Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients With Advanced Cancer

Phelps, Andrea C.; Maciejewski, Paul K.; Nilsson, Matthew; Balboni, Tracy A.; Wright, Alexi A.; Paulk, M. Elizabeth; Trice, E. D.; Schrag, Deborah; Peteet, John R.; Block, Susan D.; Prigerson, Holly G.

doi:10.1001/jama.2009.341

Cited by 370 publications

(323 citation statements)

References 43 publications

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“…1,28 We found a significantly higher frequency of LWs with advancing age. Older patients tend to address EOL issues more often than younger patients possibly as a result of their greater life experience, exposure to illness, and estate planning.…”

Section: Discussionmentioning

confidence: 49%

Advance Directives in an Oncologic Intensive Care Unit: A Contemporary Analysis of their Frequency, Type, and Impact

Halpern¹,

Pastores²,

Chou

et al. 2011

Journal of Palliative Medicine

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Background: Our objective was to provide a contemporary analysis of the prevalence, types, and impact of advance health care directives in critically ill cancer patients. Methods: We retrospectively reviewed all intensive care unit (ICU) admissions ( January 1, 2006 to April 25, 2008 at an oncologic center and identified all patients who completed a living will (LW), or health care proxy (HCP), or neither prior to ICU admission. Demographics, clinical data, end-of-life (EOL) parameters and outcomes were compared among three groups: LWs, HCPs, and no LW or HCP. Results: Of 1,333 ICU admissions, 1,121 patients (84%) were included for analysis: 176 patients (15.7%) had LW, 534 (47.6%) had HCP and 411 (36.7%) had no LW or HCP. Patients with LW were significantly more likely to be older and white as compared to patients with HCP alone, or no LW or HCP. There were no significant demographic differences between patients with HCP or no LW or HCP. Patients with HCP alone, or no LW or HCP, were significantly more likely to have Medicaid than patients with LW. There were no differences noted in ICU care, EOL management, or outcomes among the three groups. Conclusions: The prevalence of LWs in patients admitted to our oncologic ICU is low. More than half of the remaining patients had designated HCPs. Older age and white race were associated with the presence of LWs. However, the presence of LWs or HCPs did not influence ICU care, EOL management or outcomes at our institution.

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Section: Discussionmentioning

confidence: 49%

Advance Directives in an Oncologic Intensive Care Unit: A Contemporary Analysis of their Frequency, Type, and Impact

Halpern¹,

Pastores²,

Chou

et al. 2011

Journal of Palliative Medicine

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show abstract

“…The PTPQ was adapted for adult cancer patients from a validated questionnaire of parents of children with cancer and additional validated items from prior studies. [20][21][22][23][24][25] Each item on the questionnaire is scored individually with statements about the degree to which the patient endorses each item. We omitted one question pertaining to goals of care at the end of life.…”

Section: Study Measuresmentioning

confidence: 99%

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Shin

El‐Jawahri

Parkes

et al. 2016

Journal of Palliative Medicine

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Background: Although breast cancer is the second leading cause of cancer-related mortality in women in the United States, few studies focus on the supportive care needs of patients living with metastatic breast cancer (MBC). Objective: We studied quality of life (QOL), depression, anxiety, and prognostic understanding of patients with MBC. Design: We conducted a cross-sectional study of 140 patients with MBC, stratified by receipt of endocrine therapy or chemotherapy. Measurements: We evaluated anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). We assessed QOL using the Functional Assessment of Cancer Therapy-Breast (FACT-B), specifically measuring the FACT-B Trial Outcome Index (TOI), which includes physical and functional well-being and breast cancer-specific symptoms. Higher FACT-B TOI scores represent better QOL. We used a 12-item questionnaire to assess patients' perceptions of their prognosis and goals of therapy. Results: Compared to those taking endocrine therapy (n = 40), patients receiving chemotherapy (n = 100) reported lower scores on the FACT-B TOI (66.1 versus 72.5, p < 0.01) and more depression symptoms (HADS-D >7; 22% versus 7.5%, p = 0.03). Higher scores on the FACT-B TOI were associated with lower depression (b, -0.16; p < 0.01) and anxiety (b, -0.11; p < 0.01), and patients who reported frequent prognostic conversations with their oncologists had less depression (b, -1.28; p < 0.01). Thirty-nine percent (54/140) reported that their cancer was likely curable. Conclusion: Patients with MBC, particularly those treated with chemotherapy, may benefit from interventions to address their physical, functional, and breast cancer-related symptoms. Many do not report accurate prognostic understanding, and more frequent prognostic conversations might address this information gap.

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“…These observations may be partially attributable to religious doctrine viewing life as having paramount value, a commonly held view in most religions, yet there is probably greater complexity to the picture. For example, Phelps and colleagues [5] characterized the use of religious-based coping among a cohort of U.S. patients with advanced cancer and found that greater use of religious coping was significantly associated with increased use of ICU therapies prior to death [5]. This was not contingent on a specific religion per se but upon the use of a faith-based psychological coping framework.…”

mentioning

confidence: 99%

Religion and end-of-life decisions in critical care: where the word meets deed

Ford

2012

Intensive Care Med

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Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients With Advanced Cancer

Cited by 370 publications

References 43 publications

Advance Directives in an Oncologic Intensive Care Unit: A Contemporary Analysis of their Frequency, Type, and Impact

Advance Directives in an Oncologic Intensive Care Unit: A Contemporary Analysis of their Frequency, Type, and Impact

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Religion and end-of-life decisions in critical care: where the word meets deed

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