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Preferences on forgoing end-of-life treatment are stable over time with people owning an advance directive; A cohort study.
- Source :
-
Patient Education & Counseling . Dec2020, Vol. 103 Issue 12, p2571-2577. 7p. - Publication Year :
- 2020
-
Abstract
- <bold>Objective: </bold>We studied if preferences about end-of-life care of people having an advance directive (AD) stay stable over time and if (in) stability is associated with health status.<bold>Methods: </bold>A longitudinal cohort study with a population owning different types of ADs (n = 4638). Respondents repeatedly answered questionnaires between 2005-2010. Using hypothetical scenarios about advanced cancer and dementia we assessed preferences for continuing or forgoing resuscitation, mechanical ventilation, artificial nutrition and antibiotics. Using generalized estimated equations we analysed whether life-events and quality of life influenced changes in preferences.<bold>Results: </bold>The proportion of respondents with stable preferences ranged from 67 to 98 %. Preferences were most stable concerning resuscitation and least stable concerning mechanical ventilation. In only a few instances we found life-events or a change in quality of life could both increase or decrease odds to change preferences.<bold>Conclusion: </bold>Preferences concerning continuing or forgoing treatment at the end of life are stable for a majority of people with ADs, which supports their validity.<bold>Practice Implications: </bold>The value of on-going communication about preferences between patients and caregivers is confirmed by our findings concerning differences in stability between treatments and the association between stability of preferences and life-events or quality of life. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 07383991
- Volume :
- 103
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Patient Education & Counseling
- Publication Type :
- Academic Journal
- Accession number :
- 146995934
- Full Text :
- https://doi.org/10.1016/j.pec.2020.05.031