Association of illness understanding with advance care planning and end-of-life care preferences for advanced cancer patients and their family members
- 주제(키워드) Advanced cancer , Prognosis , Caregiver , Advance care planning , End-of-life care
- 주제(기타) Oncology
- 주제(기타) Health Care Sciences & Services
- 주제(기타) Rehabilitation
- 설명문(일반) [Yoo, Shin Hye; Koh, Youngil] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Lee, Jihye; Yun, Young Ho] Seoul Natl Univ, Dept Med Informat, Coll Med, Seoul, South Korea; [Kang, Jung Hun] Gyeongsang Natl Univ, Dept Internal Med, Coll Med, Jinju, South Korea; [Maeng, Chi Hoon] Kyung Hee Univ, Kyung Hee Univ Hosp, Div Med Oncol Hematol, Dept Internal Med,Coll Med, Seoul, South Korea; [Kim, Yu Jung] Seoul Natl Univ, Coll Med, Bundang Hosp, Dept Internal Med, Seongnam, South Korea; [Song, Eun-Kee] Chonbuk Natl Univ, Med Sch, Div Hematol Oncol, Jeonju, South Korea; [Yun, Hwan-Jung] Chungnam Natl Univ Hosp, Dept Internal Med, Daejeon, South Korea; [Shim, Hyun-Jeong] Chonnam Natl Univ, Div Hematol & Med Oncol, Dept Internal Med, Sch Med, Hwasun, South Korea; [Kwon, Jung Hye] Hallym Univ, Kangdong Sacred Heart Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Nam, Eun Mi] Ewha Womans Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Kang, EunKyo; Choo, Jiyeon; Yun, Young Ho] Seoul Natl Univ Hosp, Dept Family Med, Seoul, South Korea; [Yun, Young Ho] Seoul Natl Univ, Dept Biomed Sci, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 SPRINGER
- 발행년도 2020
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000169289
- 본문언어 영어
- Published As https://dx.doi.org/10.1007/s00520-019-05174-5
- PubMed https://pubmed.ncbi.nlm.nih.gov/31768736
초록/요약
Purpose Little has been determined regarding the association between patients' and families' illness understanding and preferences for medical care. We aimed to evaluate the association of illness understanding with advance care planning (ACP) and preferences for end-of-life care, such as aggressive care, early palliative care (EPC), and hospice care, among advanced cancer patients and their family caregivers. Methods Patients were recruited for a prospective cohort study at outpatient and inpatient facilities in nine university hospitals in Korea (n = 150), and their primary family caregivers were also asked to participate (n = 101). Data on ACP and end-of-life care preferences were collected only at baseline in the cohort study with optional questions and were used to analyze these study results. Results Patients with illness understanding were more likely to have documented physician orders for life-sustaining treatment (POLSTs) (adjusted odds ratio [aOR] of 4.94) and to have discussed ACP with their families (aOR 2.15) than those who did not. Being expected to live for several months, they were unlikely to prefer active treatment. Caregivers understanding patients' illness were more likely to write advance directives (ADs) and to discuss ACP; furthermore, they had already discussed ACP with family members. They did not prefer active treatment or life-sustaining treatments when their family members were expected to die within a few weeks. There was no significant association between illness understanding and preferences for EPC. Conclusion Accurately recognizing an incurable disease is associated with preferences for more ACP and less aggressive care but not with preferences for EPC or hospice care among both advanced cancer patients and their family caregivers.
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