Attitudes of patients with incurable cancer toward medical treatment in the last phase of life
Attitudes of patients with incurable cancer toward medical treatment in the last phase of life
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DOI：
10.1200/jco.2005.07.104
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发表时间：
2005-03-20
影响因子：
45.3
通讯作者：
van der Maas, PJ
中科院分区：
文献类型：
--
作者：
Voogt, E;van der Heide, A;van der Maas, PJ
目的当癌症进展到不可能治愈的阶段时，患者可能不得不考虑进一步治疗的目标。方法对癌症患者进行访谈，并在6个月和12个月后对患者进行问卷调查，了解患者对延长生命治疗和临终决策的态度。结果122例患者(平均年龄岁；标准差10.5岁；女性53%)参与研究。患者对治疗的态度可分为以下三种不同的类型：争取生活质量，争取生命长度，没有明确的偏好。年龄较大、更疲倦或积极情绪较差的患者，以及更多主动参与提前护理计划的患者比其他人更倾向于争取生活质量。癌症病史小于6个月的患者比癌症病史较长的患者更倾向于延长生命。随访期间，除癌症病史较短的患者争取长度的倾向降低外，其余患者对治疗的态度均无改变。结论重视提前护理计划的患者比其他患者更倾向于追求生活质量。癌症确诊后不久，患者通常似乎更喜欢延长生命的治疗，而当死亡临近时，生活质量变得更加重要。(C)2005年，由美国临床肿瘤学会提供。
Purpose When cancer has advanced to a stage in which cure becomes unlikely, patients may have to consider the aim of further treatment. We studied the relationship of patients' attitudes toward treatment with advance care planning and the development of these attitudes after diagnosis of incurable cancer.Patients and Methods Patients with incurable cancer were interviewed and asked to fill out a written questionnaire about their attitudes concerning life-prolonging treatment and end-of-life decision making These questions were repeated after 6 and 12 months.Results One hundred twenty-two patients (mean age, 64 years; standard deviation, 10.5 years; 53% women) participated in the study. Patients' attitudes toward treatment could be categorized into the following three different profiles: striving for quality of life, striving for length of life, and no clear preference. Patients who were older, more tired, or had less positive feelings and patients who had more often taken initiatives to engage in advance care planning were more inclined to strive for quality of life than others. Patients with a history of cancer of less than 6 months were more inclined to prefer life prolongation than patients with a longer history of cancer. During follow-up, no changes in attitudes toward treatment were found, except for patients with a short history of cancer in whom the inclination to strive for length decreased.Conclusion Patients who appreciate advance care planning were more inclined to strive for quality of life than other patients. Shortly after the diagnosis of cancer, patients typically seem to prefer life-prolonging treatment, whereas quality of life becomes more important when death is nearing. (c) 2005 by American Society of Clinical Oncology.