Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan; Department of Medicine, Keio University Graduate School of Medicine, Tokyo, Japan.
Department of Breast Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan.
J Pain Symptom Manage. 2019 Aug;58(2):235-243.e1. doi: 10.1016/j.jpainsymman.2019.04.033. Epub 2019 May 9.
Patient preferences influence end-of-life (EOL) care which patients receive. However, preferences regarding EOL care among adolescent and young adult (AYA) cancer population remain unclear.
The objective of the study was to evaluate preferences regarding EOL care among AYA cancer population.
We evaluated preferences regarding EOL care as a part of a comprehensive multicenter questionnaire study investigating the experience and needs of Japanese AYA cancer population.
A total of 349 AYA cancer population (213 AYA cancer patients and 136 AYA cancer survivors) were evaluated. Eighty-six percent (296/344), 53% (180/338), 88% (301/341), and 61% (207/342) of participants with valid response preferred to have prognostic disclosure, receive palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity, actively use palliative care, and stay home at EOL, respectively. In multivariate analysis, the preference regarding prognostic disclosure was associated positively with no child status (odds ratio [OR] = 3.05, P = 0.003) and negatively with history of chemotherapy (OR = 0.23, P = 0.009), the preference regarding palliative chemotherapy for incurable cancer with limited efficacy at the expense of considerable toxicity was associated positively with status under active cancer treatment (OR = 1.74, P = 0.03), and the preference of staying home at EOL was positively associated with anxiety (OR = 1.72, P = 0.04).
This study elucidated preferences regarding EOL care among Japanese AYA cancer population. These findings may help health care practitioners to have better understanding of preferences regarding EOL care among this population.
患者的偏好会影响他们所接受的临终关怀。然而，青少年和年轻成人（AYA）癌症患者群体的临终关怀偏好尚不清楚。
本研究旨在评估 AYA 癌症患者群体的临终关怀偏好。
我们评估了临终关怀偏好，这是一项综合多中心问卷调查研究的一部分，该研究旨在调查日本 AYA 癌症患者群体的经历和需求。
共评估了 349 名 AYA 癌症患者（213 名 AYA 癌症患者和 136 名 AYA 癌症幸存者）。有 86%（296/344）、53%（180/338）、88%（301/341）和 61%（207/342）的参与者对有明确预后的患者、接受可能具有毒性的有限疗效的姑息性化疗、积极使用姑息治疗和在家中临终表达了偏好。多变量分析显示，对预后的了解偏好与无子女状态呈正相关（比值比[OR] = 3.05，P = 0.003），与化疗史呈负相关（OR = 0.23，P = 0.009），对姑息性化疗的偏好有限的疗效而代价是相当大的毒性与积极接受癌症治疗的状态呈正相关（OR = 1.74，P = 0.03），而在家中临终的偏好与焦虑呈正相关（OR = 1.72，P = 0.04）。
本研究阐明了日本 AYA 癌症患者群体的临终关怀偏好。这些发现可能有助于医疗保健从业者更好地了解这一人群对临终关怀的偏好。
