Abstract
There is limited evidence on the relationships of preference for end-of-life life-sustaining treatments [LSTs] and diagnostic contexts like heart failure [HF] or cancer, and patient attitudes toward and perceived susceptibility to use advance directives [ADs]. Thus, this study aimed to compare attitudes and perceived susceptibility between HF patients and community-dwelling patients with cancer, and examine the associations of these variables with their preference for each LST (cardiopulmonary resuscitation [CPR], ventilation support, hemodialysis, and hospice care). Secondary data were obtained from 36 outpatients with HF (mean age, 65.44 years; male, 69.4%) and 107 cancer patients (mean age, 67.39 years; male, 32.7%). More patients with HF preferred CPR than cancer patients (41.7% and 15.9%, χ2 = 8.88, P = 0.003). Attitudes and perceived susceptibility were similar between the two diagnostic cohorts. HF patients and those with more positive attitudes had greater odds of preferring CPR (odds ratio [OR] = 3.02, confidence interval [CI] = 1.19, 7.70) and hospice care (OR = 1.14, CI = 1.06, 1.23), respectively. HF diagnosis and AD attitudes increased the preference for CPR and hospice care, respectively. This suggests that it is important to gain positive attitudes toward ADs and consider diagnostic context to facilitate informed decision-making for LSTs.
Highlights
Advances in medical therapeutics and management have prolonged patients’ survival rates after the diagnoses of heart failure (HF) [1], a non-cancerous disease but one of the most overwhelming progressive diseases [2, 3], and cancer [4, 5]
These findings indicate that improving advance directive (AD) attitudes can be an important target of interventions to facilitate informed decisions about life-sustaining treatments (LSTs), hospice care in both patients with HF and patients with cancer
One possible reason for the inconsistent findings in our study and the prior study may be differences in the outcomes; we examined the associations between sex and specific LST preferences, while prior studies examined the associations between sex and advance care planning (ACP) or AD documentation
Summary
Advances in medical therapeutics and management have prolonged patients’ survival rates after the diagnoses of heart failure (HF) [1], a non-cancerous disease but one of the most overwhelming progressive diseases [2, 3], and cancer [4, 5]. Advance directive perspectives treatment of illnesses, the burdens of care become substantial, often accompanying high morbidities and mortalities due to the chronic progressive nature of HF [1, 6], and cancer itself, treatment, or comorbid conditions [7,8,9]. The subsequent burdens in both diagnostic cohorts seem comparably high [10,11,12,13]. Number of patients with HF among hospice care recipients after admission to a nursing home was twice that of cancer patients [10].needs for advance care planning (ACP) in patients with HF and patients with advanced cancer were comparably high [13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
