Congruence of Knowledge, Experiences, and Preferences for Disclosure of Diagnosis and Prognosis between Terminally-Ill Cancer Patients and Their Family Caregivers in Taiwan

Tang, Siew Tzuh; Liu, Tsang‐Wu; Lai, Mei‐Shu; Liu, Li-Ni; Chen, Chen-Hsiu; Koong, Shin-Lan

doi:10.1080/07357900600705284

Cited by 94 publications

(103 citation statements)

References 44 publications

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“…This is in contrast with the general perception that Asian patients should be protected from being given bad news, for fear that they would not be able to cope (Huang et al, 1999;Lapine et al, 2001). However, many studies have shown that the reverse is often true (Kumar et al, 2004;Tang et al, 2006). Honesty is an important characteristic in order for the patient to trust their doctors (Nguyen and Bellamy 2006).…”

Section: Discussioncontrasting

confidence: 42%

Preferences of Malaysian Cancer Patients in Communication of Bad News

Tan

Yaakup²,

Shah³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Section: Discussioncontrasting

confidence: 42%

Preferences of Malaysian Cancer Patients in Communication of Bad News

Tan

Yaakup²,

Shah³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Physicians consistently overestimated prognosis by at least 30% [41]; their estimate of survival could be divided by 3.5 for actual survival [42]. In a previous study, fewer than one third of adult Taiwanese patients with terminal cancer and approximately half of their families reported that health care personnel had informed them about the prognosis and discussed the goals of future care [43]. The decision to begin palliative chemotherapy should not end the decision-making process, especially when that decision was made several months earlier [14,44].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Palliative Chemotherapy Affects Aggressiveness of End-of-Life Care

Hsu

Chang

et al. 2016

The Oncologist

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Introduction. Although palliative chemotherapy during end‐of‐life care is used for relief of symptoms in patients with metastatic cancer, chemotherapy may lead to more aggressive end‐of‐life care and less use of hospice service. This is a population‐based study of the association between palliative chemotherapy and aggressiveness of end‐of‐life care. Patients and Methods. Using the National Health Insurance Research Database of Taiwan, we identified 49,920 patients with metastatic cancer who underwent palliative chemotherapy from January 1, 2009, to December 31, 2011. Patients who received chemotherapy 2–6 months before death were included. Aggressiveness of end‐of‐life care was examined by previously reported indicators. Cardiopulmonary resuscitation and endotracheal tube intubation were included as indicators of aggressive end‐of‐life care. The association between palliative chemotherapy and hospice care was studied. Results. Palliative chemotherapy was associated with more aggressive treatment. After adjustment for patient age, sex, Charlson Comorbidity Index score, cancer group, primary physician's specialty, postdiagnosis survival, hospital characteristics, hospital caseload, urbanization, and geographic regions, more than one emergency room visit (p < .001), more than one intensive care unit admission (p < .001), and endotracheal intubation (p = .02) during end‐of‐life care were significantly more common in patients receiving palliative chemotherapy. Patients who did not receive palliative chemotherapy received more hospice care in the last 6 months of life (p < .001). Conclusion. Although the decision to initiate palliative chemotherapy was made several months before death, this study showed that palliative chemotherapy was associated with more aggressive end‐of‐life care, including more emergency room visits and intensive care unit admissions, and endotracheal intubation. The patients who received palliative chemotherapy received less hospice service toward the end of life. Implications for Practice: Palliative chemotherapy is used for patients with incurable cancer toward the end of life (EOL). Aggressiveness of EOL care and hospice care are related to the quality of life of these patients. This study of data from the Taiwanese National Health Insurance Research Database found that palliative chemotherapy led to more aggressive EOL care and less hospice care. There is a need to provide patients with terminal cancer access to care information that best meets their needs, especially those patients who receive palliative chemotherapy.

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“…The aggressiveness of EOL care increased over the 3 years studied, as did the health care costs in Taiwan [38]. The present study shows that 81% of Taiwanese working-age terminal cancer patients between 2009 and 2011 experienced some form of aggressive EOL care.The rates of more than 14 days ofhospitalization anddyingin an acute-care hospital were high.It has been reported that less than one-third of adult Taiwanese terminal cancer patients and approximately half of their families reported that the health care professionals had informed them about the prognosis and discussed the goals of future care with them [45]. In addition, only one in six Taiwanese cancer patients use hospice care in their last year of life [46].…”

Section: Resultsmentioning

confidence: 99%

Low Socioeconomic Status Is Associated With More Aggressive End-of-Life Care for Working-Age Terminal Cancer Patients

Chang

Yin

et al. 2014

The Oncologist

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Background. The relationship between low socioeconomic status (SES) and aggressiveness of end-of-life (EOL) care in cancer patients of working age (older than 18 years and younger than 65 years) is not clear.We assessed the association between aggressiveness of EOL care and differences in SES among working-age terminal cancer patients from Taiwan between 2009 and 2011. Methods. A total of 32,800 cancer deaths were identified from the Taiwan National Health Insurance Research Database. The indicators of aggressive EOL care (chemotherapy, more than one emergency room [ER] visit or hospital admission, more than 14 days of hospitalization, intensive care unit [ICU] admission, and death in an acute care hospital) in the last month of life were examined. The associations between SES and the indicators were explored.

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Congruence of Knowledge, Experiences, and Preferences for Disclosure of Diagnosis and Prognosis between Terminally-Ill Cancer Patients and Their Family Caregivers in Taiwan

Cited by 94 publications

References 44 publications

Preferences of Malaysian Cancer Patients in Communication of Bad News

Preferences of Malaysian Cancer Patients in Communication of Bad News

Palliative Chemotherapy Affects Aggressiveness of End-of-Life Care

Low Socioeconomic Status Is Associated With More Aggressive End-of-Life Care for Working-Age Terminal Cancer Patients

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