A comparison of attitudes toward length and quality of life between community‐dwelling older adults and patients with advanced cancer

Malhotra, Chetna; Ling, Xiang; Özdemir, Semra; Kanesvaran, Ravindran; Chan, Noreen; Finkelstein, Eric A.

doi:10.1002/pon.4344

Cited by 11 publications

(10 citation statements)

References 33 publications

(45 reference statements)

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“…A community survey of elderly people in the United States demonstrated that those with poorer functional status were more likely to have engaged in ACP, whereas a study in Singapore demonstrated that most adults aged over 50 years chose quality of life over length of life when compared with advanced cancer patients. (15,16) Such inclination increased with age. While relying solely on a modified Barthel Index < 80 to stratify patients would be an oversimplification, our study results show that stratification by functional status could indeed be considered and utilised as part of a collective strategy to help more patients achieve successful completion of ACP discussion.…”

Section: Discussionmentioning

confidence: 92%

Integrating advance care planning as part of comprehensive geriatric assessment for hospitalised frail elderly patients: findings of a cross-sectional study

Yip¹,

Wong²,

Alhamid³

et al. 2020

smedj

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The integration of advance care planning (ACP) as part of the comprehensive geriatric assessment (CGA) of hospitalised frail elderly patients, together with the clinical and demographic factors that determine successful ACP discussion, has not been previously explored. METHODSA cross-sectional study on patients and family caregivers admitted under the geriatric medicine department of a tertiary hospital was conducted from October 2015 to December 2016. RESULTS Among 311 eligible patients, 116 (37.3%) patients completed ACP discussion while 166 (53.4%) patients declined, with 62 (37.3%) of the decliners providing reasons for refusal. Univariate logistic regression analysis showed that older age, higher Charlson Comorbidity Index, poorer functional status and cognitive impairment had statistically significant associations with agreeing to ACP discussion (p < 0.05). On multivariate logistic regression analysis, only poorer functional status was significantly associated (odds ratio 2.22 [95% confidence interval 1.27-3.87]; p = 0.005). Among those who completed ACP discussion, a majority declined cardiopulmonary resuscitation (79.3%), preferred limited medical intervention or comfort care (82.8%), and opted for blood transfusion (62.9%), antibiotics (73.3%) and intravenous fluid (74.1%) but declined haemodialysis (50.9%). Decision-making was divided for enteral feeding. Among decliners, the main reasons for refusal were 'not keen' (33.9%), 'deferring to doctors' decision' (11.3%) and 'lack of ACP awareness' (11.3%). CONCLUSIONThe feasibility and utility of integrating ACP as part of CGA has been demonstrated. Poorer functional status is significantly associated with successful ACP discussion. Greater public education on end-of-life care choices (besides cardiopulmonary resuscitation) and follow-up with decliners are recommended.

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Section: Discussionmentioning

confidence: 92%

Integrating advance care planning as part of comprehensive geriatric assessment for hospitalised frail elderly patients: findings of a cross-sectional study

Yip¹,

Wong²,

Alhamid³

et al. 2020

smedj

View full text Add to dashboard Cite

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“…In advanced cancer, where survival is commonly <1 year [1,2] and symptoms and side effects are prevalent and often debilitating [3,4], the fundamental challenge is to provide care to extend survival while simultaneously supporting quality of life [5][6][7][8][9]. Specialty palliative care programs are comprised of multidisciplinary teams of clinicians who meet with patients to support their quality of life, physically and psychologically, using specialized knowledge and skills to relieve the symptoms, side effects, and stress of serious illnesses [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Impact of Interdisciplinary Outpatient Specialty Palliative Care on Survival and Quality of Life in Adults With Advanced Cancer: A Meta-Analysis of Randomized Controlled Trials

Hoerger

Wayser

Schwing

et al. 2018

Annals of Behavioral Medicine

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Background In advanced cancer, patients want to know how their care options may affect survival and quality of life, but the impact of outpatient specialty palliative care on these outcomes in cancer is uncertain. Purpose To estimate the impact of outpatient specialty palliative care programs on survival and quality of life in adults with advanced cancer. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing outpatient specialty palliative care with usual care in adults with advanced cancer. Primary outcomes were 1 year survival and quality of life. Analyses were stratified to compare preliminary studies against higher-quality studies. Secondary outcomes were survival at other endpoints and physical and psychological quality-of-life measures. Results From 2,307 records, we identified nine studies for review, including five high-quality studies. In the three high-quality studies with long-term survival data (n = 646), patients randomized to outpatient specialty palliative care had a 14% absolute increase in 1 year survival relative to controls (56% vs. 42%, p < .001). The survival advantage was also observed at 6, 9, 15, and 18 months, and median survival was 4.56 months longer (14.55 vs. 9.99 months). In the five high-quality studies with quality-of-life data (n = 1,398), outpatient specialty palliative care improved quality-of-life relative to controls (g = .18, p < .001), including for physical and psychological measures. Conclusions Patients with advanced cancer randomized to receive outpatient specialty palliative care lived longer and had better quality of life. Findings have implications for improving care in advanced cancer.

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“…The reference point for an advanced cancer patient with a short life expectancy will be closer to death compared to an older adult with many years of expected survival. Thus, ill patients would prefer prolonging their life over quality of life, as was found in the results [ 33 , 34 , 36 ]. Likewise, sick patients rated a mild and a severe disease situation very differently, but healthy patients rated the two scenarios as much more similar [ 35 ].…”

Section: Resultsmentioning

confidence: 70%

“…Another focus of PT study has been life attitudes in healthy and sick patients and reference point [ 33 , 34 , 35 , 36 , 37 ]. Current health status determines one’s reference point.…”

Section: Resultsmentioning

confidence: 99%

Prospect Theory: A Bibliometric and Systematic Review in the Categories of Psychology in Web of Science

2022

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Prospect Theory (PT) is an alternative, dynamic explanation of the phenomenon of risky decision making. This research presents an overview of PT’s history in health fields, including advancements, limitations, and bibliometric data. A systematic and bibliometric review of the scientific literature included in the psychological categories of Web of Science (WoS) was performed following the PRISMA 2020 statement for systematic reviews. A total of 37 studies (10 non-empirical and 27 empirical) were included in the sample. Bibliometric results showed thematic variability and heterogeneity regarding the production, researchers, and methodologies that are used to study PT. The systematic results highlight three main fields of PT research: preventive and screening behaviors, promotion of healthy habits, and COVID-related decision making. Personal and contextual factors which alter the usual pattern specified by PT are also described. To conclude, PT currently has an interdisciplinary character suitable for health promotion, with recent studies broadening its applicability.

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A comparison of attitudes toward length and quality of life between community‐dwelling older adults and patients with advanced cancer

Abstract: Findings indicate that attitudes towards length and quality of life differ by life stage. This has implications for end-of-life care decisions made by CDOAs, such as purchasing health or disability insurance and signing advance directives or care plans.

Cited by 11 publications

References 33 publications

Integrating advance care planning as part of comprehensive geriatric assessment for hospitalised frail elderly patients: findings of a cross-sectional study

Integrating advance care planning as part of comprehensive geriatric assessment for hospitalised frail elderly patients: findings of a cross-sectional study

Impact of Interdisciplinary Outpatient Specialty Palliative Care on Survival and Quality of Life in Adults With Advanced Cancer: A Meta-Analysis of Randomized Controlled Trials

Prospect Theory: A Bibliometric and Systematic Review in the Categories of Psychology in Web of Science

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