RESUMO
Background and aim: A better understanding of irreversible prognoses in palliative care is crucial for improving patients' quality of life and their sense of dignity. We examined whether measurements of meridian electrical conductance can noninvasively and objectively predict survival time in a hospice patient population. Experimental procedure: This was a single-center cohort study. Between 2019 and 2020, we measured skin conductance from 24 representative acupoints of 12 meridians on both sides of the body in 181 advanced cancer patients within 48 h of hospitalization and monitored their survival time. The Palliative Prognostic Score (PaP Score) was calculated for each patient, classifying them into one of three prognosis groups: Group A, B, or C. Factors associated with short-term and long-term survival were identified using multivariate regression analysis. Statistical differences in survival times were analyzed between the meridian electrical conductance measurements and PaP Scores. Results and conclusion: Analyses of the clinicopathological data from terminal cancer patients revealed that male sex, mean meridian electrical conductance measurements of ≤8.8 µA, and PaP Scores in Group C were independent predictors of short-term survival. Mean meridian electrical conductance measurements of ≤8.8 µA demonstrated good sensitivity (85.1%) and adequate specificity (60.6%) for short-term survival. A survival curve analysis revealed a mortality rate of 90.6% at 30 days among patients with meridian electrical conductance measurements of ≤8.8 µA. A mean meridian electrical conductance measurement of ≤8.8 µA can objectively assess short-term survival with advanced cancer and reduce nonbeneficial medical treatment.
RESUMO
Advance care planning (ACP) and advance directives (ADs) ensure patient autonomy in end-of life care. The number of ADs made and followed in Taiwan is still lacking. This study aimed to determine the factors that influence the willingness to participate in ACP among outpatients in Taiwan. In this study, we conducted a cross-sectional survey based on convenient sampling methods. The questionnaire included questions about participants' basic sociodemographic information, knowledge of ACP, and awareness of ACP. A total of 198 adults who were outpatients of a family medicine clinic in an affiliated hospital in Taiwan were recruited. The associations between each variable were evaluated using the χ2 test. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the logistic regression method to examine the influence of each variable on willingness to participate in ACP. Being happy and being a healthcare professional were positively correlated with ACP participation. A lack of ACP knowledge (OR = 0.30 in model A and OR = 0.42 in model C), valuing "Reducing families' end-of-life decision-making burden" (OR = 2.53 in model B and OR = 2.65 in model C), and a "Belief in a good death" (OR = 4.02 in model B and OR = 4.10 in Model C) were the main factors affecting subjects' willingness to participate in ACP. Knowing which factors influence willingness to participate in ACP helps in the promotion of ACP. Continuously educating both the general public and healthcare professionals strengthens knowledge about the right to autonomy, about its associated laws, and about the ACP process, and thus, programs should be created to provide this education. Additionally, taking into account the differences between cultures can be helpful.