Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran

Background: Nurses play a crucial role in delivering end-of-life care; however, patients' attitudes significantly influence the care process. Positive attitudes facilitate patient engagement and understanding of end-of-life options, while negative attitudes can induce fear and distress. Address...

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Main Authors: Salman Rahnama, Mohammad Sajjad Lotfi, Maryam Asadi, Zahra Rezaei-Shahsavarloo
Format: Article
Language:English
Published: Kashan University of Medical Sciences 2025-03-01
Series:Nursing and Midwifery Studies
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Online Access:https://nmsjournal.kaums.ac.ir/article_213905_c838c49652bf5e6e645ce146559dd17a.pdf
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author Salman Rahnama
Mohammad Sajjad Lotfi
Maryam Asadi
Zahra Rezaei-Shahsavarloo
author_facet Salman Rahnama
Mohammad Sajjad Lotfi
Maryam Asadi
Zahra Rezaei-Shahsavarloo
author_sort Salman Rahnama
collection DOAJ
description Background: Nurses play a crucial role in delivering end-of-life care; however, patients' attitudes significantly influence the care process. Positive attitudes facilitate patient engagement and understanding of end-of-life options, while negative attitudes can induce fear and distress. Addressing patient concerns and associated factors is essential for enhancing care during the end-stage period.Objectives: This study aimed to evaluate attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer.Methods: This cross-sectional study was conducted from November 2022 to March 2023 at Omid Hospital in Isfahan, Iran. A sample of 150 participants was selected through consecutive sampling. Data were collected using questionnaires on demographic characteristics, attitudes toward end-of-life issues, and the Mini-Mental State Examination. Statistical analyses were performed using SPSS version 22, including independent t-tests, chi-square tests, Fisher’s exact test, and binomial logistic regression.Results: The mean age of participants was 71.95 ± 6.04 years. The mean score for end-of-life concerns was 67.11 out of 135. A majority of participants preferred physician-led decision-making (76.7%) and did not support euthanasia as a personal choice (72%). Furthermore, most participants disagreed with the notion of dying alone (78.7%) and expressed a preference for home care (78.7%). Logistic regression identified three significant factors associated with end-of-life concerns: time since diagnosis (OR = 27.914, CI: 1.144–680.922, P < 0.001), marital status (OR = 0.847, CI: 0.811–0.884, P = 0.041), and family caregiver status (OR = 2.603, CI: 0.419–0.866, P = 0.006).Conclusion: Healthcare professionals should recognize and address end-of-life concerns by offering personalized support to older adults. Nurses should focus on supporting decision-making, pain management, preferred care settings, and the regulation of living wills.
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spelling doaj-art-a9ef53e8d7e448d8bebd554bcb067d652025-08-20T02:51:20ZengKashan University of Medical SciencesNursing and Midwifery Studies2322-14882322-16742025-03-01141122010.48307/nms.2025.473336.1469213905Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in IranSalman Rahnama0Mohammad Sajjad Lotfi1Maryam Asadi2Zahra Rezaei-Shahsavarloo3MSc in Medical-Surgical Nursing, Student Research Committee, Kashan University of Medical Sciences, Kashan, IranAssistant Professor of Gerontology, Trauma Nursing Research Center, University of Medical Sciences, Kashan, IranCritical Care Nursing Student, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranAssistant Professor of Nursing, Trauma Nursing Research Centre, Kashan University of Medical Sciences, Kashan, IranBackground: Nurses play a crucial role in delivering end-of-life care; however, patients' attitudes significantly influence the care process. Positive attitudes facilitate patient engagement and understanding of end-of-life options, while negative attitudes can induce fear and distress. Addressing patient concerns and associated factors is essential for enhancing care during the end-stage period.Objectives: This study aimed to evaluate attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer.Methods: This cross-sectional study was conducted from November 2022 to March 2023 at Omid Hospital in Isfahan, Iran. A sample of 150 participants was selected through consecutive sampling. Data were collected using questionnaires on demographic characteristics, attitudes toward end-of-life issues, and the Mini-Mental State Examination. Statistical analyses were performed using SPSS version 22, including independent t-tests, chi-square tests, Fisher’s exact test, and binomial logistic regression.Results: The mean age of participants was 71.95 ± 6.04 years. The mean score for end-of-life concerns was 67.11 out of 135. A majority of participants preferred physician-led decision-making (76.7%) and did not support euthanasia as a personal choice (72%). Furthermore, most participants disagreed with the notion of dying alone (78.7%) and expressed a preference for home care (78.7%). Logistic regression identified three significant factors associated with end-of-life concerns: time since diagnosis (OR = 27.914, CI: 1.144–680.922, P < 0.001), marital status (OR = 0.847, CI: 0.811–0.884, P = 0.041), and family caregiver status (OR = 2.603, CI: 0.419–0.866, P = 0.006).Conclusion: Healthcare professionals should recognize and address end-of-life concerns by offering personalized support to older adults. Nurses should focus on supporting decision-making, pain management, preferred care settings, and the regulation of living wills.https://nmsjournal.kaums.ac.ir/article_213905_c838c49652bf5e6e645ce146559dd17a.pdfterminal carecancerolder adultsattitudefrail elderly
spellingShingle Salman Rahnama
Mohammad Sajjad Lotfi
Maryam Asadi
Zahra Rezaei-Shahsavarloo
Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
Nursing and Midwifery Studies
terminal care
cancer
older adults
attitude
frail elderly
title Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
title_full Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
title_fullStr Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
title_full_unstemmed Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
title_short Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
title_sort attitudes toward end of life concerns and associated factors among hospitalized older adults with end stage cancer in iran
topic terminal care
cancer
older adults
attitude
frail elderly
url https://nmsjournal.kaums.ac.ir/article_213905_c838c49652bf5e6e645ce146559dd17a.pdf
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AT maryamasadi attitudestowardendoflifeconcernsandassociatedfactorsamonghospitalizedolderadultswithendstagecanceriniran
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