Associations between perceived interpersonal support and aggressiveness of care in the last month of life among patients with advanced cancer
Purpose To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer. Methods A multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with...
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Published in | Supportive care in cancer Vol. 32; no. 10; p. 682 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.10.2024
Springer Nature B.V |
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Abstract | Purpose
To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer.
Methods
A multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with advanced cancer (distant metastases and/or progression of disease following at least first-line chemotherapy) and poor prognosis (≤ 6 months) followed through death. At baseline, a median of 4 months from death, the McGill Quality of Life Questionnaire measured overall QoL and four QoL domains (i.e., interpersonal support, physical well-being, psychological, and existential). Postmortem data were collected via medical chart review and nurse/caregiver report and combined to capture the aggressiveness of end-of-life (EoL) care in patients’ last month of life. Aggressive EoL care was defined as any receipt of care in an intensive care unit, being on a ventilator, or chemotherapy in the last month of life.
Results
Patients with higher interpersonal support domain scores (i.e., rating the world as more “caring and responsive” to their needs and their felt support as more complete) received significantly less aggressive care in their last month of life (odds ratio = 0.39, 95% confidence interval 0.20 to 0.75,
p
= 0.004).
Conclusion
Perceived interpersonal support is the only QoL domain assessed that was associated with aggressiveness of care in the last month of life for patients with advanced cancer. Prioritizing caring and responsive relationships for patients may decrease receipt of aggressive EoL care. |
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AbstractList | Purpose
To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer.
Methods
A multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with advanced cancer (distant metastases and/or progression of disease following at least first-line chemotherapy) and poor prognosis (≤ 6 months) followed through death. At baseline, a median of 4 months from death, the McGill Quality of Life Questionnaire measured overall QoL and four QoL domains (i.e., interpersonal support, physical well-being, psychological, and existential). Postmortem data were collected via medical chart review and nurse/caregiver report and combined to capture the aggressiveness of end-of-life (EoL) care in patients’ last month of life. Aggressive EoL care was defined as any receipt of care in an intensive care unit, being on a ventilator, or chemotherapy in the last month of life.
Results
Patients with higher interpersonal support domain scores (i.e., rating the world as more “caring and responsive” to their needs and their felt support as more complete) received significantly less aggressive care in their last month of life (odds ratio = 0.39, 95% confidence interval 0.20 to 0.75,
p
= 0.004).
Conclusion
Perceived interpersonal support is the only QoL domain assessed that was associated with aggressiveness of care in the last month of life for patients with advanced cancer. Prioritizing caring and responsive relationships for patients may decrease receipt of aggressive EoL care. PurposeTo determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer.MethodsA multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with advanced cancer (distant metastases and/or progression of disease following at least first-line chemotherapy) and poor prognosis (≤ 6 months) followed through death. At baseline, a median of 4 months from death, the McGill Quality of Life Questionnaire measured overall QoL and four QoL domains (i.e., interpersonal support, physical well-being, psychological, and existential). Postmortem data were collected via medical chart review and nurse/caregiver report and combined to capture the aggressiveness of end-of-life (EoL) care in patients’ last month of life. Aggressive EoL care was defined as any receipt of care in an intensive care unit, being on a ventilator, or chemotherapy in the last month of life.ResultsPatients with higher interpersonal support domain scores (i.e., rating the world as more “caring and responsive” to their needs and their felt support as more complete) received significantly less aggressive care in their last month of life (odds ratio = 0.39, 95% confidence interval 0.20 to 0.75, p = 0.004).ConclusionPerceived interpersonal support is the only QoL domain assessed that was associated with aggressiveness of care in the last month of life for patients with advanced cancer. Prioritizing caring and responsive relationships for patients may decrease receipt of aggressive EoL care. To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer.PURPOSETo determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among