Study on consistency of patients with Hodgkin's lymphoma and their families' perception of advance directives

Objective To explore the consistency of patients with Hodgkin's Lymphoma (HL) and their families' perception of advance directives (Ads) and analyze the influencing factors to their perception of Ads. Methods Totally 107 HL patients admitted in the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2018 and 107 corresponding families were selected using convenient sampling. The demographic information of the patients and families as well as the clinical characteristics of the patients were collected. Kappa test was employed to analyze the consistency of the HL patients and their families' perception of Ads. Univariate and multivariate analyses were used to analyze the influencing factors to their perception of Ads. Results Totally 66.36% (71/107) of the HL patients were willing to formulate Ads, higher than 46.72% (50/107) , the proportion of family members who could comply with the Ads willingness of patients, and the difference was statistically significant (χ2=8.387, P=0.004) . The Kappa value was 0.222, and the consistency of Ads perception among the HL patients and their families was poor. Logistic regression analysis revealed that age, religious belief, bereavement experience, systemic symptoms, and Eastern Cooperative Oncology Group (ECOG) Performance Status were influencing factors for the HL patients to formulate Ads willingness, while religious belief and bereavement experience were influencing factors for the families to follow the patients' Ads willingness. Conclusions There is a difference in the perception of Ads between HL patients and their families, and the selection of Ads by family members cannot fully represent the patients themselves; religious beliefs and bereavement experience are common factors affecting the perception of Ads in HL patients and their families. Key words: Hodgkin's lymphoma; Advance directives; Consistency; Influencing factor; Families