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http://ir.nhri.org.tw/handle/3990099045/9569
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| Title: | A decade of changes in family caregivers' preferences for life-sustaining treatments for terminally Ill cancer patients at end of life in the context of a family-oriented society |
| Authors: | Tang, ST;Wen, FH;Liu, LN;Chiang, MC;Lee, SC;Chou, MC;Feng, WL;Lin, YC;Liu, IP;Kuo, YH;Chi, SC;Lee, KC |
| Contributors: | National Institute of Cancer Research |
| Abstract: | CONTEXT: Temporal changes in different family caregiver cohorts' preferences for life-sustaining treatments (LST) at end of life (EOL) have not been examined nor has the concept of whether caregivers' LST preferences represent a homogeneous or heterogeneous construct. Furthermore, LST preferences are frequently assessed from multiple treatments, making clinical applications difficult/infeasible. OBJECTIVES: To identify parsimonious patterns and changes in the pattern of LST preferences for two independent cohorts of family caregivers for terminally ill Taiwanese cancer patients. METHODS: Preferences for cardio-pulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, tube feeding, and dialysis were assessed among 1617 and 2056 family caregivers in 2003-2004 and 2011-2012, respectively. Patterns and changes in LST preferences were examined by multi-group latent class analysis. RESULTS: Five distinct classes were identified: uniformly preferring, uniformly rejecting, uniformly uncertain, and favoring nutritional support but rejecting or uncertain about other treatments. Class probability significantly decreased from 29.3% to 23.7% for the uniformly rejecting class, remained largely unchanged for the uniformly preferring (16.9-18.6%), and favoring nutritional support but rejecting (37.1-37.5%) or uncertain about other treatments (8.0%-10.4%) classes, but significantly increased from 7.0% to 11.5% for the uniformly uncertain class over time. CONCLUSION: Family caregivers' LST preferences for terminally ill cancer patients are a heterogeneous construct and shifted from uniformly rejecting all LSTs toward greater uncertainty. Surrogate EOL-care decision-making may be facilitated by earlier and thorough assessments of caregivers' LST preferences and tailoring interventions to the unique needs of caregivers in each class identified in this study. |
| Date: | 2016-05 |
| Relation: | Journal of Pain and Symptom Management. 2016 May;51(5):907–915.e2. |
| Link to: | http://dx.doi.org/10.1016/j.jpainsymman.2015.12.326 |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0885-3924&DestApp=IC2JCR |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:000376510700018 |
| Cited Times(Scopus): | http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84979464851 |
| Appears in Collections: | [其他] 期刊論文
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| PUB26921491.pdf | | 196Kb | Adobe PDF | 264 | View/Open |
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