A Model of Death Preparedness in Patients With Advanced Cancer: A Grounded Theory Study.
Xi Zhang, Tieying Zeng, Meizhen Zhao and 3 others
PMID 39648363WHAT IT FOUND
Patients, families and clinicians described death preparedness in advanced cancer as overlapping awareness of prognosis, emotional response, practical end-of-life planning, and giving back.
Personal, family and health-system factors shaped readiness, and some patients wanted honest information.
Key findings
01Participants described death preparedness in advanced cancer as moving through four overlapping areas: death awareness, emotional response, hospice programme, and reflexive care.
02Readiness was reported as shaped by personal, interpersonal and social factors, including support, communication, caregiver and provider preparedness, policy, care resources, and information.
03Some patients said they wanted prompt, honest information about disease and treatment so they could prepare, while others reported family members withheld information.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done only in Chinese oncology wards, so the authors say the model needs field testing in other cultures. It is a theoretical model from qualitative interviews; it had no empirical outcome data and did not test an intervention. The sample was 43 participants from two hospitals, with 12 patients, 11 family members, 16 nurses, and 4 doctors, so it may not represent all advanced cancer patients or providers. Patients with mental illness or cognitive impairment were excluded, and patients had to be aware of their condition and able to communicate, so it does not address people who cannot take part in interviews.
Declared interests
The authors declare no conflicts of interest. Funding was from the National Key Research and Development Program of China and the 2023 Scientific Research Fund of Tongji Hospital.
The easy way to misread this
Do not read the model as proof that preparing patients for death improves quality of life or reduces distress. The paper reports themes and proposes a theoretical model; it did not test an intervention or measure patient outcomes.