Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals

Ang, Guat Cheng; Zhang, Di; Lim, Kim

doi:10.11622/smedj.2016008

Cited by 23 publications

(21 citation statements)

References 10 publications

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“…In our study, most individuals nominated their family members to speak on their behalf if they were incapacitated, which is similar to what was observed in other studies (Ang, Zhang, & Lim, 2016). Among healthy and chronically ill patients, the majority did not opt for CPR or other life-sustaining measures.…”

Section: Discussionsupporting

confidence: 87%

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

Tan¹

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This chapter describes the value of "home" as the place of death and discusses the differences that exist across high-income countries in having this preference. The experiences of selected Asian, European, and North American countries are contrasted. Other than individual and clinical factors, sociodemographic changes also act in concert with shifts in caregiving and death culture to influence the organisation and operationalisation of health and social care services over time. Legal means are used in some countries to sanction the idea of self-determination in end-of-life care decision-making; and since the late 1990s, ACP has become a significant non-legalistic mechanism, through which end-of-life care preferences are made known. In some countries, changes to end-of-life care service delivery and financing have supported the shifts in deaths from inpatient to out-of-hospital care facilities. These forces shape, and act jointly with the availability of formal and informal care, to support the individual living at home. The research objective, and specific research questions to be addressed in this dissertation, are outlined in this chapter. Yoshiuchi, Fujita, Sawai, & Watanabe, 2011; Ishikawa et al., 2013), was instead sparse. Therefore, the current discourse about home deaths is, to a great extent The Canadian experience On the other hand, the case of Canada was not supported by deliberate policy changes specific to palliative care delivery. Between 1994 and 2004, there were rapid declines in hospital deaths from 78% to 61% and a corresponding increase in home deaths from 19% to 30% (Wilson et al., 2009). Although community-based palliative

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Section: Discussionsupporting

confidence: 87%

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

Tan¹

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“…Previous studies in Singapore have attempted to evaluate the end-of-life treatment decision-making process. A questionnaire conducted on geriatric patients and their relatives, doctors, and nurses by Ang et al found that patients' end-of-life treatment preferences often differed markedly from that of nominated surrogate decisionmakers 13 . A retrospective chart review performed on 683 adult patients who died in hospital without intensive care unit admission concluded that there were infrequent discussions of end-of-life issues with patients, and more work was needed to improve end-of-life care 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The resultant prevailing decision tends to be family-centric rather than patient-centric [8][9][10] . Evidence has shown that surrogate decisionmakers have poor knowledge of CPR and basic resuscitation options, and the decision made by surrogates often differs markedly from patients' own preferences [11][12][13] . Studies in Western populations have shown that only a small proportion of patients and families were knowledgeable about CPR and many overestimated the chances of survival following CPR 11,14 .…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Resuscitation—From the Patient'S Perspective

Wee

Chang

Lau

et al. 2017

Anaesth Intensive Care

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With increasing emphasis on patient autonomy, patients are encouraged to be more involved in end-of-life issues, including the use of extraordinary efforts to prolong their lives. Being able to make anticipatory decisions is seen to promote autonomy, empower patients and optimise patient care. To facilitate shared decision-making, patients need to have a clear and accurate understanding of cardiopulmonary resuscitation (CPR). This study aims to understand the knowledge and perspectives of the local community regarding resuscitation options and end-of-life decision-making and to explore ways to improve the quality of end-of-life discussions. An interviewer-administered survey was conducted with a prospectively recruited group of surgical patients admitted postoperatively to the day surgery ward of a single tertiary institution in Singapore from April to May 2015. The survey, modelled after two validated questionnaires, measured patients' knowledge, attitudes and preferences regarding CPR in a series of 18 questions. Fifty-one out of 67 (76.1%) patients completed the survey. Results indicated that 80.4% (n=41) of participants correctly understood the purpose of CPR, but 64.7% (n=33) did not know of any possible complications of CPR. Less than half (n=21, 41.2%) of participants had thought about life support measures they wanted for themselves. Most of the participants agreed that they should personally be involved in making end-of-life decisions (n=44, 86.3%). Many patients had a poor knowledge of CPR and other resuscitation measures and the majority overestimated the success rate of CPR. However, a majority were receptive to improving their knowledge and keen to discuss end-of-life issues with physicians.

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“…Whether more senior physicians have the similar preferences is open for further exploration. Ang et al 16 also describe differences between age groups among Singaporeans regarding regarding end of life care preferences. This study of Singaporeans comprised of mostly young adults and is therefore similar to our study population.…”

Section: Healthcare Professional-related Factorsmentioning

confidence: 99%

Preference for Initiation of End-of-Life Care Discussion: a quantitative study

Eng¹,

Hewitt²,

Kekalih³

2020

Preprint

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Background: Initiating discussion about end of life is often considered a difficult topic for healthcare providers, thus there is a need for further research to understand this area, particularly in developing countries. This study seeks to describe preferences for the initiation of end-of-life care conversations in Indonesia, comparing the general population and health care professionals.Methods: This study was a cross-sectional descriptive study to gain quantitative data utilizing a questionnaire distributed online. There was a total of 368 respondents (254 general population (69%); 114 healthcare professionals (31%)) with a consecutive sampling method. Result: Overall, most respondents (80.4%) would like to discuss the end of life issues with a healthcare professional in case of terminal illness. This was more marked amongst health care professionals compared with the general population (94% vs. 75%, respectively, p < 0,001). The preferred time for discussion was at first diagnosis (63%) or the request of the patients (27%), and the preferred person to start the discussion was the doctor (64%). Depth of information varies as fewer respondents would want to know about prognosis than diagnosis (76% v 93%).Conclusion: Doctors have vital role in end-of-life care discussion, and attempts should be made to encourage physicians to initiate end-of-life care discussion when needed. Further qualitative study in this topic would help to create a practical guideline to aid physicians in end-of-life care discussion.

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Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals

Cited by 23 publications

References 10 publications

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

Eliciting and honouring end-of-life care preferences : a multiple methods study on place of death

Cardiopulmonary Resuscitation—From the Patient'S Perspective

Preference for Initiation of End-of-Life Care Discussion: a quantitative study

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