Factors associated with cancer patients' distinct death‐preparedness states

Author:

Wen Fur‐Hsing1,Hsieh Chia‐Hsun23,Chou Wen‐Chi34,Su Po‐Jung4,Hou Ming‐Mo4,Shen Wen‐Chi4,Chen Jen‐Shi34,Chang Wen‐Cheng34,Tang Siew Tzuh4567ORCID

Affiliation:

1. Department of International Business Soochow University Taipei Taiwan, ROC

2. Division of Hematology‐Oncology Department of Internal Medicine New Taipei Municipal TuCheng Hospital New Taipei City Taiwan, ROC

3. School of Medicine Chang Gung University Tao‐Yuan Taiwan, ROC

4. Division of Hematology‐Oncology Chang Gung Memorial Hospital at Linkou Tao‐Yuan Taiwan, ROC

5. School of Nursing Chang Gung University Tao‐Yuan Taiwan, ROC

6. Department of Nursing Chang Gung Memorial Hospital at Kaohsiung Kaohsiung Taiwan, ROC

7. Department of Nursing Chang Gung University of Science and Technology Taoyuan Taiwan, ROC

Abstract

AbstractBackground/ObjectiveFacilitating death preparedness is important for improving cancer patients' quality of death and dying. We aimed to identify factors associated with the four death‐preparedness states (no‐preparedness, cognitive‐only, emotional‐only, and sufficient‐preparedness) focusing on modifiable factors.MethodsIn this cohort study, we identified factors associated with 314 Taiwanese cancer patients' death‐preparedness states from time‐invariant socio‐demographics and lagged time‐varying modifiable variables, including disease burden, physician prognostic disclosure, patient‐family communication on end‐of‐life (EOL) issues, and perceived social support using hierarchical generalized linear modeling.ResultsPatients who were male, older, without financial hardship to make ends meet, and suffered lower symptom distress were more likely to be in the emotional‐only and sufficient‐preparedness states than the no‐death‐preparedness‐state. Younger age (adjusted odds ratio [95% confidence interval] = 0.95 [0.91, 0.99] per year increase in age) and greater functional dependency (1.05 [1.00, 1.11]) were associated with being in the cognitive‐only state. Physician prognostic disclosure increased the likelihood of being in the cognitive‐only (51.51 [14.01, 189.36]) and sufficient‐preparedness (47.42 [10.93, 205.79]) states, whereas higher patient‐family communication on EOL issues reduced likelihood for the emotional‐only state (0.38 [0.21, 0.69]). Higher perceived social support reduced the likelihood of cognitive‐only (0.94 [0.91, 0.98]) but increased the chance of emotional‐only (1.09 [1.05, 1.14]) state membership.ConclusionsDeath‐preparedness states are associated with patients' socio‐demographics, disease burden, physician prognostic disclosure, patient‐family communication on EOL issues, and perceived social support. Providing accurate prognostic disclosure, adequately managing symptom distress, supporting those with higher functional dependence, promoting empathetic patient‐family communication on EOL issues, and enhancing perceived social support may facilitate death preparedness.

Funder

Ministry of Science and Technology, Taiwan

Chang Gung Memorial Hospital, Linkou

National Health Research Institutes

Publisher

Wiley

Subject

Psychiatry and Mental health,Oncology,Experimental and Cognitive Psychology

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