Patient characteristics associated with death literacy in advanced non-small-cell lung cancer - A preliminary single-centre cross-sectional study

Q: What is the purpose of this study on advanced NSCLC?

The study investigates baseline death literacy levels and identifies patient characteristics associated with death literacy in advanced non-small-cell lung cancer.

Q: How was death literacy measured in the study?

Death literacy was assessed using the traditional Chinese version of the Death Literacy Index, with scores ranging from 29 to 145.

Q: Which patient factors showed significant association with higher death literacy?

Higher death literacy was significantly associated with prior experience of EOL care, having discussed EOL care with a physician, and being a woman.

Sep 29, 2026

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Advanced non-small-cell lung cancer patients often face severe symptoms and functional decline, making early end-of-life (EOL) care discussions critical for quality improvement, while death literacy may strengthen such conversations. This preliminary cross-sectional study examined baseline death literacy levels and which patient characteristics were associated with death literacy in advanced NSCLC. Convenience sampling recruited 103 patients aged ≥18 with stage IIIB or higher who had completed at least first-line treatment; questionnaires covered demographics, clinical conditions, prior EOL experience, and death literacy. Higher death literacy correlated with EOL care experience, EOL discussions with physicians, and being women.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Introduction

Patient characteristics associated with death literacy in advanced non-small-cell lung cancer: A preliminary single-centre cross-sectional study Gong-Fu Lin 1, Yi-Ling Yeh2, Shiow-Ching Shun3, Ching-Yao Yang4 and Cheng-Pei Lin5,6 Palliative Care and Social Practice 2026, Vol. 20: 1–10 © The Author(s) 2026 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/26323524251408892](DOI: 10.1177/26323524251408892)[ ](DOI: 10.1177/26323524251408892)[journals.sagepub.com/home/pcr](journals.sagepub.com/home/pcr) Abstract Background: Patients with advanced non-small-cell lung cancer (NSCLC) frequently experience severe symptoms and functional decline, underscoring the need for early end-of-life (EOL) care discussions to improve care quality. Additionally, enhancing patients’ death literacy may strengthen these discussions. However, how patient characteristics influence death literacy in this population is largely unknown. Objective: This cross-sectional study explored baseline levels of death literacy and examined associated patient characteristics in advanced NSCLC. Design: A cross-sectional study was conducted. Methods: A total of 103 patients aged ⩾ 18 years with stage IIIB or higher NSCLC who had completed at least first-line cancer treatment were recruited using convenience sampling. Data were collected between June 2024 and June 2025 using structured questionnaires assessing sociodemographic, medical conditions, prior EOL care experience, and death literacy (using the traditional Chinese version of the Death Literacy Index, score range = 29–145). Descriptive statistics, Pearson’s correlation, independent t test, and stepwise regression were used to analyse associations between patient characteristics and death literacy. Result: The mean participant age was 61.62 ± 10.86 years, and the mean Karnofsky Performance Score was 67.57 ± 12.48. Many had prior experience of EOL care provision (58%) and had lost a relative (90%), but few had discussed EOL care with a physician (29%). Overall, death literacy was moderate (94.08 ± 16.45). Higher death literacy was significantly associated with experience of EOL care (β = 13.390, p < 0.001), having had an EOL care discussion with a physician (β = 10.901, p < 0.001), and being a women (β =–8.671, p = 0.001). These factors explained 37.1% of the variance in death literacy (F = 21 .030, Adjusted R2 = 0. 371). Conclusion: Healthcare providers should recognize patients’ lived experiences as important contributors to fostering open conversations around EOL care preferences. Interventions such as the Life Journey Tea House or broader public health strategies may help stimulate reflection and encourage dialogue. 1 Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan 2Department of Social Work, Tunghai University, Taichung, Taiwan 3Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan 4Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 5Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan 6Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, UK Corresponding author: Cheng-Pei Lin, Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Beitou District, Taipei 112304, Taiwan. Email: [cheng-pei.lin@nycu.edu.tw](cheng-pei.lin@nycu.edu.tw) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without fu

FAQs

What is the purpose of this study on advanced NSCLC?

The study investigates baseline death literacy levels and identifies patient characteristics associated with death literacy in advanced non-small-cell lung cancer.

How was death literacy measured in the study?

Death literacy was assessed using the traditional Chinese version of the Death Literacy Index, with scores ranging from 29 to 145.

Which patient factors showed significant association with higher death literacy?

Higher death literacy was significantly associated with prior experience of EOL care, having discussed EOL care with a physician, and being a woman.

Sep 29, 2026

Upload by Indoniesian Boy