Correlates of life-support treatment preferences among low-income home-based cancer management recipients
- Authors
- Kim, JinShil; Heo, Seongkum; Kim, Mi Yeong; Park, Eun Young; Seo, Eun Ju; Lee, Mee Ok; Jeong, Bo Yoon; Lee, Jung-Ah
- Issue Date
- Dec-2019
- Publisher
- ELSEVIER SCI LTD
- Keywords
- Advance directive; Cancer; Community; Attitudes; Symptom
- Citation
- EUROPEAN JOURNAL OF ONCOLOGY NURSING, v.43
- Journal Title
- EUROPEAN JOURNAL OF ONCOLOGY NURSING
- Volume
- 43
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/17926
- DOI
- 10.1016/j.ejon.2019.09.006
- ISSN
- 1462-3889
- Abstract
- Purpose: To examine the correlates of life-support treatment (LST) preferences from attitudes toward advance directives (ADs), perceived susceptibility, symptom frequency, symptom burden, and global health among low-income community-dwelling cancer management recipients, controlling for age, sex, education, and duration after cancer diagnosis. Methods: A cross-sectional, correlational study design was used to assess LST preferences and correlates. Data were collected from low-income cancer survivors during nurses' home visits. Results: Survivors who had mostly solid cancer participated (N = 107, mean age = 67.39 +/- 11.57 years, 32.7% males). Hospice care was the most desired (66.4%), while aggressive treatments were less preferred: cardiopulmonary resuscitation (15.9%), ventilation support (15.0%), hemodialysis (18.7%), or chemotherapy (12.1%). Higher symptom frequency was associated with a greater likelihood of preferring all aggressive treatments (odds ratios = 1.44-1.75). In addition, longer cancer duration was associated with a greater likelihood of preferring ventilation support; females had a lesser likelihood of preferring hemodialysis and chemotherapy. Higher education was associated with a lesser likelihood of preferring chemotherapy. More positive attitudes (B = 0.15, p = .001) were associated with a greater likelihood of preferring hospice care, and greater symptom burden of pain (B = 0.03, p = .047) was associated with a lesser likelihood. Conclusion: Results support the feasibility of incorporating ADs into cancer management among community-dwelling cancer survivors, with consideration of AD attitudes and symptom monitoring. An integration of AD discussion into the home visiting service could be a liaison for the quality and continuity of cancer survivorship care that guides and manages patients' survivorship issues.
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