Older adults' preferred and perceived roles in decision-making about palliative chemotherapy, decision priorities and information preferences.
J Geriatr Oncol
; 11(4): 626-632, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-31439474
ABSTRACT
AIM:
Patients with cancer have varied preferences for involvement in decision-making. We sought older adults' preferred and perceived roles in decision-making about palliative chemotherapy; priorities; and information received and desired.METHODS:
Patients ≥65y who had made a decision about palliative chemotherapy with an oncologist completed a written questionnaire. Preferred and perceived decision-making roles were assessed by the Control Preferences Scale. Wilcoxon rank-sum tests evaluated associations with preferred role. Factors important in decision-making were rated and ranked, and receipt of, and desire for information was described.RESULTS:
Characteristics of the 179 respondents median age 74y, male (64%), having chemotherapy (83%), vulnerable (Vulnerable Elders Survey-13 scoreâ¯≥â¯3) (52%). Preferred decision-making roles (nâ¯=â¯173) were active in 39%, collaborative in 27%, and passive in 35%. Perceived decision-making roles (nâ¯=â¯172) were active in 42%, collaborative in 22%, and passive in 36% and matched the preferred role for 63% of patients. Associated with preference for an active role being single/widowed (pâ¯=â¯.004, ORâ¯=â¯1.49), having declined chemotherapy (pâ¯=â¯.02, ORâ¯=â¯2.00). Ranked most important (nâ¯=â¯159) were "doing everything possible" (30%), "my doctor's recommendation" (26%), "my quality of life" (20%), and "living longer" (15%). A minority expected chemotherapy to cure their cancer (14%). Most had discussed expectations of cure (70%), side effects (88%) and benefits (82%) of chemotherapy. Fewer had received quantitative prognostic information (49%) than desired this information (67%).CONCLUSION:
Older adults exhibited a range of preferences for involvement in decision-making about palliative chemotherapy. Oncologists should seek patients' decision-making preferences, priorities, and information needs when discussing palliative chemotherapy.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Participação do Paciente
/
Qualidade de Vida
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article