ArticleGynecologic oncology2016
Room for improvement: An examination of advance care planning documentation among gynecologic oncology patients.
Article in Gynecologic oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors related to advance directives completion among cancer patients: a systematic review.BMC palliative care · 2024Pooled it
- Why is advance care planning underused in oncology settings? A systematic overview of reviews to identify the benefits, barriers, enablers, and interventions to improve uptake.Frontiers in oncology · 2023Pooled it
- Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers.Journal of the National Comprehensive Cancer Network : JNCCN · 2023Trial
- Trial
- Relationships Between Advanced Cancer Patients' Worry About Dying and Illness Understanding, Treatment Preferences, and Advance Care Planning.Journal of pain and symptom management · 2021Trial
- Supporting Advance Care Planning Among Mandarin and Cantonese Speaking Communities: A Qualitative Exploratory Study.Current oncology (Toronto, Ont.) · 2026Article
- Assessment of advance care planning readiness and its determinants among peritoneal dialysis patients in China.Scientific reports · 2026Article
- Publishing quality improvement outcomes in gynecologic oncology: Crucial in the pursuit of optimizing patient care.Gynecologic oncology reports · 2022Article
- Factors influencing death anxiety among Chinese patients with cancer: a cross-sectional study.BMJ open · 2022Article
- Gynecologic oncology patient perspectives and knowledge on advance care planning: A quality improvement intervention.Gynecologic oncology reports · 2022Article
- Advance Directives in Oncology and Haematology: A Long Way to Go-A Narrative Review.Journal of clinical medicine · 2022Review
- Understanding Factors That Predict Advance Directive Completion.Palliative medicine reports · 2022Article
- Is Advance Care Planning Associated With Decreased Hope in Advanced Cancer?JCO oncology practice · 2021Article
- Advance directives of lung cancer patients and caregivers in China: A cross sectional survey.Thoracic cancer · 2020Article
- Life unlocking card game in death and dying classroom for medical students.MedEdPublish (2016) · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectivesThe goals of this study were: (1) to evaluate patients' knowledge regarding advance directives and completion rates of advance directives among gynecologic oncology patients and (2) to examine the association between death anxiety, disease symptom burden, and patient initiation of advance directives.
methods110 gynecologic cancer patients were surveyed regarding their knowledge and completion of advance directives. Patients also completed the MD Anderson Symptom Inventory (MDASI) scale and Templer's Death Anxiety Scale (DAS). Descriptive statistics were utilized to examine characteristics of the sample. Fisher's exact tests and 2-sample t-tests were utilized to examine associations between key variables.
resultsMost patients were white (76.4%) and had ovarian (46.4%) or uterine cancer (34.6%). Nearly half (47.0%) had recurrent disease. The majority of patients had heard about advance directives (75%). Only 49% had completed a living will or medical power of attorney. Older patients and those with a higher level of education were more likely to have completed an advance directive (p<0.01). Higher MDASI Interference Score (higher symptom burden) was associated with patients being less likely to have a living will or medical power of attorney (p=0.003). Higher DAS score (increased death anxiety) was associated with patients being less likely to have completed a living will or medical power of attorney (p=0.03).
conclusionMost patients were familiar with advance directives, but less than half had created these documents. Young age, lower level of education, disease-related interference with daily activities, and a higher level of death anxiety were associated with decreased rates of advance directive completion, indicating these may be barriers to advance care planning documentation. Young patients, less educated patients, patients with increased disease symptom burden, and patients with increased death anxiety should be targeted for advance care planning discussions as they may be less likely to engage in advance care planning.
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