• J Pain Symptom Manage · Oct 2021

    Prevalence and Factors Associated with Will-to-Live in Patients with Advanced Disease: Results from a Portuguese Retrospective Study.

    • Miguel Julião, Harvey Max Chochinov, Catarina Samorinha, da Silva SoaresDuarteDDepartamento de Cuidados Paliativos da Unidade Local de Saúde do Nordeste, Bragança, Portugal., and Bárbara Antunes.
    • Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal. Electronic address: migueljuliao@gmail.com.
    • J Pain Symptom Manage. 2021 Oct 1; 62 (4): 820-827.

    ContextWill-to-live (WtL) is a complex and multifactorial dimension of end-of-life experience. Health care decisions on assisted suicide and euthanasia are rarely based on WtL evidence-based discussions.ObjectivesTo inform the debate, we aimed to evaluate the prevalence of WtL and its associations within a tertiary home-based palliative care unit.MethodsRetrospective analysis of all WtL entries registered in our anonymized clinical registry, from October 2018 to September 2020.ResultsOne-hundred and twelve patients were included: 53% were male, average age was 66 years old; 88% had malignancies, with a mean performance status of 55%. Mean for WtL of was 3.26 (SD = 3.87) with a prevalence of 60.7% strong, 8.9% moderate and 30.4% weak WtL. Weaker WtL was observed among patients who were not well adapted to their disease (P = .001), felt a burden to others (P< .001), were depressed (P = .001), anxious (P< .001) and endorsed a desire for death (P< .001). Weaker WtL was associated with pain (P = .002) and lower well-being (P = .001). Results from the logistic regression model found that the adaptation to disease emerged as a significant predictor of WtL (P = .025), and burden to others remained marginally significant (P = .087).ConclusionThe factors associated with lower WtL scores are consistent with previous studies, indicating that these patients experience a myriad of physical, psychological and existential symptoms requiring an interdisciplinary palliative care approach. These factors pertaining to WtL should be made known, as Portugal considers how to navigate death-hastening legislation.Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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