For patients with advanced cancer, making plans for future care does not appear to cause emotional distress and may even reduce anxiety. These findings were published in the Journal of Pain and Symptom Management.
Advance care planning involves making a plan now about future care, including how decisions will be made and who will be responsible. It’s been thought that some doctors might avoid discussions with patients about advance care planning because they worry that such conversations will cause patients to lose hope or feel anxiety about their future health.
Researchers recently evaluated whether advance care planning among patients with cancer would negatively impact feelings of hope (or hopelessness) and anxiety—specifically when care planning was done using online tools.
Participants in the study made advance care plans with an online tool called “Making Your Wishes Known” (makingyourwishesknown.com) or did not make any advance care plans. These 200 patients were undergoing treatment for advanced cancer and were expected to live for two years or less. The researchers evaluated all patients for hope, hopelessness, and anxiety. These levels were compared before and after advance care planning in the group who participated in planning and between patients who made care plans and those who did not. The study also assessed patient knowledge of advance care planning, patient self-determination (taking control of their own life), and satisfaction with the advance care planning process.
Patients who participated in advance care planning did not appear to experience less hope or more hopelessness than patients who did not make care plans. Furthermore, patients who made plans appeared to have slightly less anxiety after the planning process. The planning group also learned more about advance care planning and were more satisfied with the process than those who didn’t participate, though both groups gained knowledge about the process (as measured in the percentage of questions they answered correctly about advance care planning). All patients emerged with higher levels of self-determination.
According to these findings, patients with advanced cancer can make advance care plans using online tools with no risk to their emotional or psychological well-being. The online planning process did not appear to take away feelings of hope or increase hopelessness; it did in fact appear to lower anxiety levels.
Reference: Green MJ, Schubart JR, Whitehead MM, et al. Advance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients with Advanced Cancer. Journal of Pain and Symptom Management. 2014 Dec 23. pii: S0885-3924(14)00939-7. doi: 10.1016/j.jpainsymman.2014.11.293.
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