國家衛生研究院 NHRI:Item 3990099045/9569
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    题名: 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
    作者: Tang, ST;Wen, FH;Liu, LN;Chiang, MC;Lee, SC;Chou, MC;Feng, WL;Lin, YC;Liu, IP;Kuo, YH;Chi, SC;Lee, KC
    贡献者: National Institute of Cancer Research
    摘要: 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.
    日期: 2016-05
    關聯: 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
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