Effects of family-centered advance care planning on ACP readiness and quality of life in patients with advanced cancer

doi:10.3969/j.issn.1004-583X.2024.12.008

Abstract

Abstract:

Objective To analyze the effects of family-centered advance care planning (ACP) on ACP readiness and quality of life in advanced cancer patients. Methods A total of 82 patients with advanced cancer admitted to the oncology department of a top-three hospital in Yunnan Province were randomly divided into control group ( $n$ =42) and intervention group ( $n$ =40). The control group received routine clinical nursing measures for cancer patients, and the intervention group received family-centered ACP plus routine nursing care. ACP readiness and quality of life before and 1 week and 1 month after intervention between groups were analyzed. Results After intervention, there were significant differences in the ACP readiness and quality of life between the two groups (P<0.05). Conclusion Family-centered ACP can effectively improve the ACP readiness and improve the quality of life of advanced cancer patients.

Key words: neoplasms, advance care planning, readiness, quality of life

CLC Number:

R739.9

Wang Hongqian, Fang Xuewen. Effects of family-centered advance care planning on ACP readiness and quality of life in patients with advanced cancer[J]. Clinical Focus, 2024, 39(12): 1106-1110.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.12.008

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I12/1106

Figures/Tables 3

Tab.1 Comparison of general information between groups

组别		例数	性别				年龄(岁)										婚姻状况
组别		例数	男		女		≤40		41~50		51~60		61~70		≥71		未婚		已婚		离异		分居
干预组		40	23(57.5)		17(42.5)		2(5.0)		3(7.5)		19(47.5)		12(30.0)		4(10.0)		4(10.0)		21(52.5)		10(25.0)		5(12.5)
对照组		42	25(59.5)		17(40.5)		6(14.3)		5(11.9)		19(45.2)		10(23.8)		2(4.8)		4(9.5)		24(57.1)		9(21.4)		5(11.9)
χ²值			0.035				3.411										0.204
P值			0.852				0.492										0.977
组别	文化程度							医疗费用支付方式						居住地				有无宗教信仰				有无经历或接触过抢救经经历
组别	小学及以下			初中		高中及以上		自费		新农合		职工医保	居民医保	城镇		农村		有		无		有		无
干预组	20(50.0)			12(30.0)		8(20.0)		3(7.5)		24(60.0)		6(15.0)	7(17.5)	14(35.0)		26(65.0)		3(7.5)		37(92.5)		13(32.5)		27(67.5)
对照组	22(52.4)			15(35.7)		5(11.9)		2(4.8)		22(52.4)		9(21.4)	9(21.4)	10(23.8)		32(76.2)		4(9.5)		38(90.5)		15(35.7)		27(64.3)
χ²值	1.677							1.094						1.239				0.108				0.094
P值	0.700							0.778						0.266				0.743				0.759

Tab.2 Comparison of the dimension score of ACP readiness between groups after intervention

组别	例数	态度维度			信念维度			动机维度
组别	例数	干预前	干预后1周	干预后1月	干预前	干预后1周	干预后1月	干预前	干预后1周	干预后1月
干预组	40	2.80±0.35	3.21±0.40^*	3.48±0.33^*	2.75±0.34	3.68±0.44^*	3.88±0.41^*	2.79±0.37	3.28±0.48^*	3.71±0.35^*
对照组	42	2.71±0.49	2.94±0.41	3.11±0.49	2.69±0.33	3.40±0.53	3.62±0.43	2.87±0.44	3.07±0.43	3.49±0.40
组间		$F$ =20.470 P=0.001			$F$ =13.165 P=0.001			$F$ =5.348 P=0.023
时点间		$F$ =35.541 P=0.001			$F$ =143.649 P=0.001			$F$ =66.976 P=0.001
组间·时点间		$F$ =3.764 P=0.025			$F$ =3.816 P=0.024			$F$ =3.305 P=0.001

Tab.2 Comparison of the dimension score of ACP readiness between groups after intervention

