| Summary: | 碩士 === 長庚大學 === 護理學系 === 105 === The purposes of this observational, cross-sectional study were to investigate accurate prognostic awareness in terminally ill cancer patients, actual end-of-life (EOL) care received in their last month in life, and the impact of accurate prognostic awareness on EOL care. A convenience sample of terminally ill cancer patients were recruited from the four hospitals and actual EOL care received (including chemotherapy, intensive care unit [ICU] care, and hospice care) were collected by medical record reviews on the final 243 patients and analyzed by multivariate logistic regression modeling.
Study results showed that only 57.6% of patients had accurate prognostic awareness. Hospice care, chemotherapy, and ICU care was received by 70.4%, 21.8%, and 8.6% of study subjects in their last month of life, respectively. By multivariate logistic regression analysis, accurate prognostic awareness increased the likelihood of receiving hospice care at EOL (AOR: 2.06; 95% CI, 1.12- 3.80) but no impact on receiving ICU care and chemotherapy in the last month of life.
Nurse should evaluate the need for prognostic information of terminally ill cancer patients. Promoting accurate prognostic awareness, respecting patients’ preferences of EOL care, and providing appropriate EOL care can prevent futile aggressive life-sustaining treatments, decreasing the costs of unnecessary medical care, and improving the quality of life of terminally ill cancer patients at EOL.
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