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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제51권 제4호
발행연도
2019.1
수록면
1,632 - 1,638 (7page)

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Purpose Physician Orders for Life-Sustaining Treatment (POLST) form is a legal document for terminally ill patients to make medical decisions with physicians near the end-of-life. A multicenter prospective study was conducted to evaluate the feasibility of POLST administration in actual oncological practice. Materials and Methods Patients with terminal cancer, age  20 years, and capable of communicating were eligible. The primary endpoint was the completion rate of POLST. Data about physicians’ or patients’ barriers were also collected. Results From June to December 2017, 336 patients from seven hospitals were eligible. Median patient age was 66 years (range, 20 to 94 years); 52.7% were male; and 60.4% had poor performance status. Primary cancer sites were hepato-pancreato-biliary (26.2%), lung (23.2%), and gastrointestinal (19.9%). Expected survival duration was 10.6±7.3 weeks, with 41.2% receiving hospice care, 37.9% showing progression after cancer treatment, and the remaining patients were under active treatment (15.8%) or initially diagnosed with terminal cancer (5.1%). POLST forms were introduced to 60.1% of patients, and 31.3% signed the form. Physicians’ barriers were reluctance of family (49.7%), lack of rapport (44.8%), patients’ denial of prognosis (34.3%), lack of time (22.7%), guilty feelings (21.5%), and uncertainty about either prognosis (21.0%) or the right time to discuss POLST (16.6%). The patients’ barriers were the lack of knowledge/understanding of POLST (65.1%), emotional discomfort (63.5%), difficulty in decision-making (66.7%), or denial of prognosis (14.3%). Conclusion One-third of patients completed POLST forms, and various barriers were identified. To overcome such barriers, social engagement, education, and systematic support might be necessary.

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참고문헌 (30)

참고문헌 신청
Korean Supreme Court / 2009 / Withdrawing futile life-sustaining treatment / Korean Supreme Court google schola Ministry of Health and Welfare / 2016 / Act on hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life / Ministry of Health and Welfare google schola Royal College of Physicians / 2009 / Advance care planning: concise guideline to good practice, No. 12 / Royal College of Physicians google schola Houben CH / 2014 / Efficacy of advance care planning : a systematic review and meta-analysis / J Am Med Dir Assoc 15:477~489 google schola Keam B / 2013 / The attitudes of Korean cancer patients, family caregivers, oncologists, and members of the general public toward advance directives / Support Care Cancer 21:1437~1444 google schola

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