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Preparation for the end of life in patients with advanced cancer and association with communication with professional caregivers
Psycho-Oncology, 05/07/2012
Wentlandt K et al. – A substantial minority of patients with advanced cancer but with good performance status are concerned about EOL preparation, particularly in relation to their families. Better clinician–patient communication (CPC) may help patients prepare not only practically but also personally and socially in relation to the dying process and the welfare of their families.
Methods- Patients with advanced cancer but with good performance status were recruited from 24 medical oncology clinics, to participate in a cluster-randomised controlled trial of early palliative care intervention.
- Measures included the Quality of Life at the End of Life preparation for EOL subscale, and measures of CPC, functional status, comorbidity, spiritual well-being and symptom severity.
- Using chi-squared tests, t-tests and multivariate regression analyses, they examined the variables associated with preparation for EOL.
- In the 469 patients, characteristics associated with better EOL preparation were better CPC, older age, living alone, less symptom burden and better spiritual well-being.
- Thirty-one per cent agreed that they worried ‘quite a bit’ or ‘completely’ about their family's preparation to cope with the future, and 27% agreed that they would be a burden to their family.
- All preparation items except regrets about life were associated with adequacy of communication.