Elements of End-of-Life Discussions Associated With Patients' Reported Outcomes and Actual End-of-Life Care in Patients With Pretreated Lung Cancer

被引：3

作者：

Hasegawa, Takaaki ^{[1
]}

Okuyama, Toru ^{[1
,2
,3
]}

Uemura, Takehiro ^{[4
,5
]}

Matsuda, Yoshinobu ^{[6
]}

Otani, Hiroyuki ^{[7
,8
]}

Shimizu, Junichi ^{[5
]}

Horio, Yoshitsugu ^{[5
]}

Watanabe, Naohiro ^{[5
]}

Yamaguchi, Teppei ^{[5
]}

Fukuda, Satoshi ^{[4
]}

Oguri, Tetsuya ^{[4
,9
,10
]}

Maeno, Ken ^{[4
]}

Taniguchi, Yoshihiko ^{[11
]}

Nosaki, Kaname ^{[12
,13
]}

Fukumitsu, Kensuke ^{[4
]}

Akechi, Tatsuo ^{[1
,2
]}

机构：

[1] Nagoya City Univ Hosp, Ctr Psychooncol & Palliat Care, Nagoya, Aichi, Japan

[2] Nagoya City Univ, Grad Sch Med Sci, Dept Psychiat & Cognit Behav Med, Nagoya, Aichi, Japan

[3] Nagoya City Univ, Palliat Care Ctr, Dept Psychiat, West Med Ctr, 1-1-1 Hirate Cho, Kita Ku, Nagoya, Aichi 4628508, Japan

[4] Nagoya City Univ, Grad Sch Med Sci, Dept Resp Med Allergy & Clin Immunol, Nagoya, Aichi, Japan

[5] Aichi Canc Ctr Hosp, Dept Thorac Oncol, Nagoya, Aichi, Japan

[6] Natl Hosp Org, Dept Psychosomat Internal Med, Kinki Chuo Chest Med Ctr, Sakai, Osaka, Japan

[7] Natl Hosp Org, Dept Palliat Care Team, Palliat & Support Care, Kyushu Canc Ctr, Fukuoka, Fukuoka, Japan

[8] St Marys Hosp, Dept Palliat & Support Care, Palliat Care Team, Kurume, Fukuoka, Japan

[9] Nagoya City Univ, Dept Educ, Grad Sch Med Sci, Nagoya, Aichi, Japan

[10] Nagoya City Univ, Res Ctr Community Med, Grad Sch Med Sci, Nagoya, Aichi, Japan

[11] Natl Hosp Org, Dept Internal Med, Kinki Chuo Chest Med Ctr, Sakai, Osaka, Japan

[12] Natl Hosp Org, Dept Thorac Oncol, Fukuoka, Fukuoka, Japan

[13] Natl Canc Ctr Hosp East, Dept Thorac Oncol, Kashiwa, Chiba, Japan

来源：

ONCOLOGIST | 2024年 / 29卷 / 02期

关键词：

neoplasm; lung cancer; end-of-life discussion; communication; advance care planning; palliative care; ADVANCE CARE; CONSENSUS DEFINITION; NEAR-DEATH; COMMUNICATION; PREDICTORS; COMPASSION; ATTITUDES; ONCOLOGY; QUALITY; VERSION;

D O I：

10.1093/oncolo/oyad245

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background End-of-life discussions for patients with advanced cancer are internationally recommended to ensure consistency of end-of-life care with patients' values. This study examined the elements of end-of-life discussions associated with end-of-life care.Materials and Methods We performed a prospective observational study among consecutive patients with pretreated non-small cell lung cancer after the failure of first-line chemotherapy. We asked oncologists whether they had ever discussed "prognosis," "do not attempt resuscitation," "hospice," and "preferred place of death" with a patient at baseline. The quality of life (QOL) and depressive symptoms of patients were assessed using validated questionnaires at baseline and 3 months later. The end-of-life care that patients received was investigated using medical records. Oncologists' compassion and caregivers' preferences for hospice care were also assessed using questionnaires. Multiple regression analyses were conducted to examine the association between elements of end-of-life discussions and patient-reported outcomes as well as actual end-of-life care.Results We obtained 200 valid responses at baseline, 147 valid responses 3 months later, and 145 data points for medical care at the end-of-life stage. No element of the end-of-life discussion between the patient and their oncologist was significantly associated with patients' reported outcomes or actual end-of-life care. In addition, oncologists' compassion was significantly associated with improvement in both comprehensive QOL and depressive symptoms, and caregivers' preferences for hospice care and high educational level were significantly associated with hospice death.Conclusion Oncologist-patient alliances and caregivers' involvement in end-of-life discussions may be influential in achieving optimal end-of-life care. This study evaluated elements of end-of-life discussion on comprehensive quality of life and depressive symptoms in patients with incurable non-small cell lung cancer, as well as which elements are most associated with care decisions and the role of oncologists' empathy and caregivers' preferences in such decisions.

引用

页码：e282 / e289

页数：8

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