Let us talk about death: gender effects in cancer patients' preferences for end-of-life discussions.

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ID: 96491
2020
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Ranked #25 of 77 articles by views in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

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Abstract
Patients with advanced cancer often receive suboptimal end-of-life (EOL) care. Particularly males with advanced cancer are more likely to receive EOL care that is more aggressive, even if death is imminent. Critical factors determining EOL care are EOL conversations or advance care planning. However, information about gender-related factors influencing EOL conversations is lacking. Therefore, the current study investigates gender differences concerning the content, the desired time point, and the mode of initiation of EOL conversations in cancer patients.In a cross-sectional study, 186 female and male cancer patients were asked about their preferences for EOL discussions using a semi-structured interview, focusing on (a) the importance of six different topics (medical and nursing care, organizational, emotional, social, and spiritual/religious aspects), (b) the desired time point, and (c) the mode of discussion initiation.The importance of EOL topics differs significantly regarding issue (p = 0.002, η = 0.02) and gender (p < 0.001, η = 0.11). Males wish to avoid the engagement in discussions about death and dying particularly if they are anxious about their end-of-life period. They wish to be addressed regarding the "hard facts" nursing and medical care only. In contrast, females prefer to speak more about "soft facts" and to be addressed about each EOL topic. Independent of gender, the majority of patients prefer to talk rather late: when the disease is getting worse (58%), at the end of their therapy, or when loosing self-sufficiency (27.5%).The tendency of patients to talk late about EOL issues increases the risk of delayed or missed EOL conversations, which may be due to a knowledge gap regarding the possibility of disease-associated incapability. Furthermore, there are significant gender differences influencing the access to EOL conversations. Therefore, for daily clinical routine, we suggest an early two-step, gender-sensitive approach to end-of-life conversations.
Reference Key
seifart2020letsupportive Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Seifart, C;Riera Knorrenschild, J;Hofmann, M;Nestoriuc, Y;Rief, W;von Blanckenburg, P;
Journal Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Year 2020
DOI
10.1007/s00520-019-05275-1
URL
Keywords
Cancer communication palliative care end-of-life discussions gender effects

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