Preference for Aggressive End-of-Life Care among Advanced Cancer Patients in Wuhan, China: A Cross-Sectional Study

Jing Liao, Bei Wu, Jing Mao and Ping Ni
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Jing Liao: Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Bei Wu: Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York, NY 10010, USA
Jing Mao: School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Ping Ni: School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

IJERPH, 2020, vol. 17, issue 18, 1-14

Abstract: Life-sustaining treatments (LSTs) and end-of-life (EOL) care’s goal for prolonging one’s life are defined as aggressive EOL care among critically ill patients. They have limited effects and add unnecessary financial burden to advanced cancer patients. A questionnaire survey was conducted to collect information on demographics, disease conditions, preference for LSTs, and goal of EOL care among advanced cancer patients of comprehensive grade-A tertiary hospitals in Wuhan, mainland China. Most patients preferred to accept LSTs when they were in a critical condition, including cardiopulmonary resuscitation (89.9%), mechanical ventilation support (85.7%), nasogastric tube feeding (84.1%), blood transfusion (89.8%), general surgery (87.5%), and hemodialysis (85.8%). Most (88%) preferred prolonging life as the goal of EOL care. Logistic regression showed common influencing factors were participants who completed junior high/high school or below and were financially adequate had higher reference for aggressive EOL care. Patients whose physician had accurately disclosed prognosis; however, showed a decrease trend for aggressive EOL care. Most advanced cancer patients preferred to accept aggressive EOL care. Discussions about prognosis disclosure among physicians and patients should be improved. Education about LSTs’ limitations and comfort-oriented care’s benefits should be promoted among the advanced cancer patients in mainland China.

Keywords: aggressive end-of-life care; life-sustaining treatments; end-of-life care goal; preference; advanced cancer patients (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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