Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?

This study investigates how cancer patients who receive care from community specialist palliative care (CSPC) nurses differ from those who do not. Thi s was achieved by secondary data analyses from the Regional Study of Care f or the Dying, a retrospective interview survey of deaths in 1990 in 20 nati onally representative health districts. Interviews were obtained for 2074/2 915 (71%) of randomly selected cancer deaths; 574 (27.8%) were reported to have received care from a Macmillan nurse, hospice home-care nurse, or othe r community specialist palliative care nurse. Using logistic regression ana lysis 10 factors were found to predict independently CSPC use. Being depend ent with dressing/undressing, needing help at night, having constipation, e xperiencing vomiting/nausea, being mentally confused, having breast cancer and being under the age of 75 years increased the likelihood of receiving C SPC. Having a lymphoma, leukaemia or myeloma, a brain tumour and being depe ndent on others for help with self-care for more than 1 year decreased the likelihood. The use of CSPC nurses to provide expertise in symptom control and to support families of dependent patients is consistent with the aims o f palliative care, and therefore appears appropriate. Further research is, however, needed to investigate the apparent age bias in access to these ser vices, and to ensure that CSPC services are provided on the basis of need, irrespective of patient age.