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

Abstract Context 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. Objectives To examine whether the five-factor model of personality explains variation in preferences for end-of-life care in men with prostate cancer. Methods 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. Results 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 of patients 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. Conclusion 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.