Background Patients with Chronic Obstructive Pulmonary Disease (COPD) are more likely than other patients to receive life-sustaining treatments (LST) in end-of-life.
Aim To explore factors associated with intention toward life-sustaining treatments for COPD patients and their family caregivers.
Methods We administered a face-to-face questionnaire to 80 patients with COPD and 63 family caregivers in two teaching hospitals. Participants’ intentions regarding life-sustaining treatments were assessed from a validated instrument.
Results Most COPD patients and family caregivers agreed the LST decision should made by patients. If the dying is irrecoverable, 80% of patients and families would like receiving comfort care rather than life-prolonging treatments. Half of family caregivers didn’t know the LST preferences of patients. Of the 12 possible LST options, ether patients or families, the most acceptable intervention is intravenous injection medications such as antibiotics or other drugs (mean 3.7 vs 4.4). There was less willing to receive invasive treatments like endotracheal intubation and tracheostomy (mean 2.15 vs 2.42). The high burden of care may influence the willing to receive LST. But when LST are futile, both COPD patient and family tend to forgo most of the LST interventions. Overall, family caregivers scored higher on LST preferences than patients. The preferences of receiving LST may vary depending on the diverse situations and outcomes.
Discussion It is important to facilitate discussion about LST for COPD patients and family caregivers.
Conclusion Clinicians will need attempts to describe potential outcomes when posing LST interventions to their patients and families.
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