Department of Outpatient, West China Hospital, Sichuan University, Chengdu, China.
Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Thorac Cancer. 2020 Feb;11(2):253-263. doi: 10.1111/1759-7714.13237. Epub 2019 Dec 18.
This study aimed to investigate lung cancer patients and attitudes of their caregivers toward advance directives (ADs) in China.
A cross sectional study was conducted in the Department of Oncology outpatient clinic in West China Hospital, Sichuan University. A questionnaire was used to survey the attitudes of lung cancer patients and caregivers toward ADs.
A total of 148 lung cancer patients and 149 caregivers were enrolled into the study. Of these, 94.6% and 89.9% of patients and caregivers had not heard of AD and none of those in the study had ever signed an AD. A total of 79.7% patients and 75.2% caregivers were willing to sign ADs after they were provided with information. Patients who preferred the end of life period to sign ADs were 5.4 times more likely to have ADs than patients who chose to sign ADs when their disease was diagnosed (P < 0.05, 95%CI [1.27-22.93]). Caregivers who were reluctant to undergo chemotherapy when diagnosed with cancer were 2.16 times more likely to sign ADs than those willing to receive chemotherapy (P < 0.05, 95%CI [1.20-3.90]).
In China, lung cancer patients and their caregivers showed lack of knowledge about ADs, and the completion rate of ADs was extremely low. However, participants were positive about ADs and public education on ADs may help to increase the completion rate of ADs in China.
本研究旨在调查中国肺癌患者及其照顾者对预立医疗指示(AD)的态度。
本研究采用横断面研究方法,在四川大学华西医院肿瘤科门诊进行。使用问卷对肺癌患者及其照顾者对 AD 的态度进行调查。
共纳入 148 例肺癌患者和 149 例照顾者。其中,94.6%和 89.9%的患者和照顾者未听说过 AD,且研究中无人签署过 AD。在提供信息后,79.7%的患者和 75.2%的照顾者愿意签署 AD。选择在生命终末期签署 AD 的患者比选择在确诊时签署 AD 的患者签署 AD 的可能性高 5.4 倍(P<0.05,95%CI[1.27-22.93])。当被诊断患有癌症时,不愿意接受化疗的照顾者签署 AD 的可能性是愿意接受化疗的照顾者的 2.16 倍(P<0.05,95%CI[1.20-3.90])。
在中国,肺癌患者及其照顾者对 AD 的了解程度较低,AD 的完成率极低。然而,参与者对 AD 持积极态度,AD 的公众教育可能有助于提高中国 AD 的完成率。