patients with advanced cancer.A multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with advanced cancer (distant metastases and/or progression of disease following at least first-line chemotherapy) and poor prognosis (≤ 6 months) followed through death. At baseline, a median of 4 months from death, the McGill Quality of Life Questionnaire measured overall QoL and four QoL domains (i.e., interpersonal support, physical well-being, psychological, and existential). Postmortem data were collected via medical chart review and nurse/caregiver report and combined to capture the aggressiveness of end-of-life (EoL) care in patients' last month of life. Aggressive EoL care was defined as any receipt of care in an intensive care unit, being on a ventilator, or chemotherapy in the last month of life.METHODSA multisite, prospective cohort study conducted from January 2010 to May 2015 of 59 patients with advanced cancer (distant metastases and/or progression of disease following at least first-line chemotherapy) and poor prognosis (≤ 6 months) followed through death. At baseline, a median of 4 months from death, the McGill Quality of Life Questionnaire measured overall QoL and four QoL domains (i.e., interpersonal support, physical well-being, psychological, and existential). Postmortem data were collected via medical chart review and nurse/caregiver report and combined to capture the aggressiveness of end-of-life (EoL) care in patients' last month of life. Aggressive EoL care was defined as any receipt of care in an intensive care unit, being on a ventilator, or chemotherapy in the last month of life.Patients with higher interpersonal support domain scores (i.e., rating the world as more "caring and responsive" to their needs and their felt support as more complete) received significantly less aggressive care in their last month of life (odds ratio = 0.39, 95% confidence interval 0.20 to 0.75, p = 0.004).RESULTSPatients with higher interpersonal support domain scores (i.e., rating the world as more "caring and responsive" to their needs and their felt support as more complete) received significantly less aggressive care in their last month of life (odds ratio = 0.39, 95% confidence interval 0.20 to 0.75, p = 0.004).Perceived interpersonal support is the only QoL domain assessed that was associated with aggressiveness of care in the last month of life for patients with advanced cancer. Prioritizing caring and responsive relationships for patients may decrease receipt of aggressive EoL care.CONCLUSIONPerceived interpersonal support is the only QoL domain assessed that was associated with aggressiveness of care in the last month of life for patients with advanced cancer. Prioritizing caring and responsive relationships for patients may decrease receipt of aggressive EoL care. |
ArticleNumber | 682 |
Author | Korian, Sosi E. LaPlante, Charlotte D. Pavao, Madison K. Hardt, Madeleine M. Prigerson, Holly G. Maciejewski, Paul K. |
Author_xml | – sequence: 1 givenname: Madeleine M. orcidid: 0000-0001-7815-0787 surname: Hardt fullname: Hardt, Madeleine M. email: mah4048@med.cornell.edu organization: Department of Medicine, Weill Cornell Medicine, Cornell Center for Research On End-of-Life Care, Department of Radiology, Weill Cornell Medicine – sequence: 2 givenname: Madison K. surname: Pavao fullname: Pavao, Madison K. organization: Cornell Center for Research On End-of-Life Care, Department of Radiology, Weill Cornell Medicine – sequence: 3 givenname: Sosi E. surname: Korian fullname: Korian, Sosi E. organization: Cornell Center for Research On End-of-Life Care, Department of Radiology, Weill Cornell Medicine – sequence: 4 givenname: Charlotte D. surname: LaPlante fullname: LaPlante, Charlotte D. organization: Cornell Center for Research On End-of-Life Care, Weill Cornell Medical College – sequence: 5 givenname: Paul K. surname: Maciejewski fullname: Maciejewski, Paul K. organization: Department of Medicine, Weill Cornell Medicine, Cornell Center for Research On End-of-Life Care, Department of Radiology, Weill Cornell Medicine – sequence: 6 givenname: Holly G. surname: Prigerson fullname: Prigerson, Holly G. organization: Department of Medicine, Weill Cornell Medicine, Cornell Center for Research On End-of-Life Care, Department of Radiology, Weill Cornell Medicine |
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To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life... PurposeTo determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life... To determine quality of life (QoL) domains in the months leading up to death associated with the receipt of aggressive care in the last month of life among... |
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SubjectTerms | Cancer Chemotherapy Medicine Medicine & Public Health Nursing Nursing Research Oncology Pain Medicine Quality of life Rehabilitation Medicine Social support |
Title | Associations between perceived interpersonal support and aggressiveness of care in the last month of life among patients with advanced cancer |
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