Patient desires: A model for assessment of patient preferences for care of severe or terminal illness

Knops, Karen; Srinivasan, Malathi; Meyers, Frederick J.

doi:10.1017/s1478951505050455

Cited by 24 publications

(9 citation statements)

References 49 publications

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“…Evidence indicates that some patients and health care professionals think that discussion of end-of-life issues is not acceptable in our culture. 23,24 Withdrawal of life-prolonging devices at the end of life is frequently controversial, and although ICD deactivation is generally accepted, not every patient or health care professional is comfortable with it. In cases where the health care professional is not comfortable with deactivation, it is important that patients be referred to another professional who can assist them.…”

Section: Patients' Preferences Regarding Icd Deactivationmentioning

confidence: 99%

Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure

Brady

2016

Critical Care Nurse

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Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered. Health care organizations should have clear policies addressing ICD deactivation to provide for seamless integration of palliative care services throughout the course of heart failure. These policies should empower nurses to activate resources in a timely manner and should clearly outline processes for ICD deactivation.

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Section: Patients' Preferences Regarding Icd Deactivationmentioning

confidence: 99%

Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure

Brady

2016

Critical Care Nurse

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“…In addition to the emotional toll, decisions about end-of-life care are further complicated by the availability of diverse medical interventions for prolonging life and by the variability in physicians’ comfort and competency with initiating end-of-life care discussions [1]. An increased focus on patient-centered care models aimed at personalizing medicine has contributed to increased attention on shared decision making about end-of-life care preferences and greater emphasis on improving quality of life at the end of life.…”

Section: Introductionmentioning

confidence: 99%

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

Lattie

Asvat

Shivpuri

et al. 2016

Journal of Pain and Symptom Management

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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 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.

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“…The literature on quality of life and satisfaction with care reveals three goal domains: goals for the disease process, goals for quality of life and suffering, and goals for the circumstances of death. 8 Some patients continue to desire disease-directed therapy with intent to cure or halt disease progression despite uncertain benefits and significant treatment burdens. Others value quality of life and the alleviation of discomfort more than the overall length of life.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with advanced illnesses often prefer to dictate the location and circumstances of their death. 8 If a patient becomes incapacitated, surrogates must make decisions based on their knowledge of the patient's preferences. If reliable evidence regarding the patient's wishes is unavailable, the surrogate should make decisions in the patient's best interest.…”

Section: Discussionmentioning

confidence: 99%

Discussing Goals of Care for a Delirious Advanced Cancer Patient in the Hospice Setting

Reddy

Tavel

et al. 2013

Journal of Palliative Medicine

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Patient desires: A model for assessment of patient preferences for care of severe or terminal illness

Cited by 24 publications

References 49 publications

Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure

Planning for Deactivation of Implantable Cardioverter Defibrillators at the End of Life in Patients With Heart Failure

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

Discussing Goals of Care for a Delirious Advanced Cancer Patient in the Hospice Setting

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