Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan
Journal
Psycho-Oncology
Journal Volume
25
Journal Issue
2
Pages
179-186
Date Issued
2016
Author(s)
Abstract
Background Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. Methods We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. Results The good death score at admission, clear consciousness, number of admission days beyond 7, better physical care, higher physician-assessed autonomy, better emotional support, better communication, better continuity of life, and physician-reported rate of closure were factors affecting the quality of dying. Further analysis identified age (p = 0.031), consciousness (p = 0.01), and total good death scale score at death (p < 0.001) as determinants of physician-assessed autonomy. Conclusions We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan. Copyright ? 2015 John Wiley & Sons, Ltd.
SDGs
Other Subjects
adult; advanced cancer; Article; breast cancer; cancer patient; consciousness; digestive system cancer; dying; educational status; emotion; female; female genital tract cancer; head and neck cancer; hepatobiliary system tumor; hospice; human; major clinical study; male; pancreas cancer; patient autonomy; patient care; prospective study; rating scale; respiratory tract cancer; scoring system; Taiwan; aged; attitude to death; clinical trial; middle aged; multicenter study; multivariate analysis; neoplasm; palliative therapy; personal autonomy; psychology; questionnaire; terminal care; terminally ill patient; Aged; Attitude to Death; Female; Humans; Male; Middle Aged; Multivariate Analysis; Neoplasms; Palliative Care; Personal Autonomy; Prospective Studies; Surveys and Questionnaires; Taiwan; Terminal Care; Terminally Ill
Publisher
John Wiley and Sons Ltd
Type
journal article