353P - A prediction model for the intents regarding life-sustaining treatment decisions in patients with terminal cancer

Background

Life-Sustaining Treatment Decision systems have been in effect since February 2018 in South Korea. These systems ensure that medically insignificant life-sustaining treatments, which are undesired by the patient, are avoided. This study was designed to develop and verify an explanatory model of terminal cancer patients’ intent related to decisions regarding discontinuing or not performing meaningless, life-sustaining treatments in South Korea.

Methods

Data were collected from April 15 to July 10 2019, via a survey using self-reported questionnaires. A total of 220 patients, with terminal cancer, were recruited. The hypothetical model was constructed using four exogenous variables—family function, knowledge on life-sustaining treatment decisions, likelihood of the treatment outcome, and treatment burden—and three endogenous variables—attitudes towards, the efficacy of, and intent regarding life-sustaining treatment decisions.

Results

The goodness-of-fit of this hypothetical model was x²=169.25, χ²/df=1.90, RMSEA=.07, RMR=0.02, GFI=.91, AGFI=.90, NFI=.97, CFI=.98, RMSEA=.06 The results demonstrated that knowledge on, attitudes towards, the efficacy of life-sustaining treatment decisions, and treatment burden all had significant and direct effects on participants’ intent regarding their treatment decisions. Family function was indirectly associated with participants’ intent regarding life-sustaining treatment decisions. These variables explained 88.8% of the total variance with respect to the intent regarding life-sustaining treatment decisions, with knowledge on these decisions being the most influential factor.

Conclusions

The results of this study suggest that, in order to improve terminal cancer patients’ intent regarding life-sustaining treatment decisions related to discontinuing or not performing meaningless life-sustaining treatments, nursing interventions should focus on enhancing their knowledge around this topic, as well as the efficacy of these choices. In particular, a patient’s family function is a crucial intervention strategy that can enhance their intent regarding life-sustaining treatment decisions.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.