Surrogate decision-making in Korean patients with advanced cancer: a longitudinal study.
Support Care Cancer
; 21(1): 183-90, 2013 Jan.
Article
in En
| MEDLINE
| ID: mdl-22644263
ABSTRACT
PURPOSE:
Although surrogate decision-making in cancer patients is well-known, few studies investigating the prevalence of surrogate decision-making over time have been reported. The objectives of this study were to investigate the level of surrogate decision-making in advanced cancer patients over time and the impact of demographic and clinical variables on surrogate decision-making.METHODS:
The level of surrogate decision-making was measured in 572 consecutive cancer patients who died between January 1 and December 31, 2009. We reviewed 8,639 informed consent forms of these patients, calculated the proportion of decisions made by a surrogate (PDS) for each patient, and analyzed the association of PDS with demographic and clinical variables.RESULTS:
Surrogates completed 40.3 % of all consent forms. The prevalence of surrogate decision-making was higher in the end-of-life period (death <7 days, OR = 29.05; reference, >365 days). Surrogates signed consent forms more frequently for do-not-resuscitate directives, intensive care unit admission, emergency hemodialysis, surgery and invasive interventions compared with chemotherapy, radiotherapy, and diagnostic tests (OR = 3.88, P < 0.001). Patients of older age (P = 0.036) and those with a shorter duration of management (P < 0.001) were independently associated with greater PDS.CONCLUSIONS:
Surrogate decision-making was frequently observed among Korean cancer patients in this study, especially when the patient's death was imminent, and for decisions related to end-of-life care. Surrogates were also frequently involved in decisions for elderly or rapidly deteriorating patients. Healthcare professionals should consider the significant role of familial surrogates in the end-of-life period; comprehensive approaches are needed to preserve the best interest of the patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Caregivers
/
Third-Party Consent
/
Decision Making
/
Neoplasms
Type of study:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Ethics
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Support Care Cancer
Journal subject:
NEOPLASIAS
/
SERVICOS DE SAUDE
Year:
2013
Document type:
Article
Affiliation country:
Corea del Sur