Patient participation in shared decision‐making in palliative care – an integrative review

Abstract

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The Decision-Making Process for Palliative Sedation for Patients with Advanced Cancer–Analysis from a Systematic Review of Prospective Studies

“…Further efforts should be made to use a model of decision making between health care professional and patient as it is considered a quality indicator of palliative care [ 31 ] and shows consideration and also respect for patients’ autonomy [ 32 ]. Patients seem to be, in general, willing to participate in everyday care decisions, treatment-related medical decisions and end-of- life decisions [ 33 ]. Prerequisites for patient participation in shared decision making are interdisciplinary teamwork, open communication, good patient–healthcare professional relationship, a favorable environment and mutual information [ 33 ].…”

“…Patients seem to be, in general, willing to participate in everyday care decisions, treatment-related medical decisions and end-of- life decisions [ 33 ]. Prerequisites for patient participation in shared decision making are interdisciplinary teamwork, open communication, good patient–healthcare professional relationship, a favorable environment and mutual information [ 33 ]. In the case of palliative sedation, our analysis shows that in 2 Italian papers it was impossible or even inappropriate to obtain consent directly from the patient [ 23 , 26 ].…”

“…The physician’s knowledge and experience and practical skills in palliative sedation and the ethical considerations that may arise could also explain this [ 30 , 36 ]. This discussion among professionals could be regarded as positive because it involves an interdisciplinary and interprofessional and collective approach when reaching consensus, after all professionals have explained their own perspectives and arguments [ 33 ], which make the therapeutic option of palliative sedation more consistent and justified.…”

Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version

“…This study found no communication problems in many cases on admission. Open communication and relationship with healthcare professionals are necessary for patients’ decision making 20 . In such processes, precise disease insight might be gained.…”

“…Co-existence should be specifically addressed in caring for patients with anxiety 19 . Communication and relationships with healthcare professionals are also fundamentally important for patients’ decision making 20 . According to these findings, it is also important to examine their social status, including their relationships with surrounding people, when considering the quality of palliative care, including psychological aspects.…”