Gender and Observed Complexity in Palliative Home Care: A Prospective Multicentre Study Using the HexCom Model

Area of Science:

• Palliative Care
• Geriatric Medicine
• Health Services Research

Background:

• Palliative home care addresses complex needs of patients with advanced diseases.
• Understanding gender-specific differences in care complexity is crucial for tailored interventions.
• The HexCom model provides a framework for assessing multidimensional care complexity.

Purpose of the Study:

• To analyze gender differences in the complexity of palliative home care.
• To investigate how age and gender interact in shaping care complexity.
• To identify specific dimensions of care complexity that differ between men and women.

Main Methods:

• A multicentre longitudinal observational study involving 1677 patients receiving palliative home care in Catalonia, Spain.
• Utilized the HexCom model to measure care complexity across six dimensions and three levels (high, medium, low).
• Statistical analysis compared complexity levels and specific subareas between genders, with a focus on individuals over 80.

Main Results:

• Women (44%) showed less cancer prevalence but higher rates of cognitive impairment and professional caregiver use compared to men.
• Women over 80 exhibited less complexity in symptom management, emotional, spiritual, and socio-familial distress, and preferred location of death.
• Men over 80 demonstrated higher complexity in 'practice' and 'transcendence' subareas.

Conclusions:

• Observed care complexity in palliative home care is associated with male gender in individuals over 80.
• Older women over 80 present distinct care profiles with generally lower complexity than their male counterparts.
• Findings highlight the need for gender-sensitive approaches in palliative home care, especially for the elderly.