End-of-life experiences in adolescents dying with cancer.
OBJECTIVE
This study explores the experiences of individuals in early, middle, and late adolescence dying from cancer. Place of death, medications used at end of life (EOL), and discussions prior to death are examined.


METHODS
Data were obtained from a retrospective review of medical charts from 103 adolescents who died of cancer between 2000 and 2005.


RESULTS
Adolescents with leukemia/lymphoma were relatively more likely to die in an intensive care unit (p = 0.028) where cause of death was more likely to be treatment-related (p < 0.001), and EOL discussions more likely to occur in the last 7 days of life (p = 0.002). Anxiolytic use was significantly higher during late adolescence (p = 0.037).


CONCLUSIONS
Adolescents have unique developmental needs that should be considered at EOL. Timing of EOL discussions occurred very close to death for a significant number of adolescents, allowing very little time to psychologically prepare for death.
Bell
Cynthia J
CJ
Center for Research and Scholarship, School of Nursing, Indiana University, Indianapolis, IN 46202, USA. cyjbell@iupui.edu
Skiles
Jodi
J
Pradhan
Kamnesh
K
Champion
Victoria L
VL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology; D001293:Attitude to Death; D001932:Brain Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy; D015984:Causality; D002423:Cause of Death; D002648:Child; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000401:mortality / Q000523:psychology / Q000628:therapy; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology; D010817:Physician-Patient Relations; D011788:Quality of Life; D016414:Resuscitation Orders / Q000523:psychology; D017678:Sex Distribution; D012737:Sex Factors; D013727:Terminal Care / Q000706:statistics & numerical data*; D055815:Young Adult