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End-of-Life Preferences, Length-of-Life Conversations, and Hospice Enrollment in Palliative Care: A Direct Observation Cohort Study among People with Advanced Cancer.
- Source :
-
Journal of Palliative Medicine . Feb2019, Vol. 22 Issue 2, p152-156. 5p. 3 Charts, 1 Graph. - Publication Year :
- 2019
-
Abstract
- Context: Prognosis communication is one hypothesized mechanism by which effective palliative care (PC) promotes preference-concordant treatment near end of life (EOL), but little is known about this relationship. Methods: This is a multisite cohort study of 231 hospitalized patients with advanced cancer who consulted with PC. We audio-recorded the initial consultation with the PC team and coded conversations for all statements regarding expectations for how long the patient will live. We refer to these statements as length-of-life talk. We followed patients for up to six months to determine EOL treatment utilization, including hospice enrollment. Patients completed a brief interviewer-facilitated questionnaire at study enrollment. Results: Forty-four percent (101/231) of observed conversations contained at least one statement about expectations for length of life, and 60% of patients (139/231) enrolled in hospice during the six months following these conversations. The association between length-of-life talk and hospice enrollment was strong among those (155/231) who endorsed treatment preferences favoring comfort over longevity in the last weeks to months of life (odds ratio [OR]adj = 2.98; 95% confidence interval [CI] = 1.34–6.65) and weak/absent among others (69/231; ORadj = 0.70; 95% CI = 0.16–3.04). Conclusions: Talking about expectations for remaining length of life during PC consultations is associated with six-month hospice enrollment among people with advanced cancer who endorse preferences for EOL treatment that favor comfort over longevity. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TUMOR treatment
*CANCER patient psychology
*CONFIDENCE intervals
*CONVERSATION
*HOSPICE care
*LONGEVITY
*LONGITUDINAL method
*PATIENT-professional relations
*MEDICAL referrals
*SCIENTIFIC observation
*PALLIATIVE treatment
*QUESTIONNAIRES
*TUMOR classification
*PATIENTS' attitudes
*ODDS ratio
TUMOR prognosis
Subjects
Details
- Language :
- English
- ISSN :
- 10966218
- Volume :
- 22
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 134426487
- Full Text :
- https://doi.org/10.1089/jpm.2018.0476