Patientenverfügung aus der Sicht des chirurgischen Patienten

Justinger, Christoph; Richter, Sven; Moussavian, M. R.; Contreras, Tabit; Schilling, Martin K.

doi:10.1007/s00104-008-1662-z

Cited by 14 publications

(12 citation statements)

References 4 publications

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“…But 56% of the respondents with ADs also expressed their wish for more information. Similar rates were seen in a survey among surgical patients, with 65% of the study participants desiring more information [6]. Interestingly, 179 respondents did not want any additional information on ADs, and 51% of this group did not have an AD.…”

Section: Discussionsupporting

confidence: 60%

“…In our survey, the number of uninformed respondents was only 2% compared to 5% in a comparable survey carried out from 2007 to 2010 among cancer patients receiving radiotherapy [10]. Different studies identified a variable impact of several factors on the writing of an AD, with the patient's age emerging as the most consistent factor [1,4,5,6,9,10,11]. The data of the present study confirm that older patients are more likely to write an AD.…”

Section: Discussionmentioning

confidence: 96%

“…The percentage of completed ADs, not only within the general German population [4,5] but also within patient populations [6,7,8], has been small but is slowly increasing [7]. Among cancer patients, who often have to deal with serious events that can potentially result in life-threatening and thus AD-relevant situations, the percentage of patients with ADs did not seem to be higher [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Hubert¹,

Schulte²,

Belle³

et al. 2013

Oncol Res Treat

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Background: In 2009, Germany enacted a new law supporting advance directives that led to heated discussions in the media and the public. 3 years after the law passed, we surveyed patients with malignant diseases with regards to their views on advance directives. Patients and Methods: Between September 2011 and July 2012 an anonymous survey on advance directives was conducted among 617 patients at the hematology and oncology outpatient department of the University Hospital Mannheim, using a standardized questionnaire developed for this investigation. Results: Of the 503 patients who returned the questionnaire, 31% (n = 157) indicated having an advance directive. Of these 157, 54% (n = 85) completed the advance directive after 2009. 56% (282 out of 503) desired more information on advance directives. Of these, 71% (201 out of 282) wanted their general physician and 45% (128 out of 282) their specialist, to provide more information about this issue. Of the 339 patients without an advance directive, 47% (n = 158) stated that they had ‘not worried about that yet'. Conclusion: Although the percentage of patients with advance directives has increased since the legislative amendment, more information is still required by patients. It is recommended that physicians should discuss advance directives more frequently with their patients.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Hubert¹,

Schulte²,

Belle³

et al. 2013

Oncol Res Treat

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“…In cross-country comparisons German physicians were found to be more likely to exclude patients, patients’ families and non-medical staff from the decision making process [144], [145]. ADs was a well-covered theme.…”

Section: Resultsmentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

et al. 2012

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Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

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“…13,17 Nevertheless, the number of patients AD for whom surgery is planned is low—around 20%. 18–20 More generally in acute care, the prevalence of advance care planning ranges from 1% to 44%. 12,21 To palliate the lack of AD in a perioperative setting, some researchers propose to hold anticipatory multidisciplinary AD team discussions with patients/surrogates, anesthetists, surgeons, and intensivists 22 and to integrate supportive care.…”

Section: Introductionmentioning

confidence: 99%

Advance Directives and Communication Skills of Prehospital Physicians Involved in the Care of Cardiovascular Patients

2015

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Advance directives (AD) were developed to respect patient autonomy. However, very few patients have AD, even in cases when major cardiovascular surgery is to follow. To understand the reasons behind the low prevalence of AD and to help decision making when patients are incompetent, it is necessary to focus on the impact of prehospital practitioners, who may contribute to an increase in AD by discussing them with patients. The purpose of this study was to investigate self-rated communication skills and the attitudes of physicians potentially involved in the care of cardiovascular patients toward AD.Self-administered questionnaires were sent to general practitioners, cardiologists, internists, and intensivists, including the Quality of Communication Score, divided into a General Communication score (QOCgen 6 items) and an End-of-life Communication score (QOCeol 7 items), as well as questions regarding opinions and practices in terms of AD.One hundred sixty-four responses were received. QOCgen (mean (±SD)): 9.0/10 (1.0); QOCeol: 7.2/10 (1.7). General practitioners most frequently start discussions about AD (74/149 [47%]) and are more prone to designate their own specialty (30/49 [61%], P < 0.0001). Overall, only 57/159 (36%) physicians designated their own specialty; 130/158 (82%) physicians ask potential cardiovascular patients if they have AD and 61/118 (52%) physicians who care for cardiovascular patients talk about AD with some of them.The characteristics of physicians who do not talk about AD with patients were those who did not personally have AD and those who work in private practices.One hundred thirty-three (83%) physicians rated the systematic mention of patients’ AD in the correspondence between physicians as good, while 114 (71%) at the patients’ first registration in the private practice.Prehospital physicians rated their communication skills as good, whereas end-of-life communication was rated much lower. Only half of those surveyed speak about AD with cardiovascular patients. The majority would prefer that physicians of another specialty, most frequently general practitioners, initiate conversation about AD. In order to increase prehospital AD incidence, efforts must be centered on improving practitioners’ communication skills regarding death, by providing trainings to allow physicians to feel more at ease when speaking about end-of-life issues.

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Patientenverfügung aus der Sicht des chirurgischen Patienten

Abstract: Although the proportion of patients that draw up advance health care directives continues to be less than one fifth, surgical patients have a great need for information regarding the topic. Surgical hospital personnel should also set themselves to this task.

Cited by 14 publications

References 4 publications

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Advance Directives and Communication Skills of Prehospital Physicians Involved in the Care of Cardiovascular Patients

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