Determinants of Congruence Between the Preferred and Actual Place of Death for Terminal Cancer Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/165638
Category:
Abstract
Type:
Presentation
Title:
Determinants of Congruence Between the Preferred and Actual Place of Death for Terminal Cancer Patients
Author(s):
Tang, Stephanie
Author Details:
Stephanie Tang, Yale University, School of Nursing, New Haven, Connecticut, USA, email: stephanie.tang@yale.edu
Abstract:
Background: Approximately two-thirds of cancer patients wish to die at home. However, the majority of deaths from cancer occur in a hospital. In order to provide end-of-life care in accord with the wishes of terminal cancer patients, it is essential to understand the determinants of congruence between the preferred and actual place of death. Purpose: The purposes of this study were 1) to explore the degree of congruence, and 2) to identify the determinants of congruence between the preferred and actual place of death for terminal cancer patients. Theoretical Framework: Antonovsky's (1987) sense of coherence is the theoretical framework of this study. It is hypothesized that if patients perceive that dying at the preferred place has significant value, that necessary resources for achieving this preference are adequate at their disposal, and that they can comprehend the demands imposed by achieving the preference, the probability of congruence between their preferred and actual place of death will be high. Methods: Based on power analysis, a projected 160 terminal cancer patients will be recruited by a convenience sampling method. Preference of place of death was gathered by semi-structured interviews. Sense of coherence, symptom distress, and level of functional dependency were measured by Sense of Coherence Scale (SOC), Symptom Distress Scale (SDS), and Enforced Social Dependency Scale (ESDS), respectively. After the data collection interview, subjects were followed until they die to find their actual place of death. Data Analysis: The degree of congruence between the preferred and actual place of death will be addressed by kappa statistics. Logistic regression with backward selection will be used to identify determinants of congruence between the preferred and actual place of death. Results: Over 50% of the sample has been recruited. Preliminary data indicated that only approximately one-third of subjects could die at the place as they preferred. There are differences in scores of SOC, SDS, and ESDS between the congruent and noncongruent groups. Implications: Results from this study will provide the groundwork for future intervention studies or policy modification to promote death at a place in accord with patient wishes and ultimately end-of-life care can be enhanced.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDeterminants of Congruence Between the Preferred and Actual Place of Death for Terminal Cancer Patientsen_GB
dc.contributor.authorTang, Stephanieen_US
dc.author.detailsStephanie Tang, Yale University, School of Nursing, New Haven, Connecticut, USA, email: stephanie.tang@yale.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165638-
dc.description.abstractBackground: Approximately two-thirds of cancer patients wish to die at home. However, the majority of deaths from cancer occur in a hospital. In order to provide end-of-life care in accord with the wishes of terminal cancer patients, it is essential to understand the determinants of congruence between the preferred and actual place of death. Purpose: The purposes of this study were 1) to explore the degree of congruence, and 2) to identify the determinants of congruence between the preferred and actual place of death for terminal cancer patients. Theoretical Framework: Antonovsky's (1987) sense of coherence is the theoretical framework of this study. It is hypothesized that if patients perceive that dying at the preferred place has significant value, that necessary resources for achieving this preference are adequate at their disposal, and that they can comprehend the demands imposed by achieving the preference, the probability of congruence between their preferred and actual place of death will be high. Methods: Based on power analysis, a projected 160 terminal cancer patients will be recruited by a convenience sampling method. Preference of place of death was gathered by semi-structured interviews. Sense of coherence, symptom distress, and level of functional dependency were measured by Sense of Coherence Scale (SOC), Symptom Distress Scale (SDS), and Enforced Social Dependency Scale (ESDS), respectively. After the data collection interview, subjects were followed until they die to find their actual place of death. Data Analysis: The degree of congruence between the preferred and actual place of death will be addressed by kappa statistics. Logistic regression with backward selection will be used to identify determinants of congruence between the preferred and actual place of death. Results: Over 50% of the sample has been recruited. Preliminary data indicated that only approximately one-third of subjects could die at the place as they preferred. There are differences in scores of SOC, SDS, and ESDS between the congruent and noncongruent groups. Implications: Results from this study will provide the groundwork for future intervention studies or policy modification to promote death at a place in accord with patient wishes and ultimately end-of-life care can be enhanced.en_GB
dc.date.available2011-10-27T12:22:17Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:17Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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