Limitation of Futile Therapy in the Opinion of Nursing Staff Employed in Polish Hospitals—Results of a Cross-Sectional Study

Damps, Maria; Gajda, Maksymilian; Kowalska, Małgorzata; Kucewicz‐Czech, Ewa

doi:10.3390/ijerph192416975

Cited by 5 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[14][15][16] Our respondents indicated the fear of talking to the patient's family not accepting the inevitability of death or not trusting the doctor, as well as the fear of the family's legal claims, as the basic reasons for continuing futile therapy. In our earlier study regarding nurses' opinions on the discussed topic, 9 only 6% of study participants believed that they were su ciently prepared for such a conversation. This issue requires broadly understood education, workshops, and the acquisition of so-called soft skills, as indicated by over 90% of our survey participants.…”

Section: Discussionmentioning

confidence: 83%

Opinion of Polish doctors on the use of futile therapy

Damps,

Gajda,

Wiktor

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Discontinuation of futile therapy is increasingly discussed in Polish clinical practice. Taking into account the broadly understood well-being of the patient, it is necessary to consider whether all clinical options resulting from medical progress should be used for every patient and on what grounds decisions to limit therapy should be based. Our study aimed to know the opinion of Polish medical staff on the topic discussed. The study was an anonymous survey conducted in paper and electronic versions among doctors of all specialties. An analysis of the collected data was carried out using the methods of descriptive and analytical statistics. The respondents were divided into two groups according to their specialization: intensivists and doctors of other specializations. A total of 323 doctors participated in the study; 93% of participants were aware of the problem of futile therapy in adults (statistically, significantly more often intensivists, p = 0.002); 95% of respondents supported the idea of discontinuing futile therapy, and over 68% of respondents used the therapy discontinuation protocol. Among the most common reasons for undertaking futile therapy, the respondents declared (more than one answer was possible) fear of legal liability for not taking such action (93.5%), as well as fear of being accused of unethical behavior (62.2%), and fear before talking to the patient/patient’s family and their reaction (57.9%). The respondents also indicated what would facilitate making decisions about limiting futile therapy. These were primarily: precise qualification criteria for limiting therapy and education in this area (95.3%), the patient's declaration of will (87.5%), and a clear legal act (81.3%). The vast majority of study participants supported the idea of limiting futile therapy, and this issue is well-known to Polish doctors.

show abstract

Section: Discussionmentioning

confidence: 83%

Opinion of Polish doctors on the use of futile therapy

Damps,

Gajda,

Wiktor

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…According to the teachings of Hippocrates, the physician should refuse to treat those who are defeated by the disease, realizing that medicine is powerless in these cases [4]. The statistics of futility are appalling; 66-89% of the nursing staff employed in ICUs participated in futile therapy [5]. Paradoxically, people who consider themselves believers often mistakenly consider discontinuation of therapy as unethical and identify it with euthanasia; however, it merely stops the unnatural prolongation of death [5].…”

Section: Futility Statisticsmentioning

confidence: 99%

“…The statistics of futility are appalling; 66-89% of the nursing staff employed in ICUs participated in futile therapy [5]. Paradoxically, people who consider themselves believers often mistakenly consider discontinuation of therapy as unethical and identify it with euthanasia; however, it merely stops the unnatural prolongation of death [5].…”

Section: Futility Statisticsmentioning

confidence: 99%

See 1 more Smart Citation

Time-limited trial – searching for rational solutions in the functioning of intensive care units

Damps,

Kucewicz-Czech

2023

View full text Add to dashboard Cite

Introduction:Evaluating futility carries the burden of subjectivity; we do not have scales that verify the impartiality of decisions. It is very difficult to decide on the fate of a patient who shows up intubated at the intensive care unit (ICU). The uncertainty of the prognosis at the beginning of a critical illness does not allow the doctor to predict the effect of therapy in terms of survival, regaining the previous quality of life, and independent functioning. Material and methods:There are 3 options to choose from: ICU admission and all invasive procedures; refusal of ICU admission, with a sense of making decisions based on incomplete information; and a time-limited trial, which allows testing invasive procedures aimed at the potential improvement of the patient's health and the reassessment of gains and losses after a specific, defined period. It seems that the last solution is fair and acceptable to the patient/family and medics.Results: A time-limited trial is part of the concept of personalized medicine, which puts the patient at the centre of our actions. A time-limited trial is a practical proposition for patients with a doubtful prognosis and uncertainty concerning the effects of invasive and aggressive therapies. Conclusions:Patients with a limited life expectancy and exhausted physiological reserves are ideal candidates for the implementation of the described method.

show abstract

“…Although this term does not refer only to therapeutic procedures for older people, it is mainly associated with it, especially in Poland. The authors of the study have conducted studies on the use of futile therapy among nurses 1 and doctors 2 . In this article, we discuss the third part of the project -a survey conducted among students of selected public universities.…”

Section: Introductionmentioning

confidence: 99%

Opinion of young Poles on futile therapy based on a survey among university students

Damps,

Gajda,

Wiktor

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Futile therapy concerns the clinical aspects of the end-of-life period, as well as the purposefulness of therapy in the context of the quality of life of a patient with an incurable disease in its final stage. The study was an anonymous survey conducted in electronic versions among young Poles university students. The views of these young people will influence health policy in the coming decades. An analysis of the collected data was carried out using the methods of descriptive and analytical statistics. The respondents were divided into two groups according to favulty and gender. A total of 161 students participated in the study, the decision to discontinue therapy in adult patients should first be made by the patients themselves (83.2%), the therapeutic team (72.6%), the patient's family (47.2%), and only 14.9% of the respondents indicated the court decision. In the case of children, as many as 80.1% of the respondents indicated that the patient's family and doctors should make a joint decision. Students of medical universities and other faculties who took part in the study demonstrated good knowledge of issues related to the concept of futile therapy, which is a good prognosis for the future in terms of the level of public awareness. It is also positive that they are aware of the existence of various solutions regarding the possibility of expressing the patient's autonomous decision at every stage of the therapeutic procedure.

show abstract

Limitation of Futile Therapy in the Opinion of Nursing Staff Employed in Polish Hospitals—Results of a Cross-Sectional Study

Cited by 5 publications

References 27 publications

Opinion of Polish doctors on the use of futile therapy

Opinion of Polish doctors on the use of futile therapy

Time-limited trial – searching for rational solutions in the functioning of intensive care units

Opinion of young Poles on futile therapy based on a survey among university students

Contact Info

Product

Resources

About