End-of-life care preferences for people with advanced cancer and their families in intensive care units: a systematic review

Alyami, Hanan; Chan, Raymond Javan; New, Karen

doi:10.1007/s00520-019-04844-8

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…Up until now, EOL preferences among patients with cancer have been explored in some countries and regions. [15][16][17][18][19][20][21] These studies identified the preferences of patients with cancer for EOL treatment, communication, decision-making and place of care and death. Results showed that more patients with cancer preferred comfort care and maintaining their quality of life in EOL.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

et al. 2021

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ObjectivesThis study aimed to investigate the knowledge and attitudes of patients with cancer of palliative care and their preferences regarding end-of-life care in mainland China.DesignA cross-sectional study.SettingThis study was conducted in a tertiary cancer hospital.ParticipantsTwo hundred forty-seven patients with cancer were recruited and consented to fill out the questionnaires.Outcome measuresThe participants’ knowledge and attitudes of palliative care and their preferences of end-of-life care involving place of care, place of death, truth disclosure and treatments during end-of-life were measured.ResultsIn total, 239 questionnaires were valid. The vast majority of patients with cancer (81.2%) had never heard about palliative care or related policies, and only a few of them (5.8%) had somewhat or totally understanding of palliative care. Most participants (75.3%) had supportive attitudes towards palliative care. In terms of preferences for end-of-life care, most patients with cancer preferred to be cared for at home at the end of their life and to die at home. The majority of patients with cancer (65.7%) wanted to know their diagnosis or prognosis of the disease, regardless of the type of disease. More than half of the participants (54%) wished to improve their quality of life rather than prolong their life expectancy. More than a third of the patients with cancer preferred to entrust a family member or agent to sign medical decision agreements for them.ConclusionsIt is essential for healthcare providers to improve the understanding of patients with cancer of palliative care and be aware of the end-of-life care preferences of patients with cancer, in order to provide support that enables patients with cancer to receive end-of-life care that is accordant with their wishes.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

et al. 2021

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“…However, multiple studies have noted that a majority of patients prefer to die outside of the hospital with minimal emergency department (ED) visits and hospitalizations at EOL. [5][6][7] Such high-intensity care may also complicate grief for family members, as avoidance of both ICU admission and in-hospital death is associated with higher quality EOL care assessments among surviving family members. 8 Previous studies on MCCs in patients with cancer have largely focused on the link between MCCs, subpar chemotherapy receipt, and increased chemotherapy toxicity.…”

mentioning

confidence: 99%

The Association between Chronic Conditions, End-of-Life Health Care Use, and Documentation of Advance Care Planning among Patients with Cancer

McDermott

Engelberg

Sibley

et al. 2020

Journal of Palliative Medicine

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Background: Multiple chronic conditions (MCCs) are associated with increased intensity of end-of-life (EOL) care, but their effect is not well explored in patients with cancer. Objective: We examined EOL health care intensity and advance care planning (ACP) documentation to better understand the association between MCCs and these outcomes. Design: Retrospective cohort study. Setting/Subjects: Patients aged 18+ years at UW Medicine who died during 2010-2017 with poor prognosis cancer, with or without chronic liver disease, chronic pulmonary disease, coronary artery disease, dementia, diabetes with end-stage organ damage, end-stage renal disease, heart failure, or peripheral vascular disease. Measurements: ACP documentation 30+ days before death, in-hospital death, and inpatient or intensive care unit (ICU) admission in the last 30 days. We performed logistic regression for outcomes. Results: Of 15,092 patients with cancer, 10,596 (70%) had 1+ MCCs (range 1-8). Patients with cancer and heart failure had highest odds of hospitalization (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.46-1.91), ICU admission (OR 2.06, 95% CI 1.76-2.41), or in-hospital death (OR 1.62, 95% CI 1.43-1.84) versus patients with cancer and other conditions. Patients with ACP 30+ days before death had lower odds of in-hospital death (OR 0.65, 95% CI 0.60-0.71), hospitalization (OR 0.67, 95% CI 0.61-0.74), or ICU admission (OR 0.71, 95% CI 0.64-0.80). Conclusions: Patients with ACP 30+ days before death had lower odds of high-intensity EOL care. Further research needs to explore how to best use ACP to ensure patients receive care aligned with patient and family goals for care.

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“…Twenty-seven reviews identified barriers and enablers to providing patient-centred end-of-life care. [41][42][43]58,[62][63][64]66,68,77,78,80,[85][86][87][88][89][90][91][92][93][94][95][96][97][98][99] These barriers and enablers were divided into three categories: (1) system factors; (2) staff factors; and (3) patient factors.…”

Section: Klop Et Al 55mentioning

confidence: 99%

“…58,80,88,91,93,98 Greater continuity and coordination of care, as well as improved communication systems between healthcare professionals, offers the opportunity for care that is consistent with patient preferences. 58,88,93 Regular documentation of a patient's symptoms and preferences, initiated early, was vital to the management and coordination of appropriate care planning, 41 however inconsistent documentation procedures and requirements, as well as the absence of agreed upon data storage locations, was found to contribute to time consuming and burdensome processes for staff due to competing responsibilities, 91 resulting in fragmented healthcare systems where information about a patient's preferences is not easily accessible. 87 Physical care environment.…”

Section: System Factorsmentioning

confidence: 99%

A rapid umbrella review of the literature surrounding the provision of patient-centred end-of-life care

et al. 2023

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Background: Patients have reported a broad range of unmet needs in their receipt of clinical care at the end of life. Therefore, enhancing the quality of end-of-life care through patient-centred healthcare interactions is warranted. Aim: The aim of this rapid umbrella review was to synthesise previous literature reviews that have examined: (1) patient preferences for patient-centred end-of-life care; (2) barriers and enablers to patient-centred end-of-life care; (3) interventions designed to enhance patient-centred end-of-life care; and (4) patient-centred models of end-of-life care. Design: A rapid umbrella review was conducted and informed by the Joanna Briggs Institute’s methodological guidance for conducting umbrella reviews. Data sources: Three academic databases were searched for relevant literature in May 2022: MEDLINE, PsycINFO and CINAHL Plus. Inclusion criteria encompassed literature reviews that examined the topic of patient-centred care for any adult patients in end-of-life care. Results: A total of 92 literature reviews were identified. Findings suggest that there is often a discrepancy between patient preferences and the provision of care. These discrepancies have been associated with a range of barriers at the patient, staff and system levels. Common interventions included education and training for staff which were often met with improved patient outcomes. Patient-centred models of care were underrepresented across the literature. Conclusions: This review highlighted a need for healthcare systems to support staff in providing a patient-centred end of life experience through the development of a co-designed patient-centred model of care, supplemented by professional development and a systematic approach to identifying and documenting patient preferences.

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End-of-life care preferences for people with advanced cancer and their families in intensive care units: a systematic review

Cited by 10 publications

References 33 publications

Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

The Association between Chronic Conditions, End-of-Life Health Care Use, and Documentation of Advance Care Planning among Patients with Cancer

A rapid umbrella review of the literature surrounding the provision of patient-centred end-of-life care

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