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Do medical oncology patients and their support persons agree about end-of-life issues?
- Source :
-
Internal Medicine Journal . Jan2018, Vol. 48 Issue 1, p60-66. 106p. - Publication Year :
- 2018
-
Abstract
- Background The perceptions of those called on to make decisions on behalf of patients who lack capacity at the end of life must accurately reflect patient preferences. Aims To establish the extent to which the views of medical oncology outpatients are understood by their support persons, specifically with regards to (i) preferred type and location of end-of-life care, (ii) preferred level of involvement in end-of-life decision-making and (iii) whether the patient has completed an advance care plan or appointed an enduring guardian. Methods Adults with a confirmed cancer diagnosis and their nominated support persons were approached between September 2015 and January 2016 in the waiting room of an Australian tertiary referral clinic. Consenting participants completed a pen-and-paper survey. Nominated support persons answered the same questions from the patient's perspective. Results In total, 208 participants (39% of eligible dyads) participated. Observed agreement across the five outcomes ranged from 54% to 84%. Kappa values for concordance between patient-support person responses were fair to moderate (0.24-0.47) for enduring guardian, decision-making, advance care plan and care location outcomes. A slight level of concordance ( k = 0.15; 95% confidence interval: −0.02, 0.32) was found for the type of care outcome. Conclusion Relying on support persons' views does not guarantee that patients' actual preferences will be followed. Strategies that make patient preferences known to healthcare providers and support persons while they still have the capacity to do so is a critical next step in improving quality cancer care. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TERMINAL care laws
*TUMOR diagnosis
*CANCER patients
*CONFIDENCE intervals
*DECISION making
*GUARDIAN & ward
*HEALTH facilities
*SERVICES for caregivers
*PATIENT-family relations
*EVALUATION of medical care
*MEDICAL quality control
*MEDICAL personnel
*MEDICAL protocols
*PATIENT satisfaction
*STATISTICS
*SURVEYS
*DECISION making in clinical medicine
*WAITING rooms
*PATIENTS' attitudes
*TERTIARY care
Subjects
Details
- Language :
- English
- ISSN :
- 14440903
- Volume :
- 48
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Internal Medicine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 127191856
- Full Text :
- https://doi.org/10.1111/imj.13626