Patient and caregiver characteristics related to completion of advance directives in terminally ill patients
There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are...
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| Veröffentlicht in: | Palliative & supportive care 2017-02, Vol.15 (1), p.12-19 |
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| creator | Ho, Grace W.K. Skaggs, Lauren Yenokyan, Gayane Kellogg, Anela Johnson, Julie A. Lee, Mei Ching Heinze, Katherine Hughes, Mark T. Sulmasy, Daniel P. Kub, Joan Terry, Peter B. Astrow, Alan B. Zheng, Jing Lehmann, Lisa Soleymani Nolan, Marie T. |
| description | There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
A convenience sample of 206 caregiver-patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill. |
| doi_str_mv | 10.1017/S147895151600016X |
| format | Article |
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A convenience sample of 206 caregiver-patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.</description><identifier>ISSN: 1478-9515</identifier><identifier>ISSN: 1478-9523</identifier><identifier>EISSN: 1478-9523</identifier><identifier>DOI: 10.1017/S147895151600016X</identifier><identifier>PMID: 27237410</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Advance Care Planning - statistics & numerical data ; Advance Care Planning - trends ; Advance directives ; Advance Directives - psychology ; Advance Directives - statistics & numerical data ; Age ; Aged ; Aged, 80 and over ; Amyotrophic lateral sclerosis ; Amyotrophic Lateral Sclerosis - epidemiology ; Amyotrophic Lateral Sclerosis - psychology ; Cancer ; Caregivers ; Caregivers - psychology ; Caregivers - statistics & numerical data ; Cross-Sectional Studies ; Decision making ; Ethnicity ; Female ; Gastrointestinal Neoplasms - epidemiology ; Gastrointestinal Neoplasms - psychology ; Heart Failure - epidemiology ; Heart Failure - psychology ; Humans ; Intervention ; Male ; Middle Aged ; Original Articles ; Palliative care ; Pancreatic Neoplasms - epidemiology ; Pancreatic Neoplasms - psychology ; Patient satisfaction ; Patients - psychology ; Patients - statistics & numerical data ; Planning ; Prospective Studies ; Regression analysis ; Surveys and Questionnaires ; Terminally Ill - psychology ; Terminally Ill - statistics & numerical data ; United States - epidemiology</subject><ispartof>Palliative & supportive care, 2017-02, Vol.15 (1), p.12-19</ispartof><rights>Copyright © Cambridge University Press 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c504t-ef319a092f85c71f58a35773465272299cc510423ce03f87ec5a022a41ba016d3</citedby><cites>FETCH-LOGICAL-c504t-ef319a092f85c71f58a35773465272299cc510423ce03f87ec5a022a41ba016d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S147895151600016X/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,230,314,780,784,885,27923,27924,55627</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27237410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ho, Grace W.K.</creatorcontrib><creatorcontrib>Skaggs, Lauren</creatorcontrib><creatorcontrib>Yenokyan, Gayane</creatorcontrib><creatorcontrib>Kellogg, Anela</creatorcontrib><creatorcontrib>Johnson, Julie A.</creatorcontrib><creatorcontrib>Lee, Mei Ching</creatorcontrib><creatorcontrib>Heinze, Katherine</creatorcontrib><creatorcontrib>Hughes, Mark T.</creatorcontrib><creatorcontrib>Sulmasy, Daniel P.</creatorcontrib><creatorcontrib>Kub, Joan</creatorcontrib><creatorcontrib>Terry, Peter B.</creatorcontrib><creatorcontrib>Astrow, Alan B.</creatorcontrib><creatorcontrib>Zheng, Jing</creatorcontrib><creatorcontrib>Lehmann, Lisa Soleymani</creatorcontrib><creatorcontrib>Nolan, Marie T.</creatorcontrib><title>Patient and caregiver characteristics related to completion of advance directives in terminally ill patients</title><title>Palliative & supportive care</title><addtitle>Pall Supp Care</addtitle><description>There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
