Differences between COPD patients and their families regarding willingness toward life-sustaining treatments

Abstract

Background/Purpose: Patients with chronic obstructive pulmonary disease (COPD) receive more life-sustaining treatments (LSTs) than those with other diseases. The aims of this study were to explore the willingness of COPD patients and their families to consent to LSTs and compare the differences between their levels of willingness. Methods: A cross-sectional survey was conducted, and structured questionnaires were used for data collection. Results: A total of 219 valid samples were collected, including 109 patients and 110 families. Sixty percent of family members indicated that they did not know the intentions of the patient. Families were significantly more willing for patients to receive LSTs than the patients themselves. The level of willingness of patients and families varied according to the situation and LST interventions. When patients were in a vegetative state or medical treatments were futile, the willingness of COPD patients and their families to receive LSTs significantly decreased. Endotracheal intubation and external defibrillation were the least likely to be requested, whereas the willingness to receive medication injections and noninvasive ventilation was greatest. Conclusion: Communication between families and patients on the issue of LST should be facilitated. Adequate information on the patient’s condition and possible LSTs should be provided to avoid COPD patients receiving inappropriate LSTs. Keywords: Chronic obstructive pulmonary disease, Life-sustaining treatment, End-of-life, Willingness, Decision making