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Cited by 44Palliative Care and End-of-Life IssuesPalliative and Oncologic CareEthics and bioethics in healthcare

End-of-Life Care Preferences in Patients with Severe and Persistent Mental Illness and Chronic Medical Conditions: A Comparative Cross-Sectional Study

Elie, Dominique, Marino, Amanda, Torres-Platas, Susana G., Noohi, Saeid, Semeniuk, Trent, Segal, Marilyn, Looper, Karl J., Rej, Soham·2018·The American Journal of Geriatric Psychiatry
DOI 10.1016/j.jagp.2017.09.018
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Abstract

Objectives Physicians rarely engage severe and persistent mental illness (SPMI) patients in end-of-life care discussion despite an increased risk of debilitating medical illnesses and mortality. Access to quality palliative care and medical assistance in dying (MAID) has become a priority in Canada and many jurisdictions. In this study, we compared SPMI and chronic medically ill (CMI) patients' end-of-life care preferences and comfort level with end-of-life care discussion, and identified potential predictors of interest in MAID.Design Comparative cross-sectional study.Setting Hospital-based.Participants We recruited 106 SPMI and 95 CMI patients at the Jewish General Hospital, Canada. Patients aged ≥40 years, without severe cognitive impairment, able to communicate in English or French and provide written informed consent were included.Measurements Attitudes towards pain management, palliative sedation, MAID, and artificial life support were collected with the Health Care Preferences Questionnaire. Adjusted odd ratios (aOR) were calculated for each end-of-life care intervention. Comfort with discussion was rated on a Likert scale. A stepwise regression analysis was performed to identify predictors of interest in MAID.Results SPMI was not correlated to any end-of-life care intervention, except for MAID where SPMI patients were less likely to support its use (aOR: 0.48, 95% CI: 0.25-0.94, p = 0.03). Religiosity was also correlated with interest in MAID (aOR: 0.14, 95% CI: 0.06-0.31, p < 0.001). Patients in both groups were comfortable talking about end-of-life care.Conclusions SPMI patients are able to voice their end-of-life care preferences, and contrary to some fears, do not want MAID more than CMI patients.

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Authors
Elie, D., Marino, A., Torres-Platas, S. G., Noohi, S., Semeniuk, T., Segal, M., Looper, K. J., & Rej, S.
Affiliations
Jewish General Hospital (CA)
ORCID
Venue
The American Journal of Geriatric Psychiatry
Publisher
Elsevier BV
Published
2018-01
Volume
26
Issue
1
Pages
89-97
ISSN
1064-7481 (ISSN-L)
DOI
10.1016/j.jagp.2017.09.018
OpenAlex
W2756595785
Semantic Scholar
7c9753d0e4a7d591636619728118793cffed76f5
Cited by
44
References
40
Citations by year
2026: 6 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 1 · 2017: 1
FWCI
3.59
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Geriatric Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • McGill Faculty of Medicine
  • Canadian Institute for Health Research
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
end-of-life preferences, severe and persistent mental illness, chronic disease, medical assistance in dying, palliative care, palliative sedation, artificial life support, pain management, end-of-life discussions, religiosity
MeSH terms
Aged, Mental Disorders, Canada, Chronic Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Religion and Psychology, Terminal Care, Suicide, Assisted, Patient Preference

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