Associations Between Personality and End-of-Life Care Preferences Among Men with Prostate Cancer: A Clustering Approach

Increased focus on patient-centered care models has contributed to greater emphasis on improving quality of life at the end of life through personalized medicine. However, little is known about individual-level factors impacting end-of-life care preferences.

To examine whether the five-factor model of personality explains variation in preferences for end-of-life care in men with prostate cancer.

Two hundred twelve men with a prostate cancer diagnosis (mean age = 62 years) completed a measure of the five-factor model of personality -spanning the personality dimensions of neuroticism, agreeableness, extraversion, openness, and conscientiousness - and reported on end-of-life care preferences. Cluster analyses were used to partition the sample into groups with similar care preferences. Analyses of variance and Chi-square tests were used to evaluate differences in care preferences among the groups.

Cluster analyses revealed three groups of participants: "Comfort-Oriented Patients," "Service-Accepting Patients," and "Service-Reluctant Patients. " Most (67%) were Comfort-Oriented, preferring palliative care and opposing life support services. A subset were Service-Accepting (17%), preferring both palliative care and life support, or were Service-Reluctant (16%), preferring neither. Service-Reluctant patients endorsed significantly higher levels of neuroticism (emotional instability and negativity) than Comfort-Oriented Patients. Comfort-Oriented patients endorsed significantly higher levels of agreeableness than Service-Accepting patients and Service-Reluctant patients.

Findings suggest that personality traits are associated with specific health care preferences. Individuals high on neuroticism are likely to report reluctance toward all forms of end-of-life care, and may benefit from in-depth information about the process and likely outcomes of receiving life support and palliative care services.

Journal of pain and symptom management. 2015 Sep 04 [Epub ahead of print]

Emily G Lattie, Yasmin Asvat, Smriti Shivpuri, James Gerhart, Sean O'Mahony, Paul Duberstein, Michael Hoerger

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.  Siteman Cancer Center, Barnes-Jewish Hospital, St. Louis, Missouri. , Department of Behavioral Sciences. , Department of Behavioral Sciences. , Department of Palliative Medicine, Rush University Medical Center, Chicago, Illinois. , Departments of Psychiatry and Family Medicine, University of Rochester, Rochester, New York. , Departments of Psychology, Psychiatry, and Medicine, Tulane University, New Orleans, Louisiana, USA.