Factors That Influence Attitudes toward Advance Directives among Female Cancer Patients

Area of Science:

• Oncology
• Palliative Care
• Bioethics

Background:

• Advance directives (ADs) are crucial for patient autonomy in end-of-life care.
• Understanding patient attitudes toward ADs is essential for effective implementation.
• Cancer patients, particularly women, may have unique perspectives on ADs and death.

Purpose of the Study:

• To identify attitudes toward advance directives (ADs) among female cancer patients.
• To determine factors influencing these attitudes toward ADs.
• To explore patient preferences for discussing ADs.

Main Methods:

• Cross-sectional study involving 153 female cancer patients (gynecological or breast cancer) at a university hospital.
• Data collected via questionnaires assessing demographics, disease/AD characteristics, knowledge, and attitudes.
• Statistical analysis included t-tests, ANOVA, and multiple regression.

Main Results:

• Only 2% of participants had completed ADs, despite a mean positive attitude score of 3.30.
• Key factors associated with positive AD attitudes included positive views on dignified death, prior life-sustaining treatment discussions, and intention to create ADs.
• Eastern Cooperative Oncology Group Performance Status was a significant negative predictor; identified factors explained 38.5% of the variance in AD attitudes.

Conclusions:

• Female cancer patients generally hold positive attitudes towards ADs and dignified death.
• Patients prefer discussing ADs while active, mentally sound, and capable of decision-making.
• Proactive education on ADs upon hospitalization or during outpatient treatment is recommended to facilitate completion and discussion.