Attitudes to End-of-Life Decisions in Paediatric Intensive Care

Akpinar, Aslıhan; Senses, Muesser Ozcan; Er, Rahime Aydın

doi:10.1177/0969733008097994

Cited by 19 publications

(21 citation statements)

References 30 publications

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“…Although withdrawing treatment was often felt to be reprehensible, professionals also admitted it to be part of their job. In one study, for example, 40% of the Turkish intensive-care nurses justified withdrawing treatment when there was no medical benefit [27], and another study [75] found that 40% of the intensive-care physicians had discontinued treatment in patients with an incurable disease on more than one occasion. Withdrawing treatment was more difficult than not initiating the treatment [40], and was often a matter for discussion.…”

Section: Resultsmentioning

confidence: 99%

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Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

et al. 2012

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BackgroundOur aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care.MethodsA systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality.ResultsFifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such as the decision to withdraw or withhold treatments. The diagnosis, prognosis and end-of-life decisions are seldom discussed with the patient, and communication about pain and mental problems is often limited. Language barriers and the dominance of the family may exacerbate communication problems.ConclusionsThis review confirms the view that family members of patients with a Turkish or Moroccan background have a central role in care, communication and decision making at the end of life. This, in combination with their continuing hope for the patient’s recovery may inhibit open communication between patients, relatives and professionals as partners in palliative care. This implies that organizations and professionals involved in palliative care should take patients’ socio-cultural characteristics into account and incorporate cultural sensitivity into care standards and care practices.

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Section: Resultsmentioning

confidence: 99%

“…In one study 75% of health staff disagreed with the statement that, nutrition should be stopped if a patient wants euthanasia [58], while 68% of the nurses in another study agreed that artificial nutrition should always be continued [27]. …”

Section: Resultsmentioning

confidence: 99%

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

et al. 2012

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“…Despite the expectation for nurses to contribute significantly to the decision‐making process in EOL care, existing research reveals that nurses' actual involvement in the decision‐making process is far below the expected level (Kennard et al , ; Akpınar, ; Yaguchi et al , ; Akpinar et al , ; Langley et al , ). A study conducted in Turkey demonstrated that nurses lack sufficient knowledge and skills in ethical decision making (Ersoy and Göz, ).…”

Section: Introductionmentioning

confidence: 99%

Turkish critical care nurses' views on end‐of‐life decision making and practices

Badır

Topçu

Türkmen

et al. 2015

Nursing in Critical Care

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“…34 This result could also be interpreted as nurses being reluctant to stop treatment, as generally noted in health care professionals. 30,35 The tendency of more than half of the intensive care nurses not to discharge the patient with brain death, whose parents intended to donate his organs, was interesting because they preferred to save prospective patients' lives. This result also suggested that the nurses applied the Regulation on Organ and Tissue Donation, which states that 'medical support can only be discontinued if relatives of the patient approve it after brain death of the patient is declared to them'.…”

Section: Discussionmentioning

confidence: 99%

Turkish nurses’ decision making in the distribution of intensive care beds

Ersoy

Akpinar

2010

Nurs Ethics

Self Cite

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The aim of this study was to assess the opinions and role of intensive care unit (ICU) nurses regarding the distribution of ICU beds. We conducted this research among 30% of the attendees at two ICU congresses in Turkey. A self-administered questionnaire was used, which included 13 cases and allocation criteria. Of the total (136 nurses), 53.7% participated in admission/discharge decisions. The most important criterion was quality of life as viewed by the physician; the least important was the patient's social status. According to the findings, the nurses thought that medical benefit and avoiding discrimination were important. On the other hand their ignorance of patients' autonomous preferences arouses suspicions about these nurses' role in advocating for patients' rights. For this reason, nurses' role in allocation decisions should be clearly described and should also be the basis on which intensive care nurses' duties in allocation decisions should be determined.

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Attitudes to End-of-Life Decisions in Paediatric Intensive Care

Cited by 19 publications

References 30 publications

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

Turkish critical care nurses' views on end‐of‐life decision making and practices

Turkish nurses’ decision making in the distribution of intensive care beds

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