The Understanding of Terminal Cancer and Its Relationship with Attitudes toward End-of-Life Care Issues

被引：10

作者：

Lee, June Koo ^{[1
]}

Yun, Young Ho ^{[2
]}

An, Ah Reum ^{[3
]}

Heo, Dae Seog ^{[1
]}

Park, Byeong-Woo ^{[4
]}

Cho, Chi-Heum ^{[5
]}

Kim, Sung ^{[6
]}

Lee, Dae Ho ^{[7
,8
]}

Lee, Soon Nam ^{[9
]}

Lee, Eun Sook ^{[10
]}

Kang, Jung Hun ^{[11
]}

Kim, Si-Young ^{[12
]}

Lee, Jung Lim ^{[13
]}

Lee, Chang Geol ^{[14
]}

Lim, Yeun Keun ^{[15
]}

Kim, Samyong ^{[16
]}

Choi, Jong Soo ^{[17
]}

Jeong, Hyun Sik ^{[18
]}

Chun, Mison ^{[19
]}

机构：

[1] Seoul Natl Univ Hosp, Dept Internal Med, Seoul 110744, South Korea

[2] Seoul Natl Univ, Dept Med Sci, Coll Med, Seoul 110799, South Korea

[3] Seoul Natl Univ Hosp, Dept Family Med, Seoul 110744, South Korea

[4] Yonsei Univ, Coll Med, Dept Surg, Med Ctr, Seoul, South Korea

[5] Keimyung Univ, Dept Obstet & Gynecol, Sch Med, Taegu, South Korea

[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea

[7] Univ Ulsan, Coll Med, Asan Med Ctr, Qual Life Improvement Team, Seoul, South Korea

[8] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Oncol, Seoul, South Korea

[9] Ewha Womans Univ, Dept Internal Med, Sect Med Oncol, Sch Med, Seoul, South Korea

[10] Korea Univ, Sch Med, Dept Surg, Anam Med Ctr, Seoul, South Korea

[11] Gyeongsang Natl Univ, Dept Internal Med, Postgrad Med Sch, Jinju, South Korea

[12] Kyung Hee Univ Hosp, Dept Med Oncol Hematol, Seoul, South Korea

[13] Fatima Hosp, Dept Hematooncol, Taegu, South Korea

[14] Yonsei Univ, Coll Med, Dept Radiat Oncol, Yonsei Canc Ctr, Seoul, South Korea

[15] Kwangju Christian Hosp, Kwangju, South Korea

[16] Chungnam Natl Univ, Dept Internal Med, Coll Med, Div Hematooncol, Taejon, South Korea

[17] Hongcheon Asan Hosp, Dept Internal Med, Hongcheon, South Korea

[18] Good Samaritan Hosp, Pohang, South Korea

[19] Ajou Univ, Sch Med, Dept Radiat Oncol, Suwon 441749, South Korea

来源：

MEDICAL DECISION MAKING | 2014年 / 34卷 / 06期

关键词：

terminal cancer; end of life; terminology; life-sustaining treatment; palliative care; PALLIATIVE CARE; FAMILY CAREGIVERS; SURVIVAL PREDICTION; PHYSICIANS; PREFERENCES; PATIENT; CONCORDANCE; DISCLOSURE; ILLNESS; DISEASE;

D O I：

10.1177/0272989X13501883

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background. Although terminal cancer is a widely used term, its meaning varies, which may lead to different attitudes toward end-of-life issues. The study was conducted to investigate differences in the understanding of terminal cancer and determine the relationship between this understanding and attitudes toward end-of-life issues. Methods. A questionnaire survey was performed between 2008 and 2009. A total of 1242 cancer patients, 1289 family caregivers, 303 oncologists from 17 hospitals, and 1006 participants from the general population responded. Results. A 6-month life expectancy was the most common understanding of terminal cancer (45.6%), followed by treatment refractoriness (21.1%), metastatic/recurrent disease (19.4%), survival of a few days/weeks (11.4%), and locally advanced disease (2.5%). The combined proportion of treatment refractoriness and 6-month life expectancy differed significantly between oncologists and the other groups combined (76.0% v. 65.9%, P = 0.0003). Multivariate analyses showed that patients and caregivers who understood terminal cancer as survival of a few days/weeks showed more negative attitudes toward disclosure of terminal status compared with participants who chose treatment refractoriness (adjusted odds ratio [aOR] 0.42, 95% confidence interval [CI] 0.22-0.79 for patients; aOR 0.34, 95% CI 0.18-0.63 for caregivers). Caregivers who understood terminal cancer as locally advanced or metastatic/recurrent disease showed a significantly lower percentage of agreement with withdrawal of futile life-sustaining treatment compared with those who chose treatment refractoriness (aOR 0.19, 95% CI 0.07-0.54 for locally advanced; aOR 0.39, 95% CI 0.21-0.72 for metastatic/recurrent). Conclusions. The understanding of terminal cancer varied among the 4 participant groups. It was associated with different preferences regarding end-of-life issues. Standardization of these terms is needed to better understand end-of-life care.

引用

页码：720 / 730

页数：11

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