A convenience sample of 206 caregiver-patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.</description><subject>Advance Care Planning - statistics & numerical data</subject><subject>Advance Care Planning - trends</subject><subject>Advance directives</subject><subject>Advance Directives - psychology</subject><subject>Advance Directives - statistics & numerical data</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amyotrophic lateral sclerosis</subject><subject>Amyotrophic Lateral Sclerosis - epidemiology</subject><subject>Amyotrophic Lateral Sclerosis - psychology</subject><subject>Cancer</subject><subject>Caregivers</subject><subject>Caregivers - psychology</subject><subject>Caregivers - statistics & numerical data</subject><subject>Cross-Sectional Studies</subject><subject>Decision making</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Gastrointestinal Neoplasms - epidemiology</subject><subject>Gastrointestinal Neoplasms - psychology</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - psychology</subject><subject>Humans</subject><subject>Intervention</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Articles</subject><subject>Palliative care</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - psychology</subject><subject>Patient satisfaction</subject><subject>Patients - psychology</subject><subject>Patients - statistics & numerical data</subject><subject>Planning</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Surveys and Questionnaires</subject><subject>Terminally Ill - psychology</subject><subject>Terminally Ill - statistics & numerical data</subject><subject>United States - epidemiology</subject><issn>1478-9515</issn><issn>1478-9523</issn><issn>1478-9523</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkV1LHDEUhoNU1Gp_QG8k4I03q_mYTGZuCrLYVhAUbKF34WzmzBrJTNYku-C_b5ZdF9si9Cohed73fLyEfObsgjOuLx94pZtWccVrxhivf-2Ro_XTpFVCftjduTokH1N6YkwIyfQBORRaSF1xdkT8PWSHY6YwdtRCxLlbYaT2ESLYjNGl7GyiET1k7GgO1IZh4TG7MNLQU-hWMFqknYtoc9Em6kZahIMbwfsX6ryni02NdEL2e_AJP23PY_Lz6_WP6ffJ7d23m-nV7cQqVuUJ9pK3wFrRN8pq3qsGpNJaVrUqjYu2tVZxVglpkcm-0WgVlNGg4jMoW-jkMfmy8V0sZwN2ttSO4M0iugHiiwngzJ8_o3s087AyTavrqpLF4HxrEMPzElM2g0sWvYcRwzIZ3mjVSCWE-g9U1HUrJasLevYX-hSWsaxpTdWqBKIbXSi-oWwMKUXsd31zZtaxm39iL5rTtwPvFK85F0BuTWGYRdfN8U3td21_A5UauGk</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Ho, Grace W.K.</creator><creator>Skaggs, Lauren</creator><creator>Yenokyan, Gayane</creator><creator>Kellogg, Anela</creator><creator>Johnson, Julie A.</creator><creator>Lee, Mei Ching</creator><creator>Heinze, Katherine</creator><creator>Hughes, Mark T.</creator><creator>Sulmasy, Daniel P.</creator><creator>Kub, Joan</creator><creator>Terry, Peter B.</creator><creator>Astrow, Alan B.</creator><creator>Zheng, Jing</creator><creator>Lehmann, Lisa Soleymani</creator><creator>Nolan, Marie T.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170201</creationdate><title>Patient and caregiver characteristics related to completion of advance directives in terminally ill patients</title><author>Ho, Grace W.K. ; Skaggs, Lauren ; Yenokyan, Gayane ; Kellogg, Anela ; Johnson, Julie A. ; Lee, Mei Ching ; Heinze, Katherine ; Hughes, Mark T. ; Sulmasy, Daniel P. ; Kub, Joan ; Terry, Peter B. ; Astrow, Alan B. ; Zheng, Jing ; Lehmann, Lisa Soleymani ; Nolan, Marie T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c504t-ef319a092f85c71f58a35773465272299cc510423ce03f87ec5a022a41ba016d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Advance Care Planning - statistics & numerical data</topic><topic>Advance Care Planning - trends</topic><topic>Advance directives</topic><topic>Advance Directives - psychology</topic><topic>Advance Directives - statistics & numerical data</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amyotrophic lateral sclerosis</topic><topic>Amyotrophic Lateral Sclerosis - epidemiology</topic><topic>Amyotrophic Lateral Sclerosis - psychology</topic><topic>Cancer</topic><topic>Caregivers</topic><topic>Caregivers - psychology</topic><topic>Caregivers - statistics & numerical data</topic><topic>Cross-Sectional Studies</topic><topic>Decision making</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Gastrointestinal Neoplasms - epidemiology</topic><topic>Gastrointestinal Neoplasms - psychology</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - psychology</topic><topic>Humans</topic><topic>Intervention</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Articles</topic><topic>Palliative care</topic><topic>Pancreatic Neoplasms - epidemiology</topic><topic>Pancreatic Neoplasms - psychology</topic><topic>Patient satisfaction</topic><topic>Patients - psychology</topic><topic>Patients - statistics & numerical data</topic><topic>Planning</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Surveys and Questionnaires</topic><topic>Terminally Ill - psychology</topic><topic>Terminally Ill - statistics & numerical data</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ho, Grace W.K.</creatorcontrib><creatorcontrib>Skaggs, Lauren</creatorcontrib><creatorcontrib>Yenokyan, Gayane</creatorcontrib><creatorcontrib>Kellogg, Anela</creatorcontrib><creatorcontrib>Johnson, Julie A.</creatorcontrib><creatorcontrib>Lee, Mei Ching</creatorcontrib><creatorcontrib>Heinze, Katherine</creatorcontrib><creatorcontrib>Hughes, Mark T.</creatorcontrib><creatorcontrib>Sulmasy, Daniel P.</creatorcontrib><creatorcontrib>Kub, Joan</creatorcontrib><creatorcontrib>Terry, Peter B.</creatorcontrib><creatorcontrib>Astrow, Alan B.</creatorcontrib><creatorcontrib>Zheng, Jing</creatorcontrib><creatorcontrib>Lehmann, Lisa Soleymani</creatorcontrib><creatorcontrib>Nolan, Marie T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Palliative & supportive care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ho, Grace W.K.</au><au>Skaggs, Lauren</au><au>Yenokyan, Gayane</au><au>Kellogg, Anela</au><au>Johnson, Julie A.</au><au>Lee, Mei Ching</au><au>Heinze, Katherine</au><au>Hughes, Mark T.</au><au>Sulmasy, Daniel P.</au><au>Kub, Joan</au><au>Terry, Peter B.</au><au>Astrow, Alan B.</au><au>Zheng, Jing</au><au>Lehmann, Lisa Soleymani</au><au>Nolan, Marie T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient and caregiver characteristics related to completion of advance directives in terminally ill patients</atitle><jtitle>Palliative & supportive care</jtitle><addtitle>Pall Supp Care</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>15</volume><issue>1</issue><spage>12</spage><epage>19</epage><pages>12-19</pages><issn>1478-9515</issn><issn>1478-9523</issn><eissn>1478-9523</eissn><abstract>There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
A convenience sample of 206 caregiver-patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>27237410</pmid><doi>10.1017/S147895151600016X</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Advance Care Planning - statistics & numerical data Advance Care Planning - trends Advance directives Advance Directives - psychology Advance Directives - statistics & numerical data Age Aged Aged, 80 and over Amyotrophic lateral sclerosis Amyotrophic Lateral Sclerosis - epidemiology Amyotrophic Lateral Sclerosis - psychology Cancer Caregivers Caregivers - psychology Caregivers - statistics & numerical data Cross-Sectional Studies Decision making Ethnicity Female Gastrointestinal Neoplasms - epidemiology Gastrointestinal Neoplasms - psychology Heart Failure - epidemiology Heart Failure - psychology Humans Intervention Male Middle Aged Original Articles Palliative care Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - psychology Patient satisfaction Patients - psychology Patients - statistics & numerical data Planning Prospective Studies Regression analysis Surveys and Questionnaires Terminally Ill - psychology Terminally Ill - statistics & numerical data United States - epidemiology |
| title | Patient and caregiver characteristics related to completion of advance directives in terminally ill patients |
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