The life-sustaining treatments among cancer patients at end of life and the caregiver's experience and perspectives.
OBJECTIVE
The goal of this study was to investigate the utilization of and attitudes toward life-sustaining treatments (LSTs) at the end of life.


METHODS
We identified 4,042 families of cancer patients who had died at any of 17 hospitals in Korea during 2004. Among those, we analyzed the interviews provided by 1,592 (39.4%) primary caregivers. Only women who provided information in baseline and follow-up point could be included for internal comparison.


RESULTS
Most caregivers did not discuss with their patient the option of utilizing the intensive care unit (ICU; 92.7%) or cardiopulmonary resuscitation (CPR; 93.7%) to prolong an ending life. Logistic regressions indicated that the ICU was more likely to be utilized when patients experienced an unexpected medical problem before dying, discussed the ICU with the family caregiver, or were low-educated. CPR was more likely to be used if the patient died within 6 months of diagnosis or the family caregiver was <65 years old. Family caregivers more likely to use the ICU if placed in the same situation again were those whose patients had a higher monthly income or died within 6 months of diagnosis, low-educated, or had utilized the ICU.


CONCLUSIONS
Our findings underscore the importance of discussing LST with terminally ill patients based on adequate information.
Yun
Young Ho
YH
National Cancer Control Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea. lawyun08@ncc.re.kr
Lee
Myung Kyung
MK
Chang
Yoon Jung
YJ
You
Chang Hoon
CH
Kim
Samyong
S
Choi
Jong Soo
JS
Lim
Ho-Yeong
HY
Lee
Chang Geol
CG
Choi
Youn Seon
YS
Hong
Young Seon
YS
Kim
Si-Young
SY
Heo
Dae Seog
DS
Jeong
Hyun Sik
HS
D000368:Aged; D001294:Attitude to Health; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D017028:Caregivers / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007723:Korea / Q000453:epidemiology; D008020:Life Support Care / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000628:therapy; D016017:Odds Ratio; D010166:Palliative Care; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000706:statistics & numerical data*