Attitudes of terminally ill cancer patients about euthanasia and assisted suicide: predominance of psychosocial determinants and beliefs over symptom distress and subsequent survival.
Attitudes of terminally ill cancer patients about euthanasia and assisted suicide: predominance of psychosocial determinants and beliefs over symptom distress and subsequent survival.
复制标题
绝症癌症患者对安乐死和协助自杀的态度：心理社会决定因素和信念对症状困扰和随后的生存的主导作用。
DOI：
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发表时间：
2002
影响因子：
45.3
通讯作者：
E. Bruera
中科院分区：
文献类型：
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作者：
M. Suarez‐Almazor;C. Newman;J. Hanson;E. Bruera
目的
虽然安乐死和医生协助自杀(PAS)是有争议的问题，但那些受影响最严重的晚期患者的观点很少被探讨。我们的目的是评估晚期癌症患者对安乐死/PAS的态度是否由他们的症状苦恼决定。
患者和方法
我们对100名晚期癌症患者进行了调查。使用Likert量表对与安乐死/PAS合法化相关的陈述进行评分。我们还询问了患者他们考虑结束生命的频率。他们的反应被分析与疾病特征有关，包括对症状严重程度、社会人口学特征、对癌症患者痛苦的一般信念和存活率的评估。
结果
大多数患者(69%)在一种或多种情况下支持安乐死或PAS。这些态度和症状之间的关联很弱，仅在呼吸急促的单变量分析中是一致的。没有观察到疼痛、恶心、幸福感、食欲不振、抑郁或随后的生存之间的显著关联。同意安乐死与男性，缺乏宗教信仰，以及对癌症患者及其家人的痛苦的一般信念显著相关。在多变量分析中，唯一在统计上与支持相关的特征是宗教信仰的力量，以及癌症患者是他们家庭的沉重负担的看法。自杀念头的频率与幸福感差、抑郁、焦虑和呼吸短促有关，但与其他躯体症状如疼痛、恶心和食欲不振无关。
结论
症状强度对晚期癌症患者对安乐死的态度影响有限。我们的发现表明，患者的观点主要是由心理社会特征和信念决定的，而不是疾病的严重性或症状性痛苦。
PURPOSE
Although euthanasia and physician-assisted suicide (PAS) are controversial issues, the views of those most affected, terminal patients, are seldom explored. Our objective was to assess whether the attitudes about euthanasia/PAS of terminally ill cancer patients were determined by their symptomatic distress.
PATIENTS AND METHODS
We conducted a survey of 100 patients with terminal cancer. Statements related to the legalization of euthanasia/PAS were scored using Likert scales. We also asked patients how often they had considered ending their lives. Their responses were analyzed in relation to disease characteristics, including an assessment of symptomatic severity, sociodemographic features, general beliefs about the suffering of cancer patients, and survival.
RESULTS
Most patients (69%) supported euthanasia or PAS for one or more situations. The association between these attitudes and symptoms was weak, consistent in univariate analysis only for shortness of breath. No significant associations were observed with pain, nausea, well-being, loss of appetite, depression, or subsequent survival. Agreement with euthanasia was significantly related to male sex, lack of religious beliefs, and general beliefs about the suffering of cancer patients and their families. In multivariate analysis, the only characteristics that remained statistically associated with support were the strength of religious beliefs and the perception that patients with cancer are a heavy burden on their families. Frequency of suicidal ideation was associated with poor well-being, depression, anxiety, and shortness of breath, but not with other somatic symptoms such as pain, nausea, and loss of appetite.
CONCLUSION
Symptom intensity had limited impact on the attitudes about euthanasia of terminally ill cancer patients. Our findings suggest that patient views are primarily determined by psychosocial traits and beliefs, as opposed to disease severity or symptomatic distress.