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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

Title
Association of illness understanding with advance care planning and end-of-life care preferences for advanced cancer patients and their family members
Authors
Yoo, Shin HyeLee, JihyeKang, Jung HunMaeng, Chi HoonKim, Yu JungSong, Eun-KeeKoh, YoungilYun, Hwan-JungShim, Hyun-JeongKwon, Jung HyeNam, Eun MiKang, EunKyoChoo, JiyeonYun, Young Ho
Ewha Authors
남은미
SCOPUS Author ID
남은미scopus
Issue Date
2020
Journal Title
SUPPORTIVE CARE IN CANCER
ISSN
0941-4355JCR Link

1433-7339JCR Link
Citation
SUPPORTIVE CARE IN CANCER vol. 28, no. 6, pp. 2959 - 2967
Keywords
Advanced cancerPrognosisCaregiverAdvance care planningEnd-of-life care
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
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.
DOI
10.1007/s00520-019-05174-5
Appears in Collections:
의과대학 > 의학과 > Journal papers
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