.000
Sleep disorders	Before intervention	2.42 ± 0.50	2.54 ± 0.50	-1.905	0.058
	After intervention	2.02 ± 0.46^a	1.60 ± 0.59^a	6.302	0.000
Hypnotic drugs	Before intervention	2.02 ± 0.39	1.98 ± 0.35	0.857	0.392
	After intervention	1.50 ± 0.50	1.02 ± 0.44	8.090	0.000
Daytime function	Before intervention	2.51 ± 0.50	2.53 ± 0.50	-0.317	0.751
	After intervention	1.97 ± 0.38^a	1.51 ± 0.50^a	8.222	0.000

^aP < 0.05.

P compared with before the intervention. Group A (control) received conventional care; group B (observation) received home-based hospice care.

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Table 6 Comparison of Functional Assessment of Cancer Therapy-General scores between the two groups, mean ± SD

Group	n	Physical		Social/family		Emotion		Function
Group	n	Before intervention	After intervention	Before intervention	After intervention	Before intervention	After intervention	Before intervention	After intervention
Group A	126	11.02 ± 1.44	9.98 ± 1.13^a	9.56 ± 0.98	9.43 ± 0.93	7.52 ± 0.93	9.99 ± 1.08^a	6.52 ± 0.63	8.06 ± 0.76^a
Group B	126	11.25 ± 1.41	10.43 ± 0.92^a	9.46 ± 0.88	13.74 ± 1.28^a	7.43 ± 0.95	13.59 ± 1.40^a	6.59 ± 0.54	9.04 ± 0.75^a
t value		-1.281	-3.467	0.852	-30.578	0.760	-22.854	-0.947	-10.302
P value		0.201	0.001	0.395	0.000	0.448	0.000	0.345	0.000

^aP < 0.05.

P compared with before the intervention. Group A (control) received conventional care; group B (observation) received home-based hospice care.

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Table 7 Results of multiple linear regression analysis on factors influencing the improvement of mental disorder burden (n = 126)

Independent variables	Model 1 Δ HAMA		Model 2 Δ HAMD		Model 3 Δ PSQI
Independent variables	β (95%CI)	P value	β (95%CI)	P value	β (95%CI)	P value
Age	-0.105 (-0.420 to 0.210)	0.483	-0.084 (-0.389 to 0.221)	0.601	-0.053 (-0.283 to 0.177)	0.661
Sex	0.085 (-0.224 to 0.394)	0.562	0.117 (-0.185 to 0.419)	0.441	0.041 (-0.187 to 0.269)	0.718
Clinical stage	-0.151 (-0.464 to 0.162)	0.339	-0.250 (-0.564 to -0.010)	0.041	-0.125 (-0.357 to 0.107)	0.262
Living status	-0.179 (-0.492 to 0.134)	0.253	-0.310 (-0.618 to -0.046)	0.021	-0.142 (-0.374 to 0.090)	0.230
Education level	0.187 (-0.121 to 0.495)	0.226	0.351 (0.040 to 0.662)	0.027	0.147 (-0.082 to 0.376)	0.203
Pre-intervention ESAS pain score	-0.283 (-0.594 to -0.029)	0.028	-0.162 (-0.473 to 0.149)	0.311	-0.331 (-0.562 to -0.100)	0.005
Pre-intervention FACT-G social/family well-being score	0.316 (0.006 to 0.626)	0.045	0.267 (-0.043 to 0.577)	0.087	0.176 (-0.051 to 0.403)	0.124
Pre-intervention total PFS-R score	-0.214 (-0.525 to 0.097)	0.185	-0.223 (-0.534 to 0.088)	0.157	-0.287 (-0.518 to -0.056)	0.014
Caregiver training completion	0.374 (0.062 to 0.686)	0.020	0.232 (-0.084 to 0.548)	0.142	0.201 (-0.033 to 0.435)	0.092
Pain control target reached	0.243 (-0.071 to 0.557)	0.128	0.203 (-0.113 to 0.519)	0.206	0.408 (0.176 to 0.640)	0.001
Model statistics	R² = 0.361, after adjustment R² = 0.294		R² = 0.332, after adjustment R² = 0.264		R² = 0.398, after adjustment R² = 0.332
Model statistics	F = 5.115, P < 0.001		F = 4.475, P < 0.001		F = 6.013, P < 0.001

Δ Hamilton Anxiety Scale/Δ Hamilton Depression Scale/Δ Pittsburgh Sleep Quality Index, pre-intervention score minus post-intervention score. β, standardized regression coefficient, the absolute value indicates the relative influence of the independent variable on the dependent variable. Age, actual value. Sex, male = 1, female = 0. Clinical stage, stage Ⅲ = 0, stage IV = 1. Living status, not-living alone = 0, living alone = 1. Education level, below high school = 0, high school or above = 1. Pre-intervention Edmonton Symptom Assessment System pain score, actual value. Pre-intervention Functional Assessment of Cancer Therapy-General social/family well-being score, actual value. Pre-intervention total Revised Piper Fatigue Scale score, actual value. Caregiver training completion, not all training completed = 0, all training completed = 1. Pain control target reached, not reached = 0, reached = 1. HAMA: Hamilton Anxiety Scale; HAMD: Hamilton Depression Scale; PSQI: Pittsburgh Sleep Quality Index; CI: Confidence interval; ESAS: Edmonton Symptom Assessment System; FACT-G: Functional Assessment of Cancer Therapy-General; PFS-R: Revised Piper Fatigue Scale.

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Citation: Hou R, Xue XR, Qiao JY, Liu BX. Home-based hospice care alleviates the burden of mental disorders in older patients with advanced cancer. World J Psychiatry 2026; 16(9): 119705
URL: https://www.wjgnet.com/2220-3206/full/v16/i9/119705.htm
DOI: https://dx.doi.org/10.5498/wjp.119705

Hou R, Xue XR, Qiao JY, Liu BX. Home-based hospice care alleviates the burden of mental disorders in older patients with advanced cancer. World J Psychiatry 2026; 16(9): 119705 [DOI: 10.5498/wjp.119705]

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