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Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

  • Li, Xing (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Dong, Min (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Wen, Jing-Yun (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Wei, Li (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Ma, Xiao-Kun (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Xing, Yan-Fang (Department of Nephrology, the Third Affiliated Hospital of Guangzhou Medical University) ;
  • Deng, Yun (Department of Radiation Oncology, the Fifth Affiliated Hospital of Sun Yat-sen University) ;
  • Chen, Zhan-Hong (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Chen, Jie (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Ruan, Dan-Yun (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Lin, Ze-Xiao (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Wang, Tian-Tian (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Wu, Dong-Hao (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Liu, Xu (State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center of Sun Yat-sen University) ;
  • Hu, Hai-Tao (Department of General Surgery, the Second Affiliated Hospital of GuangDong Pharmaceutical University) ;
  • Lin, Jia-Yu (Department of Medical Oncology, the Sixth Affiliated Hospital of Sun Yat-sen University) ;
  • Li, Zhuang-Hua (Department of Medical Oncology, Dongguan People's Hospital) ;
  • Liu, Yuan-Chao (Department of Oncology, the First Hospital of Yueyang) ;
  • Xia, Qing (Department of Oncology, the First Hospital of Shanghai) ;
  • Jia, Chang-Chang (Cell-gene therapy Translational Medicine Research Center, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Wu, Xiang-Yuan (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University) ;
  • Lin, Qu (Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University)
  • Published : 2015.10.06

Abstract

Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.

Keywords

References

  1. Ahmad MM, Al-Gamal E (2014). Predictors of cancer awareness among older adult individuals in Jordan. Asian Pac J Cancer Prev, 15, 10927-32.
  2. Aydogan U, Doganer YC, Kilbas Z, et al (2015). Predictors of knowledge level and awareness towards breast cancer among Turkish females. Asian Pac J Cancer Prev, 16, 275-82. https://doi.org/10.7314/APJCP.2015.16.1.275
  3. Chan TE, Peart NS, Chin J (2013). Evolving legal responses to dependence on families in New Zealand and Singapore healthcare. J Med Ethics.
  4. Chen X, Fan R (2010). The family and harmonious medical decision making: cherishing an appropriate Confucian moral balance. J Med Philos, 35, 573-86. https://doi.org/10.1093/jmp/jhq046
  5. Cheng KY, Ming T, Lai A (2012). Can familism be justified? Bioethics, 26, 431-9. https://doi.org/10.1111/j.1467-8519.2010.01871.x
  6. Fan R (2011). The Confucian bioethics of surrogate decision making: its communitarian roots. Theor Med Bioeth, 32, 301-13. https://doi.org/10.1007/s11017-011-9191-z
  7. Fan R, Yu E 2011. The renaissance of Confucianism in contemporary China.
  8. Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al (2014). Challenges to effective cancer control in China, India, and Russia. Lancet Oncol, 15, 489-538. https://doi.org/10.1016/S1470-2045(14)70029-4
  9. Koerner SS, Shirai Y (2012). The negative impact of global perceptions of and daily care-related family conflict on Hispanic caregivers: familism as a potential moderator. Aging Ment Health, 16, 486-99. https://doi.org/10.1080/13607863.2011.638905
  10. Lam W, Fielding R, Chan M, et al (2003). Participation and satisfaction with surgical treatment decision-making in breast cancer among Chinese women. Breast Cancer Res Treat, 80, 171-80. https://doi.org/10.1023/A:1024568732213
  11. Li EC, Wen CF (2010). Should the confucian familydetermination model be rejected? A case study. J Med Philos, 35, 587-99. https://doi.org/10.1093/jmp/jhq045
  12. Li X, Deng Y, Chen J, et al (2014). Deceptive information and the financial burden for Chinese cancer patients. Lancet Oncol, 15, 299.
  13. Li X, Dong J (2011). The loss of health trust in China: actualities and causes. computer science and service system (CSSS), 2011 international conference on. IEEE, 2737-40.
  14. Li X, Xing YF, Chen ZH, et al (2013). Palliative care in urban areas of China. Lancet Oncol, 14, 339.
  15. Say R, Murtagh M, Thomson R (2006). Patients' preference for involvement in medical decision making: a narrative review. Patient Educ Couns, 60, 102-14. https://doi.org/10.1016/j.pec.2005.02.003
  16. Sessums LL, Zembrzuska H, Jackson JL (2011). Does this patient have medical decision-making capacity? JAMA, 306, 420-7. https://doi.org/10.1001/jama.2011.1023
  17. Tariman JD, Berry DL, Cochrane B, et al (2010). Preferred and actual participation roles during health care decision making in persons with cancer: a systematic review. Ann Oncol, 21, 1145-51. https://doi.org/10.1093/annonc/mdp534
  18. Yang T, Zhang H, Shen F, et al (2013). Appeal from Chinese doctors to end violence. Lancet, 382, 1703-4. https://doi.org/10.1016/S0140-6736(13)62401-0