The effect of underlying health status on patient or surrogate preferences for end-of-life care: a pilot study.
This study explored the role of health status, as measured by the Palliative Performance Score, in shaping patient preferences for end-of-life care. Scores were correlated with 3 potential goals of care: prolonging life, maintaining function, and maximizing comfort among patients seen in palliative care consultation. Eighty-six patients expressed treatment preferences: 16 (19%) preferred prolonging life, 23 (27%) preferred maintaining function, and 47 (54%) preferred maximizing comfort (P < .0001); their average scores +/- standard deviation were, respectively, 51.9 +/- 19.4, 56.5 +/- 16.7, and 45.3 +/- 14.1 (P = .0459). There was a significant relationship between patient preferences and Palliative Performance Score, with lower scores indicating preferences for comfort and higher scores indicating a preference for maintaining function and life expectancy. Further research is needed to test the sensitivity of health status, as measured by the Palliative Performance Score, in affecting patient preferences.
Bambauer
Kara Zivin
KZ
Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA.
Gillick
Muriel R
MR
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010166:Palliative Care; D010358:Patient Participation; D017060:Patient Satisfaction; D010865:Pilot Projects; D012720:Severity of Illness Index; D013727:Terminal Care