Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan

Cheng, Shao‐Yi; Lin, Wen Yuan; Cheng, Ya Hui; Huang, Chien Hsiun; Chen, Ching-Yu; Hwang, Shinn Jang; Tsai, Shih Tzu; Chiu, Tai‐Yuan

doi:10.1002/pon.3901

Cited by 16 publications

(14 citation statements)

References 28 publications

(35 reference statements)

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“…This hypothesis is based on the empirical finding that these interventions were associated with a higher QODD in patients with cancer. [16][17][18][19] We divided patients with ILD into three groups based on the presence or absence of palliative care access (ie, specialised palliative care services, opioid use or both) and their participation in end-oflife discussions: patients without both palliative care access and participation in end-of-life discussion (group A); patients with either palliative care access or participation in end-of-life discussion (group B); and patients with both palliative care access and participation in end-of-life discussion (group C). Each group was ranked according to the intensity of the interventions, and the Jonckheere-Terpstra trend test was performed to explore the associations between these interventions and GDI score.…”

Section: Discussionmentioning

confidence: 99%

Quality of dying and death in patients with interstitial lung disease compared with lung cancer: an observational study

Koyauchi

Suzuki

Sato

et al. 2020

Thorax

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BackgroundThere is limited knowledge regarding the quality of dying and death (QODD) and end-of-life interventions in patients with interstitial lung disease (ILD). Hence, differences in QODD and end-of-life interventions between patients with ILD and those with lung cancer (LC) remain poorly understood.MethodsThe primary aim of this study was to explore the differences in QODD and end-of-life interventions among patients dying with ILD versus those dying with LC. We performed a mail survey to quantify the QODD of a bereaved family’s perspective using the Good Death Inventory (GDI) score. Moreover, we examined the end-of-life interventions by medical chart review.ResultsOf 361 consecutive patients analysed for end-of-life interventions, 167 patients whose bereaved families completed questionnaires were analysed for QODD. Patients with ILD had lower GDI scores for QODD than those with LC (p=0.04), particularly in domains related to ‘physical and psychological distress relief’ and ‘prognosis awareness and participation in decision making’ (p=0.02, respectively). In end-of-life interventions, patients with ILD were less likely to receive specialised palliative care services (8.5% vs 54.3%; p<0.001) and opioids (58.2% vs 73.4%; p=0.003). Additionally, lower frequencies of participation of patients with ILD in end-of-life discussion were also observed (40.8% vs 62.4%; p=0.007).ConclusionPatients with ILD had lower QODD and poorer access to palliative care and decision making than those with LC. Additional efforts to improve QODD in patients with ILD, particularly in symptom relief and decision-making processes, are urgently warranted.

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Section: Discussionmentioning

confidence: 99%

Quality of dying and death in patients with interstitial lung disease compared with lung cancer: an observational study

Koyauchi

Suzuki

Sato

et al. 2020

Thorax

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“…By using the validated 'Good Death Scale' we had previously developed, we measured the associated correlates that affect quality of dying and patient autonomy. Four medical centers participated in the study and the team held monthly teleconference discussions (5).…”

Section: Taiwan Research Network and Cross-cultural Collaborationmentioning

confidence: 99%

“…The use of aggressive medical treatments for cancer patients aware of their prognosis in the last month of life, such as CPR and intubation, also declined over this period. In addition, research concluded that physician-assessed autonomy is an important factor allowing for a good death, and is highly correlated with age, level of consciousness and quality of dying at the end of life in advanced cancer patients in Taiwan (5). Community engagement, in particular to help the patient and family achieve a good death at home, has been progressing, due to the cultural propensity to die at home (6).…”

Section: Introductionmentioning

confidence: 99%

Advances of Hospice Palliative Care in Taiwan

Cheng

Chen

Chiu

2016

Korean J Hosp Palliat Care

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Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.

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“…O esforço contínuo da equipe de CP em preservar a autonomia do paciente aumenta a qualidade do morrer, já que um paciente consciente da iminência da morte pode contribuir com o plano de tratamento e facilitar o processo de aceitação da terminalidade da vida, da propriedade em realizar seus desejos e da pontualidade em escolher o momento adequado para tal (CHENG et al, 2016). Esta categoria apresenta os conhecimentos adquiridos durante a formação acadêmica dos profissionais de saúde envolvidos nos cuidados com a criança.…”

Section: ) Compreensão E Desenvolvimento Dos Cuidados Paliativosunclassified

Cuidados Paliativos Em Pediatria: Saberes E Práticas Da Equipe Multiprofissional

Nunes¹,

Higa²,

Augusto³

et al. 2022

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Cancer patient autonomy and quality of dying-a prospective nationwide survey in Taiwan

Abstract: We concluded that physician-assessed autonomy would affect a good death and was highly correlated with age, consciousness level, and quality of dying at the end for advanced cancer patients in Taiwan.

Cited by 16 publications

References 28 publications

Quality of dying and death in patients with interstitial lung disease compared with lung cancer: an observational study

Quality of dying and death in patients with interstitial lung disease compared with lung cancer: an observational study

Advances of Hospice Palliative Care in Taiwan

Cuidados Paliativos Em Pediatria: Saberes E Práticas Da Equipe Multiprofissional

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