End-of-Life Care Attitudes, Values, and Practices Among Health Care Workers

Goel, Ashish; Chhabra, Gaurav; Weijma, Robyn; Solari, Marla; Thornton, Sarah; Achondo, Bernardita; Pruthi, Sonal; Gupta, Vineet; Kalantri, Shriprakash; Ramavat, Anurag Snehi; Kalra, Om Prakash

doi:10.1177/1049909113479440

Cited by 9 publications

(4 citation statements)

References 33 publications

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“…Several studies [13,[16][17][18] found that it was a combination of the treating oncologist's di culty in transitioning from curative to palliative care and the unrealistic expectations from patients and their families. Also, physicians tend to overestimate the chance of survival [19,20]. In a study by T. S. Chang et al, suggested that treating physician had more aggressive attitude in treating patients at their end of life and gave more intensive management to their patients [21].…”

Section: Discussionmentioning

confidence: 99%

End of Life Care Practices at a Tertiary Cancer Centre in India: An Observational Study

Maurya,

Gupta,

Rathore

et al. 2024

Am J Hosp Palliat Care

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Purpose To assess the End of life care (EOLC ) practices and the magnitude of futile care in a tertiary cancer center. To find out the barriers in provision of good EOLC in cancer patients. Methods An observational study was done on 129 patients. Patients were enrolled using the palliative prognostic index (PPI) in the end of life stages. Socio-demographic and clinical details were recorded. Detailed counselling done by the palliative physician or the oncologist was recorded. The barriers in provision of care were recorded. Results In this study initial experience of 129 patients were analyzed. PPI score was >6 (survival shorter than 3 weeks) in 85 (65.89%) ; 34 (26.36%) had PPI score between >4 to 6 (survival between 3 to 6 weeks); and 10 (7.75%) patients had PPI score less than equal to 4( survival more than 6 weeks).77 (59.69%) patients preferred home as their place for EOLC while 41(31.78%) preferred hospital, 7 (5.43%) preferred hospice while 4 (3.10%) opted ICU for their EOLC . The most common barrier associated was caregiver related in 34 case, followed by physician related in 14 cases and patients related in 3 cases, because of hope of being cured in hospital, social stigma, fear of worsening of symptoms at home, denial. Conclusion EOLC is the least studied part of patient care with various barriers. With proper communication and a good palliative care support, futile treatment can be avoided. With healthy communication we can empower family members and patients for a good EOLC.

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Section: Discussionmentioning

confidence: 99%

End of Life Care Practices at a Tertiary Cancer Centre in India: An Observational Study

Maurya,

Gupta,

Rathore

et al. 2024

Am J Hosp Palliat Care

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“…The second concern is that it is often unclear whether the conclusions drawn from studies about autonomy are derived from the experiences of dying people (Monforte-Royo et al, 2011; Ohnsorge et al, 2014a). At times, the conclusions are based on the views of healthcare professionals (Kelner, 1993; Peretti-Watel et al, 2003; Seale, 2009; Goel et al, 2014), or the perspectives of family members or the general public (Chambaere. et al, 2012; Inthorn et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Autonomy and control in the wish to die in terminally ill patients: A systematic integrative review

Rodríguez-Prat

Wilson²,

Agulles³

2021

Pall Supp Care

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Background/Objective Personal autonomy and control are major concepts for people with life-limiting conditions. Patients who express a wish to die (WTD) are often thought of wanting it because of loss of autonomy or control. The research conducted so far has not focused on personal beliefs and perspectives; and little is known about patients’ understanding of autonomy and control in this context. The aim of this review was to analyze what role autonomy and control may play in relation to the WTD expressed by people with life-limiting conditions. Methods A systematic integrative review was conducted. The search strategy used MeSH terms in combination with free-text searching of the EBSCO Discovery Service (which provides access to multiple academic library literature databases, including PubMed and CINAHL), as well as the large PsycINFO, Scopus, and Web of Science library literature databases from their inception until February 2019. The search was updated to January 2021. Results After the screening process, 85 full texts were included for the final analysis. Twenty-seven studies, recording the experiences of 1,824 participants, were identified. The studies were conducted in Australia (n = 5), Canada (n = 5), USA (n = 5), The Netherlands (n = 3), Spain (n = 2), Sweden (n = 2), Switzerland (n = 2), Finland (n = 1), Germany (n = 1), and the UK (n = 1). Three themes were identified: (1) the presence of autonomy for the WTD, (2) the different ways in which autonomy is conceptualized, and (3) the socio-cultural context of research participants. Significance of results Despite the importance given to the concept of autonomy in the WTD discourse, only a few empirical studies have focused on personal interests. Comprehending the context is crucial because personal understandings of autonomy are shaped by socio-cultural–ethical backgrounds and these impact personal WTD attitudes.

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“…There were circumstances, however, in which hastening the end of a life seemed the only apparent way to relieve suffering. Several countries or states have legislation permitting or decriminalizing euthanasia; these include Belgium, Finland, New Zealand, Netherlands, Norway, Sweden, Switzerland, Thailand and the United States [ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

Euthanasia: A Controversial Entity Among Students of Karachi

Kumar

Naqvi

Giyanwani

et al. 2017

Cureus

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BackgroundA serene death may be achieved through skilled and compassionate care, as well as by the dying person's own sense of having lived a righteous life. The purpose of this study is to acquire information about students’ knowledge and understanding of euthanasia.Materials and MethodsFour hundred and fifty-six students from four classes of two institutions with similar demographic characteristics were included in this cross-sectional study. A questionnaire adapted from a study of ‘Gruber, et al.’ was distributed among the respondents after obtaining a verbal informed consent. The questionnaire had two parts, first dealing with demographics of respondents, and in the second part students were given different situations and asked about their decision in that particular setting to understand their opinion about euthanasia.ResultsThere were 31.7% medical students and 12.9% non-medical students in favor to provide complete medical information (p < 0.001) while 59.2% non-medical students thought that complete information should be given to a patient if any iatrogenic incident occurred. Same favored by 33.7% of medical students (p < 0.001). The majority of medical students (84.5%) felt that cardiopulmonary resuscitation (CPR) must always be provided (p < 0.001) and this was acceptable more among females (p = 0.001). Furthermore, medical students (57.6%) were more in favor of continuing maximum medical treatment including CPR than non-medical students (42.9%, p = 0.003). A total of 83% non-medical students and 46% medical students found euthanasia an acceptable practice.ConclusionResults show a significant difference in perception of medical and non-medical students regarding euthanasia. Non-medical students are more in favor of euthanasia than medical students. Also, it is observed that males seem to be more inclined towards euthanasia while females are more in favor to provide maximum medical treatment.

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End-of-Life Care Attitudes, Values, and Practices Among Health Care Workers

Abstract: To avoid cumbersome through well-meant interventions, it is important that the caregiving team is aware of the patient's own wishes with respect to EOLC issues.

Cited by 9 publications

References 33 publications

End of Life Care Practices at a Tertiary Cancer Centre in India: An Observational Study

End of Life Care Practices at a Tertiary Cancer Centre in India: An Observational Study

Autonomy and control in the wish to die in terminally ill patients: A systematic integrative review

Euthanasia: A Controversial Entity Among Students of Karachi

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