Preference for Palliative Care in Cancer Patients: Are Men and Women Alike?
Preference for Palliative Care in Cancer Patients: Are Men and Women Alike?
复制标题
DOI：
10.1016/j.jpainsymman.2018.03.014
复制
发表时间：
2018-07-01
影响因子：
4.7
通讯作者：
Duberstein, Paul R.
中科院分区：
文献类型：
--
作者：
Saeed, Fahad;Hoerger, Michael;Duberstein, Paul R.
上下文。男性和受教育程度低的人接受姑息治疗的可能性较小。了解这些差异是一个高度优先的问题。在这项对晚期癌症患者的研究中，我们假设男性和受教育程度较低的人对姑息治疗的态度较差。我们对从383名患者收集的数据进行了横断面分析，这些数据来自癌症护理的价值和选项(VOICE)临床试验的研究条目。如果肿瘤医生告诉他们进一步的治疗无济于事，患者被问及他们对姑息治疗的偏好。姑息治疗被定义为“舒适护理”，其重点是“生活质量，但不是治愈”。回应选项肯定是否定的，可能是否定的，不确定的，可能是肯定的，当然是肯定的。那些更喜欢姑息治疗(肯定或可能是)的人与所有其他人进行了比较。预测因素是患者性别和教育程度。协变量包括年龄、种族、疾病侵袭性和经济压力。女性比男性更倾向于姑息治疗[优势比(95%CI)][3.07(1.80-5.23)]。教育对姑息治疗偏好的影响无统计学意义[0.85(0.48-1.48)]。患者对姑息治疗偏好的显著性别差异可以部分解释临终关怀方面的性别差异。在男性中促进姑息治疗的干预措施可以缩小这些差异。(C)2018年美国临终关怀与姑息医学学会。爱思唯尔公司出版，版权所有。
Context. Men and those with low educational attainment are less likely to receive palliative care. Understanding these disparities is a high priority issue.Objectives. In this study of advanced cancer patients, we hypothesized that men and those with lower levels of educational attainment would have less favorable attitudes toward palliative care.Methods. We performed a cross-sectional analysis of data collected from 383 patients at study entry in the Values and Options in Cancer Care (VOICE) clinical trial. Patients were asked about their preferences for palliative care if their oncologist informed them that further treatment would not be helpful. Palliative care was defined as "comfort care" that focuses on "quality of life, but not a cure." Response options were definitely no, possibly no, unsure, possibly yes, and definitely yes. Those preferring palliative care (definitely or possibly yes) were compared to all others. Predictors were patient gender and education level. Covariates included age, race, disease aggressiveness, and financial strain.Results. Women were more likely [odds ratio (95% CI)] than men to prefer palliative care [3.07 (1.80-5.23)]. The effect of education on preferences for palliative care was not statistically significant [0.85 (0.48-1.48)].Conclusion. Significant gender differences in patients' preferences for palliative care could partially account for gender disparities in end-of-life care. Interventions to promote palliative care among men could reduce these disparities. (C) 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.