Table. Patient Responses to Advance Directive Modules on Goals of Care, Priorities Near the End of Life, and Ratings of Health States.
| Choice | Estimated probability, % (95% CI)a | P value | |
|---|---|---|---|
| Pre–COVID-19 period | COVID-19 period | ||
| Overall goals of care if sick and not getting better (n = 293)b | |||
| Comfort and QOL | 20.5 (14.1-26.9) | 24.5 (18.9-30.1) | .43 |
| Comfort and QOL with treatments that may prolong life without hospitalization | 37.3 (31.4-43.6) | 38.7 (33.1-44.3) | |
| Comfort and QOL with hospitalization but no life support treatments | 14.4 (10.2-18.7) | 13.4 (9.5-17.3) | |
| Comfort and QOL with a short period of life support in a hospital | 21.0 (14.9-27.2) | 18.0 (13.3-22.6) | |
| Prolonged life | 6.7 (3.3-10.2) | 5.4 (2.8-8.0) | |
| Important priorities near the end of life (n = 272)c | |||
| Having loved ones around me | 82.2 (74.9-89.4) | 74.7 (68.5-80.9) | .14 |
| Being alert enough to talk with loved ones | 71.6 (62.7-80.5) | 76.8 (70.6-83.1) | .34 |
| Not spending a lot of time on life support machines | 65.2 (55.8-74.5) | 74.2 (68.1-80.4) | .11 |
| Not spending a lot of time in an ICU | 42.2 (32.6-51.7) | 46.6 (39.3-53.8) | .48 |
| Not having pain | 41.3 (31.7-51.0) | 39.6 (32.5-46.7) | .78 |
| Having someone from my religion or spiritual faith visit me | 27.8 (18.7-36.4) | 20.3 (14.3-26.2) | .17 |
| Living as long as possible | 25.3 (17.1-33.6) | 19.2 (13.5-24.8) | .22 |
| Dying at home | 20.4 (12.7-28.2) | 23.3 (17.0-29.5) | .58 |
| Health states perceived as similar to or worse than dying comfortably (n = 283)d | |||
| I cannot live outside a medical facility | 91.1 (85.3-96.9) | 92.2 (88.4-95.9) | .77 |
| I rely on a breathing machine to live | 89.0 (82.7-95.4) | 94.3 (91.0-97.5) | .12 |
| I need care all the time | 83.6 (76.2-91.0) | 93.9 (90.6-97.2) | .01 |
| I am confused all the time | 81.9 (74.4-89.4) | 93.4 (89.9-97.0) | .03 |
| I cannot get out of bed | 79.9 (71.8-88.0) | 83.8 (78.6-88.9) | .42 |
| I rely on a feeding tube to live | 75.6 (67.0-84.2) | 88.7 (84.2-93.1) | .01 |
| I cannot control by bladder or bowels | 73.7 (64.9-82.6) | 87.3 (82.6-92.0) | .01 |
| I have to stay home all day | 67.4 (57.9-77.0) | 74.4 (68.1-80.6) | .23 |
| I am in moderate pain all the time | 65.9 (56.4-75.3) | 68.1 (61.6-74.7) | .70 |
| I am wheelchair bound | 57.5 (47.8-67.1) | 58.3 (51.5-65.0) | .89 |
Abbreviations: COVID-19, coronavirus disease 2019; ICU, intensive care unit; QOL, quality of life.
a
Estimated using multivariable logistic regression adjusting for patient age and patient-reported health status.
b
Probability of electing stated preference for care. Comparison of response distribution in pre–COVID-19 period with COVID-19 period performed using Kruskal-Wallis test.
c
Probability of rating end-of-life goal as extremely important.
d
Probability of rating health state as equal to or worse than dying comfortably.