Skip to main content
Top
Published in: Supportive Care in Cancer 2/2010

01-02-2010 | Original Article

The life-sustaining treatments among cancer patients at end of life and the caregiver’s experience and perspectives

Authors: Young Ho Yun, Myung Kyung Lee, Yoon Jung Chang, Chang Hoon You, Samyong Kim, Jong Soo Choi, Ho-Yeong Lim, Chang Geol Lee, Youn Seon Choi, Young Seon Hong, Si-Young Kim, Dae Seog Heo, Hyun Sik Jeong

Published in: Supportive Care in Cancer | Issue 2/2010

Login to get access

Abstract

Goals of work

The goal of this study was to investigate the utilization of and attitudes toward life-sustaining treatments (LSTs) at the end of life.

Materials and methods

We identified 4,042 families of cancer patients who had died at any of 17 hospitals in Korea during 2004. Among those, we analyzed the interviews provided by 1,592 (39.4%) primary caregivers. Only women who provided information in baseline and follow-up point could be included for internal comparison.

Main results

Most caregivers did not discuss with their patient the option of utilizing the intensive care unit (ICU; 92.7%) or cardiopulmonary resuscitation (CPR; 93.7%) to prolong an ending life. Logistic regressions indicated that the ICU was more likely to be utilized when patients experienced an unexpected medical problem before dying, discussed the ICU with the family caregiver, or were low-educated. CPR was more likely to be used if the patient died within 6 months of diagnosis or the family caregiver was <65 years old. Family caregivers more likely to use the ICU if placed in the same situation again were those whose patients had a higher monthly income or died within 6 months of diagnosis, low-educated, or had utilized the ICU.

Conclusions

Our findings underscore the importance of discussing LST with terminally ill patients based on adequate information.
Appendix
Available only for authorised users
Literature
2.
go back to reference Lynn J, Teno JM, Phillips RS et al (1997) Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med 126:97–106PubMed Lynn J, Teno JM, Phillips RS et al (1997) Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med 126:97–106PubMed
9.
go back to reference Diamond EL, Jernigan JA, Moseley RA et al (1989) Decision-making ability and advance directive preferences in nursing home patients and proxies. Gerontologist 29:622–626PubMed Diamond EL, Jernigan JA, Moseley RA et al (1989) Decision-making ability and advance directive preferences in nursing home patients and proxies. Gerontologist 29:622–626PubMed
13.
go back to reference Sulmasy DP, Terry PB, Weisman CS et al (1998) The accuracy of substituted judgments in patients with terminal diagnoses. Ann Intern Med 128:621–629PubMed Sulmasy DP, Terry PB, Weisman CS et al (1998) The accuracy of substituted judgments in patients with terminal diagnoses. Ann Intern Med 128:621–629PubMed
17.
go back to reference Yun YH et al (2004) Public attitudes toward dying with dignity and hospice·palliative care. Korean J of Hospice and Palliative Care 7(1):17–28 Yun YH et al (2004) Public attitudes toward dying with dignity and hospice·palliative care. Korean J of Hospice and Palliative Care 7(1):17–28
21.
go back to reference Hui E, Ho SC, Tsang J et al (1997) Attitudes toward life-sustaining treatment of older persons in Hong Kong. J Am Geriatr Soc 45:1232–1236PubMed Hui E, Ho SC, Tsang J et al (1997) Attitudes toward life-sustaining treatment of older persons in Hong Kong. J Am Geriatr Soc 45:1232–1236PubMed
23.
go back to reference Lurie N, Pheley AM, Miles SH et al (1992) Attitudes toward discussing life-sustaining treatments in extended care facility patients. J Am Geriatr Soc 40:1205–1208PubMed Lurie N, Pheley AM, Miles SH et al (1992) Attitudes toward discussing life-sustaining treatments in extended care facility patients. J Am Geriatr Soc 40:1205–1208PubMed
26.
go back to reference Hilfiker D (1983) Sounding Board. Allowing the debilitated to die. Facing our ethical choices. N Engl J Med 308:716–719PubMedCrossRef Hilfiker D (1983) Sounding Board. Allowing the debilitated to die. Facing our ethical choices. N Engl J Med 308:716–719PubMedCrossRef
27.
go back to reference McCormick TR, Conley BJ (1995) Patients’ perspectives on dying and on the care of dying patients. West J Med 163:236–243PubMed McCormick TR, Conley BJ (1995) Patients’ perspectives on dying and on the care of dying patients. West J Med 163:236–243PubMed
Metadata
Title
The life-sustaining treatments among cancer patients at end of life and the caregiver’s experience and perspectives
Authors
Young Ho Yun
Myung Kyung Lee
Yoon Jung Chang
Chang Hoon You
Samyong Kim
Jong Soo Choi
Ho-Yeong Lim
Chang Geol Lee
Youn Seon Choi
Young Seon Hong
Si-Young Kim
Dae Seog Heo
Hyun Sik Jeong
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 2/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0644-0

Other articles of this Issue 2/2010

Supportive Care in Cancer 2/2010 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine