TY - JOUR
T1 - Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis
AU - van der Velden, Naomi C A
AU - van Laarhoven, Hanneke W M
AU - Nieuwkerk, Pythia T
AU - Kuijper, Steven C
AU - Sommeijer, Dirkje W
AU - Ottevanger, Petronella B
AU - Fiebrich, Helle-Brit
AU - Dohmen, Serge E
AU - Creemers, Geert-Jan
AU - de Vos, Filip Y F L
AU - Smets, Ellen M A
AU - Henselmans, Inge
N1 - Funding Information:
Supported by Dutch Cancer Society (KWF Kankerbestrijding; 11547).
Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2022/11
Y1 - 2022/11
N2 - PURPOSE:When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time).METHODS:We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4).RESULTS:Overall, patients' attitudes toward striving for QL became less positive over 6 months (P <.01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness (P <.001), less fighting spirit (P <.05), less state anxiety (P <.001), and more observed SDM (P <.05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety (P <.001) related to more positive attitudes toward striving for LL.CONCLUSION:Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.
AB - PURPOSE:When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time).METHODS:We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4).RESULTS:Overall, patients' attitudes toward striving for QL became less positive over 6 months (P <.01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness (P <.001), less fighting spirit (P <.05), less state anxiety (P <.001), and more observed SDM (P <.05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety (P <.001) related to more positive attitudes toward striving for LL.CONCLUSION:Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.
KW - Humans
KW - Longevity
KW - Neoplasms/therapy
KW - Oncologists
KW - Prognosis
KW - Quality of Life
UR - http://www.scopus.com/inward/record.url?scp=85141891427&partnerID=8YFLogxK
U2 - 10.1200/OP.22.00185
DO - 10.1200/OP.22.00185
M3 - Article
C2 - 36201709
SN - 2688-1527
VL - 18
SP - e1818-e1830
JO - JCO oncology practice
JF - JCO oncology practice
IS - 11
ER -