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Preparation for the end of life and life completion during late-stage lung cancer: An exploratory analysis

Published online by Cambridge University Press:  18 January 2017

Gail Adorno  and
Cara Wallace
Gail Adorno*
Affiliation:
School of Social Work, The University of Texas at Arlington, Arlington, Texas
Cara Wallace
Affiliation:
College of Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
*
Address correspondence and reprint requests to: Gail Adorno, School of Social Work, The University of Texas at Arlington, Box 19129, 211 South Cooper Street, Arlington, Texas, 76019-0129. E-mail: [email protected].
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Abstract

Objective:

Our aim was to explore preparation for the end of life (EoL) and life closure among persons with advanced metastatic lung cancer. Understanding quality of life through the lens of preparation and completion is important since the trajectory of lung cancer can be relatively short, often leading to application of cancer-directed therapies near death without the opportunity for advance planning or palliative care. Clinical research is needed to understand the kinds of distress specific to older adults with advanced lung cancer that are amendable to palliative care interventions.

Method:

We employed an exploratory cross-sectional design to examine psychosocial and existential concerns among a purposive sample (N = 30) of advanced lung cancer patients using the “end-of-life preparation” and “life completion” subscales of the Quality of Life at the End of Life (QUAL–E) questionnaire. Nonparametric methods were employed to analyze preparation, completion, global quality of life (QoL), and the associations among depressive symptoms, preparation, completion, and global QoL.

Results:

Higher scores on life completion were associated with better global QoL, and with items related to transcendence, communicative acts, and interpersonal relationships demonstrating important contributions. The perception of being a future burden on family members was the greatest concern within the preparation domain. Depressive symptoms were not associated with preparation, completion, or global QoL.

Significance of Results:

Psychosocial and existential issues contribute to QoL at the EoL among older adults with late-stage lung cancer during cancer-directed therapy, concurrent care, and hospice. The role of preparation, especially self-perceived burden, merits further research early on in the oncological setting. The preparation and life completion subscales of the QUAL–E are feasible clinical tools for facilitating dyadic communication about sensitive topics in the palliative care setting.

Keywords

Lung cancerPreparationCompletionQuality of lifeEnd of lifeExistential
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 5 , October 2017 , pp. 554 - 564
Copyright
Copyright © Cambridge University Press 2017 

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