Decision-making capacity in terminally-ill cancer patients
Little research has focused on terminally ill patients' ability to make end-of-life decisions. The purpose of this study was to explore the decision-making capacity of elderly, terminally ill cancer patients and better understand factors that may affect this ability. This researcher hypothesized that elderly patients with terminal illness were likely to have compromised decision-making skills as compared to a healthy group of comparison participants. Decision-making capacity was measured utilizing the Hopkins Competency Assessment Kit, the Bechara Gambling Task, the Concept Assessment Kit, and the Mini Mental Status Exam. It was further hypothesized that symptoms of depression, level of physical functioning, and extent of physical symptomatology would have a negative impact on decision-making skills. These variables were measured respectively by the Hamilton Depression Rating Scale, Karnofsky Performance Rating Scale, and the Memorial Symptoms Assessment Scale. This researcher also believed that significant relationships existed among decision-making tasks. Two groups were evaluated, elderly terminally ill cancer patients (n = 43), and healthy elderly comparison participants (n = 35). The results revealed significant impairment in decision-making skills of those with terminal cancer as compared with healthy comparison participants with regards to all measures except the Bechara Gambling Task. General demographic factors such as age, race, and education could not explain these differences in performance. Significant relationships among decision-making tasks were also revealed. On the contrary, the clinical variables described above did not impact decision-making skills as expected. Suggestions and insights offered as to why original hypotheses were not supported. Limitations regarding sample and measurement choices discussed. Implications for significant findings including clinical and policy issues explored. Future research directions addressed. ^
Health Sciences, Mental Health|Health Sciences, General|Psychology, Clinical
Brooke Myers Sorger,
"Decision-making capacity in terminally-ill cancer patients"
(January 1, 2005).
ETD Collection for Fordham University.