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Association of illness understanding with advance care planning and end-of-life care preferences for advanced cancer patients and their family members.
Yoo, Shin Hye; Lee, Jihye; Kang, Jung Hun; Maeng, Chi Hoon; Kim, Yu Jung; Song, Eun-Kee; Koh, Youngil; Yun, Hwan-Jung; Shim, Hyun-Jeong; Kwon, Jung Hye; Nam, Eun Mi; Kang, EunKyo; Choo, Jiyeon; Yun, Young Ho.
Afiliación
  • Yoo SH; Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
  • Lee J; Department of Medical Informatics, Seoul National University College of Medicine, Seoul, South Korea.
  • Kang JH; Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, South Korea.
  • Maeng CH; Division of Medical Oncology-Hematology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, South Korea.
  • Kim YJ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
  • Song EK; Division of Hematology/Oncology, Chonbuk National University Medical School, Jeonju, South Korea.
  • Koh Y; Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
  • Yun HJ; Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea.
  • Shim HJ; Division of Hematology and Medical Oncology, Department of Internal Medicine, Chonnam National University School of Medicine, Hwasun, South Korea.
  • Kwon JH; Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
  • Nam EM; Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea.
  • Kang E; Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
  • Choo J; Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
  • Yun YH; Department of Medical Informatics, Seoul National University College of Medicine, Seoul, South Korea. lawyun08@gmail.com.
Support Care Cancer ; 28(6): 2959-2967, 2020 Jun.
Article en En | MEDLINE | ID: mdl-31768736
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidado Terminal / Comprensión / Planificación Anticipada de Atención / Prioridad del Paciente / Neoplasias Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics / Patient_preference Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2020 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidado Terminal / Comprensión / Planificación Anticipada de Atención / Prioridad del Paciente / Neoplasias Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Ethics / Patient_preference Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2020 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Alemania