End-of-life care preferences for people with advanced cancer and their families in intensive care units: a systematic review
Advanced cancer patients’ end-of-life care preferences in oncology units, medical-surgical units, nursing homes and palliative care services have been established. However, less is known about end-of-life care preferences of patients with advanced cancer in intensive care units and their families.
To explore end-of-life care preferences of patients with advanced cancer and their families in intensive care units and if these align with essential elements for end-of-life care.
Electronic databases were searched up to February 2018. Reference lists of retrieved articles were screened for potential studies.
A total of 112 full text articles were retrieved. Of these, 12 articles reporting outcomes from 10 studies were eligible for inclusion. The majority were retrospective chart reviews (n = 7) and conducted in developed countries (n = 9). Care preferences change over time with deteriorating physical condition. Ongoing patient-centred communication and shared decision-making are critical as is teamwork and involvement of a palliative care team. Marital status, gender and ethnicity appear to influence care preferences. Of those studies examining patient preferences and/or the receiving of their preferences, these could be aligned with approximately half of the Australian essential elements for end-of-life care.
Providing end-of-life care for patients with advanced cancer in intensive care units is challenging. No studies have investigated prospectively the end-of-life care preferences of patients and their families in this acute setting. Further research is required to determine the elements of care preferences for patients with advanced cancer and their families in intensive care units in developing countries.
KeywordsEnd-of-life care Terminal care Advanced cancer Intensive care unit
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The author(s) also declare that they have full control of all primary data and that they agree to allow the journal to review their data if requested.
- 2.Jang RW, Krzyzanowska MK, Zimmermann C, Taback N, Alibhai SM (2015) Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer. J Natl Cancer Inst 107(3)Google Scholar
- 4.World Health Organisation. Cancer: fact sheets 2017 2017 [cited 2017 11 DEC]. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/
- 7.Worldwide Palliative Care Alliance. Global Atlas of Palliative Care at the End of Life 2014 [cited 2017 22 Nov]. Available from: http://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf
- 8.Australian Commission on Safety and Quality in Health Care (2015) National Consensus Statement: essential elements for safe and high-quality end-of-life care. ACSQHC, SydneyGoogle Scholar
- 9.Canadian Nurses Association.2018 The palliative approach to care and the role of the nurse. OttawaGoogle Scholar
- 10.The National Institute for health and care excellence. 2015 Care of dying adults in the last days of life.Google Scholar
- 16.Australian Institute of Health and Welfare.n.d. Informal carer—relationship to care recipient [cited 2017 20 DEC]. Available from: http://meteor.aihw.gov.au/content/index.phtml/itemId/269485
- 17.Effective Public Health Practice Project .1998 Quality Assessment Tool For Quantitative Studies [cited 2017. Available from: https://merst.ca/wp-content/uploads/2018/02/quality-assessment-tool_2010.pdf
- 18.Truog RD, Campbell ML, Curtis JR, Haas CE, Luce JM, Rubenfeld GD, Rushton CH, Kaufman DC, American Academy of Critical Care Medicine (2008) Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med 36(3):953–963CrossRefGoogle Scholar
- 23.Fu S, Hong DS, Naing A, Wheler J, Falchook G, Wen S, Howard A, Barber D, Nates J, Price K, Kurzrock R (2011) Outcome analyses after the first admission to an intensive care unit in patients with advanced cancer referred to a phase I clinical trials program. J Clin Oncol 29(26):3547–3552CrossRefGoogle Scholar
- 26.Balboni TA, Balboni M, Enzinger AC, Gallivan K, Paulk ME, Wright A, Steinhauser K, VanderWeele TJ, Prigerson HG (2013) Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life. JAMA Intern Med 173(12):1109–1117CrossRefGoogle Scholar
- 27.Loggers ET, Maciejewski PK, Paulk E, DeSanto-Madeya S, Nilsson M, Viswanath K, Wright AA, Balboni TA, Temel J, Stieglitz H, Block S, Prigerson HG (2009) Racial differences in predictors of intensive end-of-life care in patients with advanced cancer. J Clin Oncol 27(33):5559–5564CrossRefGoogle Scholar
- 32.Wickson-Griffiths A, Kaasalainen S, Ploeg J, McAiney C (2014) Revisiting retrospective chart review: an evaluation of nursing home palliative and end-of-life care research. Palliat Med Care 1(2):8Google Scholar
- 33.Sutton J, Austin Z (2015) Qualitative research: data collection, analysis, and management. Can J Hosp Pharm 68(3):226–231Google Scholar
- 41.UK Department of Health (2008) End of life care strategy. In: Life PHQCfAAatEo, editor. London: UK Department of HealthGoogle Scholar