Preferences for surrogate designation and decision-making process in older versus younger adults with cancer: A comparative cross-sectional study

PATIENT EDUCATION AND COUNSELING

卷:102

Article

Martinez-Tapia, Claudia¹  Canoui-Poitrine, Florence^1,2  Caillet, Philippe^1,3,4  Bastuji-Garin, Sylvie^1,2,5  Tournigand, Christophe^6,7  Assaf, Elias⁶  Varnier, Gwenaelle³  Pamoukdjian, Frederic^8,9  Brain, Etienne¹⁰  Rollot-Trad, Florence¹¹  Laurent, Marie^1,3  Paillaud, Elena^1,3,4 

[1] Paris Est Univ, UPEC, IMRB EA CEpiA Clin Epidemiol & Ageing Unit 7376, DHU A TVB, Creteil, France

[2] Henri Mondor Hosp, AP HP, Publ Hlth Dept, Creteil, France

[3] Henri Mondor Hosp, AP HP, Internal Med & Geriatr Dept, Paris Sud Val de Marne Geriatr Oncol Clin, Creteil, France

[4] Georges Pompidou European Hosp HEGP, AP HP, Geriatr Dept, Paris, France

[5] Henri Mondor Hosp, AP HP, Clin Res Unit URC Mondor, Creteil, France

[6] Henri Mondor Hosp, AP HP, Dept Med Oncol, Creteil, France

[7] Paris Est Univ, UPEC, Unit EC2M3, VIC DHU, Creteil, France

[8] Avicenne Hosp, AP HP, Geriatr Dept, Coordinat Unit Geriatr Oncol, Bobigny, France

[9] Paris 13 Univ, Sorbonne Paris Cite, Hlth Educ & Practices Lab, LEPS EA3412, Bobigny, France

[10] Hop Rene Huguenin, Inst Curie, Dept Med Oncol, St Cloud, France

[11] Inst Curie Hosp, Geriatr Oncol & Support Care Dept, Paris, France

关键词: Cancer;    Surrogate;    Medical information;    Medical decision-making;    Patient preference;   

DOI  :  10.1016/j.pec.2018.09.024

来源: Elsevier

【 摘 要 】

Objective: To compare the preferences of older (>= 70 years old) versus younger (<70 years old) cancer patients regarding surrogate designation and decision making. Methods: A cross-sectional survey. Patient characteristics and information about surrogacy and involvement in decision making were collected. Associations between patient characteristics and preferences were examined. Results: The study included 130 patients aged >= 70 years (mean age 80 years) and 102 patients aged <70 years (mean age 55) and. Factors independently associated with surrogate knowledge (66%): younger age, more children living nearby, high income; factors associated with having already designated a surrogate (62%): younger age, decreased number of daily medications; factors associated with designating a surrogate after questionnaire administration (40%): low education, metastasis. Patients requiring an informed consent for any intervention was associated with older age (adjusted OR [aOR](peryear) = 1.04[95% confidence interval 1.00-1.08]), not living alone (aOR =2.52[1.00-6.36]), and having children (aOR = 4.49[1.13-17.81]). Conclusion: All cancer patients, wanted to be fully informed and 72% wanted to be involved in medical decisions. Preferences for decision control vary between age groups, depending on family members' presence and living alone. Practice implications: Sharing complete and clear information should be an important key in the process of cancer patients' care, regardless of patient age. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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