Factors associated with the decision to withhold life-sustaining treatments among middle-aged and older adults who die in hospital

TitleFactors associated with the decision to withhold life-sustaining treatments among middle-aged and older adults who die in hospital
Publication TypeJournal Article
Year of Publication2018
AuthorsCheon, J
JournalKorean Journal of Adult Nursing
Volume30
Issue5
Pagination527
ISSN Number1225-4886
KeywordsAdvance care planning, Decision making, Hospitalization
Abstract

Purpose: As advanced medical care has resulted in the unintended consequence of prolonging deaths, there is a growing interest in the decision to withhold life-sustaining treatments. The purpose of this study was to determine factors associated with the decision to withhold life-sustaining treatments in middle-aged and older adults who die in hospital in the United States. Methods: This cross-sectional correlational study conducted secondary analysis of 2000-2012 exit interview data from the Health and Retirement Study. Adults aged 50 and older who died in hospital and who had made a decision regarding life-sustaining treatments were included. Multivariable logistic regression was used to identify factors related to the decision to withhold life-sustaining treatments. Results: Among 1,412 adults, the prevalence of the decision to withhold life-sustaining treatments was 61.1%. Significant factors associated with the decision to withhold life-sustaining treatments were being African American (Adjusted Odds Ratio [AOR]=0.50, 95% Confidential Interval [CI]=0.30~0.86), Catholic (AOR=0.5, 95% CI=0.32~0.93), having at least one private insurance policy (AOR=1.40, 95% CI=1.02~1.92), having a living will (AOR=1.71, 95% CI=1.04~2.83), and having discussed end-of-life care with someone (AOR=1.810, 95% CI=1.25~2.62). Conclusion: Differences in race and religious affiliation should be considered when older adults, family members, and health care providers make decisions regarding life-sustaining treatments at the end-of-life. Also, health insurance coverage for advance care planning makes it easier for people to discuss life-sustaining treatments with health care providers.

URLhttps://synapse.koreamed.org/DOIx.php?id=10.7475/kjan.2018.30.5.527
DOI10.7475/kjan.2018.30.5.527
Short TitleKorean J Adult Nurs
Citation Key9995