Is Advance Care Planning Associated With Decreased Hope in Advanced Cancer?

JCO Oncology Practice
Michael G CohenYael Schenker

Abstract

Providers have cited fear of taking away hope from patients as one of the principal reasons for deferring advance care planning (ACP). However, research is lacking on the relationship between ACP and hope. We sought to investigate the potential association between ACP and hope in advanced cancer. This is a cross-sectional analysis of baseline data from a primary palliative care intervention trial. All patients had advanced solid cancers. Three domains of ACP were measured using validated questions to assess discussion with oncologists about end-of-life (EOL) planning, selection of a surrogate decision maker, and completion of an advance directive. Hope was measured using the Hearth Hope Index (HHI). Multivariable regression was performed, adjusting for variables associated with hope or ACP. A total of 672 patients were included in this analysis. The mean age was 69.3 ± 10.2 years; 54% were female, and 94% were White. Twenty percent of patients (132 of 661) reported having a discussion about EOL planning, 51% (342 of 668) reported completing an advance directive, and 85% (565 of 666) had chosen a surrogate. There was no difference in hope between patients who had and had not had an EOL discussion (adjusted mean difference in HHI...Continue Reading

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Citations

May 28, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ryan D NippMatthew Loscalzo
Nov 18, 2021·Cancer·Benjamin W Corn, David B Feldman
Nov 18, 2021·Cancer·Michael G CohenYael Schenker

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