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Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis. / van der Velden, Naomi C. A.; van Laarhoven, Hanneke W. M.; Nieuwkerk, Pythia T. et al.

In: JCO oncology practice, Vol. 18, No. 11, 01.11.2022, p. e1818-e1830.

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@article{6203b2fd1b0d4c90a8fb71591de4dcfb,
title = "Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis",
abstract = "PURPOSE: When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time). METHODS: We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4). RESULTS: Overall, patients' attitudes toward striving for QL became less positive over 6 months (P < .01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness (P < .001), less fighting spirit (P < .05), less state anxiety (P < .001), and more observed SDM (P < .05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety (P < .001) related to more positive attitudes toward striving for LL. CONCLUSION: Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.",
author = "{van der Velden}, {Naomi C. A.} and {van Laarhoven}, {Hanneke W. M.} and Nieuwkerk, {Pythia T.} and Kuijper, {Steven C.} and Sommeijer, {Dirkje W.} and Ottevanger, {Petronella B.} and Helle-Brit Fiebrich and Dohmen, {Serge E.} and Geert-Jan Creemers and {de Vos}, {Filip Y. F. L.} and Smets, {Ellen M. A.} and Inge Henselmans",
note = "Funding Information: Supported by Dutch Cancer Society (KWF Kankerbestrijding; 11547). Publisher Copyright: {\textcopyright} American Society of Clinical Oncology.",
year = "2022",
month = nov,
day = "1",
doi = "10.1200/OP.22.00185",
language = "English",
volume = "18",
pages = "e1818--e1830",
journal = "JCO oncology practice",
issn = "2688-1535",
publisher = "American Society of Clinical Oncology",
number = "11",

}

RIS

TY - JOUR

T1 - Attitudes Toward Striving for Quality and Length of Life Among Patients With Advanced Cancer and a Poor Prognosis

AU - van der Velden, Naomi C. A.

AU - van Laarhoven, Hanneke W. M.

AU - Nieuwkerk, Pythia T.

AU - Kuijper, Steven C.

AU - Sommeijer, Dirkje W.

AU - Ottevanger, Petronella B.

AU - Fiebrich, Helle-Brit

AU - Dohmen, Serge E.

AU - Creemers, Geert-Jan

AU - de Vos, Filip Y. F. L.

AU - Smets, Ellen M. A.

AU - Henselmans, Inge

N1 - Funding Information: Supported by Dutch Cancer Society (KWF Kankerbestrijding; 11547). Publisher Copyright: © American Society of Clinical Oncology.

PY - 2022/11/1

Y1 - 2022/11/1

N2 - PURPOSE: When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time). METHODS: We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4). RESULTS: Overall, patients' attitudes toward striving for QL became less positive over 6 months (P < .01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness (P < .001), less fighting spirit (P < .05), less state anxiety (P < .001), and more observed SDM (P < .05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety (P < .001) related to more positive attitudes toward striving for LL. CONCLUSION: Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.

AB - PURPOSE: When deliberating palliative cancer treatment, insight into patients' attitudes toward striving for quality of life (QL) and length of life (LL) may facilitate goal-concordant care. We investigated the (1) attitudes of patients with advanced cancer toward striving for QL and/or LL and whether these change over time, and (2) characteristics associated with these attitudes (over time). METHODS: We performed a secondary analysis of a randomized controlled trial on improving shared decision making (SDM), without differentiation between intervention arms. Patients (n = 173) with advanced cancer, a median life expectancy of < 12 months without anticancer treatment, and a median survival benefit of < 6 months from systemic therapy were included in seven Dutch hospitals. We used audio-recorded consultations and surveys at baseline (T0), shortly after the consultation (T2), at 3 and 6 months (T3 and T4). Primary outcomes were patients' attitudes toward striving for QL and LL (Quality Quantity Questionnaire; T2, T3, and T4). RESULTS: Overall, patients' attitudes toward striving for QL became less positive over 6 months (P < .01); attitudes toward striving for LL did not change on group level. Studying individual patients, 76% showed changes in their attitudes toward striving for QL and/or LL at some point during the study, which occurred in various directions. More helplessness/hopelessness (P < .001), less fighting spirit (P < .05), less state anxiety (P < .001), and more observed SDM (P < .05) related to more positive attitudes toward striving for QL. Lower education, less helplessness/hopelessness, more fighting spirit, and more state anxiety (P < .001) related to more positive attitudes toward striving for LL. CONCLUSION: Oncologists may explore patients' attitudes toward striving for QL and LL repeatedly and address patients' coping style and emotions during SDM to facilitate goal-concordant care throughout the last phase of life.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85141891427&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/36201709

U2 - 10.1200/OP.22.00185

DO - 10.1200/OP.22.00185

M3 - Article

C2 - 36201709

AN - SCOPUS:85141891427

VL - 18

SP - e1818-e1830

JO - JCO oncology practice

JF - JCO oncology practice

SN - 2688-1535

IS - 11

ER -

ID: 27494081