The Process of Advance Care Planning in HCT Candidates and Proxies

Abstract

The purpose of this study was to examine the relationship between hematopoietic cell transplant candidate and proxy advance care planning (ACP) behavior and attitudes. A total of 49 candidates and 44 proxies completed the Advance Directive Attitudes Survey, Multidimensional Health Locus of Control Scale, Family Decision Making Self-Efficacy Scale, and the State-Trait Anxiety Inventory. In all, 45% of candidates reported completing an advance directive (AD), while only 26% had ADs on file; 80% of candidates discussed ACP wishes with their loved ones and 15% discussed ACP wishes with their medical team. The AD completers were significantly (1) older, (2) more positive about ADs, and (3) were less likely to believe that health events happen by chance. Discrepancies between reported ACP behavior and communication with health care practitioners have implications for end-of-life care.

Keywords

advance care planning proxy advance directive end-of-life care hematopoietic cell transplant candidates

Get full access to this article

View all access options for this article.

References

Sudore

Fried

. Redefining the “planning” in advance care planning: preparing for end-of-life decision making. Ann Intern Med. 2010;153(4):256–261.

http://www.nia.nih.gov/health/publication/advance-care-planning. NIH 2013. Accessed March 12, 2013.

Omnibus Budget Reconciliation Act of 1990, Pub. L. No. 101-508. Sec. 4206-4751. 1990.

Halpern

Pastores

Chou

Chawla

Thaler

. Advance directives in an oncologic intensive care unit: a contemporary analysis of their frequency, type, and impact. J Palliat Med. 2011;14(4):483–489.

Cardenas-Turanzas

Gaeta

Ashoori

Price

Nates

. Demographic and clinical determinants of having do not resuscitate orders in the intensive care unit of a comprehensive cancer center. J Palliat Med. 2011;14(1):45–50.

Perkins

. Controlling death: the false promise of advance directives. Ann Intern Med. 2007;147(1):51–57.

Teno

Lynn

Wenger

. Advance directives for seriously ill hospitalized patients: effectiveness with the patient self-determination act and the SUPPORT intervention. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. J Am Geriatr Soc. 1997;45(4):500–507.

Saraiya

Bodnar-Deren

Leventhal

. End-of-life planning and its relevance for patients' and oncologists' decisions in choosing cancer therapy. Cancer. 2008;113(suppl 12):3540–3547.

Alano

Pekmezaris

Tai

. Factors influencing older adults to complete advance directives. Palliat Support Care. 2010;8(3):267–275.

10.

Zager

Yancy

. A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature. Worldviews Evid Based Nurs. 2011;8(4):202–211.

11.

Cohen

McCannon

Edgman-Levitan

Kormos

. Exploring attitudes toward advance care directives in two diverse settings. J Palliat Med. 2010;13(12):1427–1432.

12.

Joffe

Mello

Cook

Lee

. Advance care planning in patients undergoing hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2007;13(1):65–73.

13.

Ganti

Lee

Vose

. Outcomes after hematopoietic stem-cell transplantation for hematologic malignancies in patients with or without advance care planning. J Clin Oncol. 2007;25(35):5643–5648.

14.

Duckworth

Forti

Russell

. Advance care planning information and distress in hematopoietic cell transplant candidates and proxies. Psycho-Oncology. 2013;22(suppl 2):100–101.

15.

Nolan

Bruder

. Patients' attitudes toward advance directives and end-of-life treatment decisions. Nurs Outlook. 1997;45(5):204–208.

16.

Wallston

Stein

Smith

. Form C of the MHLC scales: a condition-specific measure of locus of control. J Pers Assess. 1994;63(3):534–553.

17.

Nolan

Hughes

Kub

. Development and validation of the Family Decision-Making Self-Efficacy Scale. Palliat Support Care 2009 September;7(3):315–21.

18.

Spielberger

Gorsuch

Lushene

. STAI: Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.

19.

Mystakidou

Parpa

Panagiotou

Tsilika

Galanos

Gouliamos

. Caregivers' anxiety and self-efficacy in palliative care. Eur J Cancer Care (Engl). 2013;22(2):188–195.

20.

Ahles

Tope

Furstenberg

Hann

Mills

. Psychologic and neuropsychologic impact of autologous bone marrow transplantation. J Clin Oncol. 1996;14(5):1457–1462.

21.

Kuehlmeyer

Borasio

Jox

. How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study. J Med Ethics. 2012;38(6):332–337.

22.

Greene

Murdock

. Multidimensional control beliefs, socioeconomic status, and health. Am J Health Behav. 2013;37(2):227–237.