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MeyersKathy_Final_12.11.20.pdf (1.09 MB)

ETD Abstract Container

Abstract Header

Symptom Severity, End of Life Preferences, Religiosity, and Advance Care Planning in Patients with Advanced Cancer

Meyers, Kathy Jo
http://orcid.org/0000-0002-7445-9784
http://rave.ohiolink.edu/etdc/view?acc_num=case160769744309473

Abstract Details

2021, Doctor of Philosophy, Case Western Reserve University, Nursing.
Patients with advanced cancer suffered symptoms, physical and psychological. Each cancer has specific symptoms that worsened with progression, causing increased severity of symptoms and influencing end of life (EOL) decision-making. Decision-making at EOL taking the form of an advance care plan (ACP) included a Living Will (LW), Do Not Attempt Resuscitation (DNAR), or Durable Power of Attorney for Healthcare (DPoAHC). The ACP was influenced by symptoms, EOL values, family wishes, race, or the desire to live as long as possible. The purpose of this secondary data analysis was to examine symptom severity, EOL preferences, religiosity, and ACP in patients with advanced cancer. This study was guided by the Quality of Life Model and the Conceptual Framework for Individual and Family EOL Decision Making. This descriptive secondary analysis assessed 378 patients with advanced cancers from Seidman Cancer Center's outpatient clinics at University Hospitals Cleveland Medical Center, Cleveland, Ohio. The Edmonton Symptom Assessment Scale measured the symptom severity, EOL preferences were measured by the EOL Values scale, religiosity was operationalized using the Abbreviated Santa Clara Strength of Religious Faith Questionnaire, and ACP types were documented in the electronic health record. The study results indicated that the most severe symptoms were tiredness, followed by pain, shortness of breath, and loss of appetite. Compared to White participants, non-White participants had a greater desire to follow religious teachings, live as long as possible, and a higher total religiosity score. Non-White participants were more likely to have the one-criterion documented ACP (DNAR). White participants were more likely to have two or three criteria ACP. Symptom severity was significantly different among ACP types, and the DNAR group presented the most severe symptoms. The study findings suggested severe symptoms impact ACP. Open dialogue between the patient, caregivers, and healthcare professionals needed to start before symptoms became severe. Further, race and religiosity impact ACP. Healthcare providers needed to engage patients in EOL discussion and assist in formulating an appropriate individualized ACP. Future studies using qualitative or mixed methods could provide potential enlightenment into patient understanding, preferences, choices, and experience around ACP participation.
Chao-Pin Hsiao (Committee Chair)
Barbara Daly (Committee Member)
Sara Douglas (Committee Member)
Richard Lee (Committee Member)
114 p.
Nursing
Cancer, Symptom Severity, End of Life, Religiosity, Quality of Life

Recommended Citations

Citations

  • Meyers, K. J. (2021). Symptom Severity, End of Life Preferences, Religiosity, and Advance Care Planning in Patients with Advanced Cancer [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case160769744309473

    APA Style (7th edition)

  • Meyers, Kathy. Symptom Severity, End of Life Preferences, Religiosity, and Advance Care Planning in Patients with Advanced Cancer. 2021. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case160769744309473.

    MLA Style (8th edition)

  • Meyers, Kathy. "Symptom Severity, End of Life Preferences, Religiosity, and Advance Care Planning in Patients with Advanced Cancer." Doctoral dissertation, Case Western Reserve University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case160769744309473

    Chicago Manual of Style (17th edition)

case160769744309473
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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.