Effects of end-of-life discussions on patientsʹ affective outcomes

The purpose of this article is to review affective outcomes of end-of-life discussions on patients and characteristics of end-of-life discussions. A systematic review was conducted. Published interventions, prospective studies, and surveys were retrieved from MEDLINE, PubMed, PsychINFO, CancerLit, CINAHL, and Cochrane Database of Systematic Reviews from January 1980 to December 2002, and the reference lists of the retrieved articles. Retrieved articles suggested that end-of-life discussions contributed to the increase of patient satisfaction and perceived benefits and satisfaction with the communication. Most end-of-life discussions occurred with relatively healthy elderly patients in outpatient setting and were 5 to 15 minute-long conversations initiated by physicians. The scope of discussions was limited to the completion of an advance directive and life-sustaining treatment options. No evidence of negative affective outcomes of end-of-life discussions in patients was found; however, very little research has been conducted. The effect of end-of-life discussions should be evaluated on the basis of patientsʹ perspectives using standardized measures.