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Abstract
Purpose
The purpose of this study was to explore the chronic patients' preferences for care near the end of life.
Methods
This is a descriptive survey research, with subjects of 161 outpatients with hypertension, diabetes mellitus or chronic renal failure.
Results
The majority of the subjects do not want meaningless life sustaining treatment and they report thinking positively about family or health care professional to participate in their end of life decision making process. Subjects reported preferring adequate pain management and spiritual support at the end of life. In regard to advance directives (ADs), those subjects with chronic disease report thinking positively about the necessity of ADs and its institutionalization. However, the subjects report not having the detailed information on the proper time and method of writing their ADs.
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Table 1.
General and Disease related Characteristics of Subjects (N=161)
| Characteristics | Categories | n (%) or M±SD |
|---|---|---|
| Gender | Male | 85 (52.8) |
| Female | 76 (47.2) | |
| Age (year) | 58.90±9.84 | |
| ≤50 | 29 (18.0) | |
| 51~60 | 62 (38.5) | |
| ＞60 | 70 (43.5) | |
| Marital status | Married | 123 (76.4) |
| Not married | 11 (6.8) | |
| Divorced/bereaved | 27 (16.8) | |
| Religion | Yes | 115 (71.5) |
| No | 46 (28.5) | |
| Education | ≤Middle school | 60 (37.3) |
| High school | 53 (32.9) | |
| ≥College | 48 (29.8) | |
| Occupation | Yes | 68 (42.2) |
| No | 93 (57.8) | |
| Experience of acquaintances' death | Yes | 69 (42.9) |
| No | 92 (57.1) | |
| Relationship with acquaintance∗ | Parents | 31 (44.9) |
| Spouse | 5 (7.2) | |
| Sibling | 9 (13.1) | |
| Others | 24 (34.8) | |
| Caring experience for dying person | Yes | 28 (17.4) |
| No | 133 (82.6) | |
| Relationship with dying person† | Parents | 17 (60.7) |
| Spouse | 3 (10.7) | |
| Sibling | 5 (17.9) | |
| Others | 3 (10.7) | |
| Written will | Yes | 7 (4.3) |
| No | 154 (95.7) | |
| Content of will | Funeral arrangements | 4 (57.1) |
| Inheritance matters Family | 1 2 (14.3) (28.6) | |
| Disease | Hypertension | 60 (37.2) |
| Diabetes | 50 (31.1) | |
| Chronic renal failure | 51 (31.7) | |
| Duration of illness(year) | ＜1 | 23 (14.3) |
| 1~5 | 57 (35.4) | |
| 6~10 | 30 (18.6) | |
| ＞10 | 51 (31.7) | |
| Experience of ICU admission | Yes | 35 (21.7) |
| No | 126 (78.3) | |
| Types of life sustaining treatment | Ventilator | 4 (11.4) |
| CPR | 2 (5.7) | |
| Artificial nutrition | 1 (2.9) | |
| Inotropic drugs | 1 (2.9) | |
| Intubation | 1 (2.9) | |
| Non | 27 (77.1) |
Table 2.
Advance Directives related Characteristics of Subjects (N=161)
Table 3.
Preferences for Care Near the End of Life among Patients with Chronic Disease (N=161)
Table 4.
Preference for Care Near the End of Life according to Characteristic of Subjects (N=161)
Table 5.
Comparison of PCEOL according to Necessity and Main Agent of ADs (N=161)
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