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Supportive Care in Cancer
Published in: Supportive Care in Cancer 10/2016

Open Access 01-10-2016 | Original Article

Knowledge, attitudes, and influencing factors of cancer patients toward approving advance directives in China

Authors: Ru-jun Zheng, Yan Fu, Qiu-fen Xiang, Mei Yang, Lin Chen, Ying-kang Shi, Chun-hua Yu, Jun-ying Li

Published in: Supportive Care in Cancer | Issue 10/2016

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Abstract

Purpose

Many cancer patients do not have advance directives (ADs), which may lead to unwanted excessive or aggressive care when patients have lost decision-making capacity. The aim of this study was to investigate knowledge and attitudes of approving ADs and explore factors associated with willing to designate ADs among cancer patients in China.

Methods

We conducted semi-structured interview method investigating 753 in-patients with cancer in two cancer centers.

Results

Of those subjects, none of the cancer patients had an AD. Only 22.4 % (118 of 526) approved ADs. Comparing with the disapproved ADs group, the approved ADs group were more likely to discuss the AD with oncologist or nurse (χ 2 = 180.4, p < 0.001) in the cancer center (χ 2 = 244.1, p < 0.001), and they chose more comfort care (χ 2 = 18.8, p < 0.001). Most of cancer patients in the two groups wanted to die at home (72.8 %, 73.7 %, respectively). The older patients (OR, 1.04, 95 % CI, 1.02–1.07, p = 0.001), female (OR, 0.55, 95 % CI, 0.35–0.88, p = 0.013), with higher education levels (OR, 3.38, 95 % CI, 1.92–5.96, p < 0.001), with religious beliefs (OR, 2.91, 95 % CI, 1.71–4.94, p < 0.001), and with higher scores of ECOG (OR, 1.46, 95 % CI, 1.17–1.82, p = 0.001) were associated with desiring for ADs.

Conclusions

Our findings indicate that there was a dearth of knowledge and different attitudes toward approving ADs among cancer patients, and some factors of demographic and clinical characteristics influenced their willing to designate ADs. This research highlights the importance of propagandizing the ADs to the public, especially to the patients, and further discussing with them when the time is ripe.
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Metadata
Title
Knowledge, attitudes, and influencing factors of cancer patients toward approving advance directives in China
Authors
Ru-jun Zheng
Yan Fu
Qiu-fen Xiang
Mei Yang
Lin Chen
Ying-kang Shi
Chun-hua Yu
Jun-ying Li
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3223-1

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