Concordance of preferences for end-of-life care between terminally ILL cancer patients and their family caregivers in Taiwan
Journal
Journal of Pain and Symptom Management
Journal Volume
30
Journal Issue
6
Pages
510-518
Date Issued
2005
Abstract
There is a dearth of information in the literature about the concordance of preferences for end-of-life care between terminally ill patients and their family surrogates outside the Western countries. The purpose of this study was to examine the extent of concordance in preferences for end-of-life care goals and life-sustaining treatments between Taiwanese terminally ill cancer patients and their primary family caregivers. A total of 617 dyads of patients-family caregivers across 21 hospitals throughout Taiwan were surveyed. Overall agreements on the goals for end-of-life care and preferences for initiating life-sustaining treatments ranged from 62.4% to 96.9% (average: 71.0%). Kappa values for the extent of concordance ranged from 0.13 to 0.46 (average: 0.29), indicating poor to moderate consistency in personal preferences. Family caregivers had a significantly more aggressive attitude toward each examined life-sustaining treatment for their ill family members than the patients' own stated preferences. In societies, such as in Asian countries, where physicians' respect for patient autonomy is frequently subordinate to the power of family, disagreements between a patient and family about end-of-life care may result in the patient's preferences being overridden at the end of life. To effect real change and to gain increased agreement on preferences for end-of-life care, an open dialogue between patients and their primary family caregivers should become standard. ? 2005 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Subjects
Concordance of preferences; End-of-life care; Preferences for life-sustaining treatments
Other Subjects
article; cancer; cancer patient; caregiver; family counseling; health care; hospice patient; human; medical information; Taiwan; Adult; Advance Directives; Age Distribution; Aged; Aged, 80 and over; Attitude to Death; Caregivers; Decision Making; Female; Humans; Male; Middle Aged; Neoplasms; Proxy; Questionnaires; Resuscitation Orders; Sex Distribution; Statistics; Taiwan; Terminal Care
Type
journal article