组别	例数	态度维度			信念维度			动机维度
组别	例数	干预前	干预后1周	干预后1月	干预前	干预后1周	干预后1月	干预前	干预后1周	干预后1月
干预组	40	2.80±0.35	3.21±0.40^*	3.48±0.33^*	2.75±0.34	3.68±0.44^*	3.88±0.41^*	2.79±0.37	3.28±0.48^*	3.71±0.35^*
对照组	42	2.71±0.49	2.94±0.41	3.11±0.49	2.69±0.33	3.40±0.53	3.62±0.43	2.87±0.44	3.07±0.43	3.49±0.40
组间		$F$ =20.470 P=0.001			$F$ =13.165 P=0.001			$F$ =5.348 P=0.023
时点间		$F$ =35.541 P=0.001			$F$ =143.649 P=0.001			$F$ =66.976 P=0.001
组间·时点间		$F$ =3.764 P=0.025			$F$ =3.816 P=0.024			$F$ =3.305 P=0.001

Tab.3 Comparison of the total score and some dimension scores of quality of life between groups after intervention

组别	例数	角色功能维度				情绪功能维度				认知功能维度
组别	例数	干预前	干预后1周		干预后1月	干预前	干预后1周		干预后1月	干预前	干预后1周		干预后1月
干预组	40	3.12±0.48	2.71±0.53^*		2.48±0.58^*	3.19±0.40	2.80±0.49^*		2.44±0.31^*	3.05±0.40	2.72±0.44^*		2.58±0.47^*
对照组	42	3.02±0.58	2.96±0.52		2.87±0.56	3.24±0.43	3.05±0.41		2.77±0.55	3.16±0.42	2.96±0.45		2.87±0.49
组间		$F$ =6.331 P=0.014				$F$ =13.741 P=0.001				$F$ =16.077 P=0.001
时点间		$F$ =11.791 P=0.001				$F$ =34.504 P=0.001				$F$ =14.779 P=0.001
组间·时点间		$F$ =4.647 P=0.011				$F$ =4.413 P=0.024				$F$ =7.623 P=0.001
组别		社会功能维度						生命质量总分
组别		干预前		干预后1周		干预后1月		干预前		干预后1周		干预后1月
干预组		3.09±0.54		2.74±0.52^*		2.43±0.42^*		3.15±0.36		2.82±0.38^*		2.65±0.32^*
对照组		3.13±0.33		2.98±0.44		2.73±0.50		3.11±0.41		3.03±0.47		2.87±0.46
组间		$F$ =9.644 P=0.003						$F$ =7.292 P=0.008
时点间		$F$ =10.947 P=0.001						$F$ =16.059 P=0.001
组间·时点间		$F$ =7.517 P=0.001						$F$ =2.837 P=0.032

Tab.3 Comparison of the total score and some dimension scores of quality of life between groups after intervention

组别	例数	角色功能维度				情绪功能维度				认知功能维度
组别	例数	干预前	干预后1周		干预后1月	干预前	干预后1周		干预后1月	干预前	干预后1周		干预后1月
干预组	40	3.12±0.48	2.71±0.53^*		2.48±0.58^*	3.19±0.40	2.80±0.49^*		2.44±0.31^*	3.05±0.40	2.72±0.44^*		2.58±0.47^*
对照组	42	3.02±0.58	2.96±0.52		2.87±0.56	3.24±0.43	3.05±0.41		2.77±0.55	3.16±0.42	2.96±0.45		2.87±0.49
组间		$F$ =6.331 P=0.014				$F$ =13.741 P=0.001				$F$ =16.077 P=0.001
时点间		$F$ =11.791 P=0.001				$F$ =34.504 P=0.001				$F$ =14.779 P=0.001
组间·时点间		$F$ =4.647 P=0.011				$F$ =4.413 P=0.024				$F$ =7.623 P=0.001
组别		社会功能维度						生命质量总分
组别		干预前		干预后1周		干预后1月		干预前		干预后1周		干预后1月
干预组		3.09±0.54		2.74±0.52^*		2.43±0.42^*		3.15±0.36		2.82±0.38^*		2.65±0.32^*
对照组		3.13±0.33		2.98±0.44		2.73±0.50		3.11±0.41		3.03±0.47		2.87±0.46
组间		$F$ =9.644 P=0.003						$F$ =7.292 P=0.008
时点间		$F$ =10.947 P=0.001						$F$ =16.059 P=0.001
组间·时点间		$F$ =7.517 P=0.001						$F$ =2.837 P=0.032

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