Religious coping associated with increased use of life-prolonging care near death [Новость добавлена - 08.06.2009]

             Clinical question

Is a higher level of religious coping associated with an increased use of life-prolonging care in adults with advanced cancer?

Bottom line

In this study, a higher level of religious coping to understand and adapt to the stress of advanced cancer with metastases was significantly associated with an increased use of mechanical ventilation and intensive life-prolonging care in the last week of life. Similarly, patients meeting criteria for high-level religious coping were less likely to do any advance care planning, including do-not-resuscitate orders and living wills. (LOE = 1b)

Reference

Phelps AC, Maciejewski PK, Nilsson M, et al. Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 2009;301(11):1140-1147.

Study design: Cohort (prospective), Funding, Government; Allocation: N/A; Setting: Outpatient (any) Earn Mainpro credits

Synopsis

Many patients turn to their religious beliefs to understand and adapt to the stress of terminal illness. These investigators identified a subcohort of 345 consenting and eligible individuals as part of the nationally funded, multisite Coping With Cancer Study. Eligibility criteria included advanced cancer with metastases, disease progression following chemotherapy, age of at least 20 years, and a complete baseline assessment of coping mechanisms and postmortem data. Using standardized and validated questionnaires, patients received scores designating them at a high level or low level (above or below the median score, respectively) of positive religious coping. Additional information obtained at baseline included advance care planning and end-of-life treatment preferences. After adjusting for potential demographic confounders, a high level of religious coping significantly correlated with receipt of mechanical ventilation and intensive life-prolonging care in the last week of life. There were no significant associations between level of religious coping and cardiopulmonary resuscitation, death in the intensive care unit, and use of hospice care. High-level religious coping also significantly correlated with less advance care planning, including do-not-resuscitate orders and living wills.

CEE&FSU Palliative Care Monthly E-mail Newsletter 

Vol.5 No5 May 2009