End-of-Life Preparedness and Quality of Advance Care Planning Discussions in Patients With Advanced Metastatic Cancer.

OBJECTIVES

To describe end-of-life (EOL) preparedness, the quality of advance care planning (ACP) discussions, and their effect on EOL preparedness in patients with metastatic cancer enrolled in a phase 1/2 clinical trial.

SAMPLE & SETTING: 81 English-speaking adults aged 18 years or older with advanced metastatic cancer who were enrolled in a phase 1/2 clinical trial and hospitalized at a comprehensive cancer center in South Texas.

METHODS & VARIABLES: A nonexperimental descriptive study was conducted in two parts in 2022. Data were collected using the Quality of Communication Questionnaire and the preparation for EOL subscale of the Quality of Life at the EOL-Cancer questionnaire.

RESULTS

About half of the sample (n = 40) reported being well prepared for EOL and 41 reported being not well prepared for EOL. Patients reported being moderately to completely worried about being a burden to family (n = 36), their family's ability to cope with the future (n = 42), and frightened by thoughts of dying (n = 27). Quality of ACP communication was significantly correlated with EOL preparedness (r = 0.38, p < 0.001).

IMPLICATIONS FOR NURSING

As integral parts of the healthcare team, nurses can communicate with patients with advanced cancer about ACP and initiate EOL discussions, enhance patients' awareness of their EOL stage, and encourage them to plan their EOL care.