scholarly journals Retrospective study of decision-making regarding end-of-life care near death for terminally ill cancer patients

2014 ◽  
Vol 9 (3) ◽  
pp. 118-123
Author(s):  
Sachie Kuriaki ◽  
Tomohiko Kamimura
Keyword(s):  
Decision Making ◽  
Retrospective Study ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminally Ill ◽  
Life Care ◽  
Terminally Ill Cancer Patients

Accurate prognostic awareness and preference states influence the concordance between terminally ill cancer patients’ states of preferred and received life-sustaining treatments in the last 6 months of life

2019 ◽  
Vol 33 (8) ◽  
pp. 1069-1079 ◽  
Author(s):  
Fur-Hsing Wen ◽  
Jen-Shi Chen ◽  
Wen-Cheng Chang ◽  
Wen-Chi Chou ◽  
Chia-Hsun Hsieh ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Nutritional Support ◽  
Terminally Ill ◽  
Cardiac Massage ◽  
Life Care ◽  
Terminally Ill Cancer Patients ◽  
Life Sustaining Treatment ◽  
To Receive

Background: Factors facilitating/hindering concordance between preferred and received life-sustaining treatments may be distorted if preferences and predictors are measured long before death. Aim: To examine factors facilitating/hindering concordance between cancer patients’ preferred and received life-sustaining-treatment states in their last 6 months. Design: Longitudinal, observational design. Setting/participants: States of preferred and received life-sustaining treatments (cardio-pulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, and nasogastric tube feeding) were examined in 218 Taiwanese cancer patients by a latent transition model with hidden Markov modeling. Multivariate logistic regression modeling was used to examine factors facilitating/hindering concordance between preferred and received life-sustaining-treatment states. Results: Concordance between preferred and received life-sustaining-treatment states was poor (40.8%, kappa value (95% confidence interval): 0.05 [–0.03, 0.14]). Patients who accurately understood their prognosis and preferred comfort care were significantly more likely to receive preferred life-sustaining treatments before death than those who did not know their prognosis but wanted to know, those who were uniformly uncertain about what life-sustaining treatments they preferred to receive, and those who preferred nutritional support but declined other life-sustaining treatments. Patient age, physician–patient end-of-life-care discussions, symptom distress, and functional dependence were not associated with concordance between preferred and received life-sustaining-treatment states. Conclusion: Prognostic awareness and preferred states of life-sustaining treatments were significantly associated with concordance between preferred and received life-sustaining-treatment states. Personalized interventions should be developed to cultivate terminally ill cancer patients’ accurate prognostic awareness, allowing them to formulate realistic life-sustaining-treatment preferences and facilitating their receiving value-concordant end-of-life care.

Associations between accurate prognostic understanding and end-of-life care preferences and its correlates among Taiwanese terminally ill cancer patients surveyed in 2011-2012

2014 ◽  
Vol 23 (7) ◽  
pp. 780-787 ◽  
Author(s):  
Siew Tzuh Tang ◽  
Tsang-Wu Liu ◽  
Jyh-Ming Chow ◽  
Chang-Fang Chiu ◽  
Ruey-Kuen Hsieh ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminally Ill ◽  
Life Care ◽  
Terminally Ill Cancer Patients

scholarly journals Longitudinal Changes and Predictors of Caregiving Burden While Providing End-of-Life Care for Terminally Ill Cancer Patients

2013 ◽  
Vol 16 (6) ◽  
pp. 632-637 ◽  
Author(s):  
Kwo C. Lee ◽  
Wen-Cheng Chang ◽  
Wen-Chi Chou ◽  
Po-Jung Su ◽  
Chia-hsun Hsieh ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminally Ill ◽  
Life Care ◽  
Caregiving Burden ◽  
Longitudinal Changes ◽  
Terminally Ill Cancer Patients

Preferences for Aggressive End-of-life Care and Their Determinants Among Taiwanese Terminally Ill Cancer Patients

2015 ◽  
Vol 38 (3) ◽  
pp. E9-E18 ◽  
Author(s):  
Li N. Liu ◽  
Chen H. Chen ◽  
Tsang W. Liu ◽  
Yu C. Lin ◽  
Shiuyu C.K. Lee ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminally Ill ◽  
Life Care ◽  
Terminally Ill Cancer Patients

Determinants of death in an inpatient hospice for terminally ill cancer patients

2004 ◽  
Vol 2 (4) ◽  
pp. 361-370 ◽  
Author(s):  
SIEW TZUH TANG ◽  
RUTH MCCORKLE ◽  
ELIZABETH H. BRADLEY ph.d.
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminally Ill ◽  
The United States ◽  
Local Health ◽  
Life Care ◽  
Terminally Ill Cancer Patients ◽  
At Home

Objective:Despite the strong emphasis on home-based end-of-life care in the United States and the recognition of dying at home as a gold standard of quality of care, hospice home care is not a panacea and death at home may not be feasible for every terminally ill cancer patient. Admission to an inpatient hospice and dying there may become a necessary and appropriate solution to distressing patients or exhausted families. However, the factors associated with death in an inpatient hospice have not been examined in previous studies.Methods:A prospective cohort study was conducted to investigate the determinants of death in an inpatient hospice for terminally ill cancer patients. Approximately two-fifths (40.8%) of the 180 terminally ill cancer patients in this study died in inpatient hospices over the 3-year study period.Results:Results from Cox proportional hazards model with adjustment for covariates revealed several factors that were significantly associated with dying in inpatient hospice, as opposed to home, in a nursing home, or in the hospital. Patients were more likely to die in an inpatient hospice if they received hospice care before death (hazard ratio [HR] = 7.32, 95% confidence interval [CI]: 3.21–16.67), if they had a prestated preference to die in an inpatient hospice (HR = 4.86, 95% CI: 2.24–10.51), if they resided in New Haven County (HR = 1.70, 95% CI: 1.00–2.93), or if they experienced higher levels of functional dependency (HR = 1.05, 95% CI: 1.02–1.08).Significance of results:The high prevalence of inpatient hospice deaths for terminally ill cancer patients in this study was related to the local health care system characteristics, health care needs at the end of life, and personal preference of place of death. Findings from this study may shed light on future directions for developing end-of-life care tailored to the needs of cancer patients who are admitted to hospices and eventually die there.

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