The Autonomy Experience of Patients in Palliative Care

Lavoie, Mireille; Blondeau, Danielle; Picard-Morin, Jocelyne

doi:10.1097/njh.0b013e318202425c

Cited by 22 publications

(19 citation statements)

References 23 publications

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“…Patients whose sense of meaning in life did not change with illness displayed a better score of quality of life. Palliative care patients valued being able to perform daily tasks and feeling useful when appropriate [21]. Patients who feel independent may present higher levels of optimism, self-esteem, social support and spiritual wellbeing, in addition to fewer symptoms of depression [16,67].…”

Section: Discussionmentioning

confidence: 99%

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The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

et al. 2020

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Background: Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients. Methods: A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one's perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients' definitions of spirituality was based on the interpretative phenomenological process. Results: Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one's decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones' values and beliefs. Conclusion: The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients' spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

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Section: Discussionmentioning

confidence: 99%

“…Autonomy can be related to the capacity for decisionmaking as well as functional capacity [21]. Furthermore, palliative care patients' perception of autonomy may be described as a sense of freedom along with having the right to make his or her own decisions [22].…”

Section: Introductionmentioning

confidence: 99%

The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

et al. 2020

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“…Our results demonstrate that when knowledge from professionals is contextualized to the individual patient as a personVrelated, for example, to the patient's biography, beliefs, values, and emotions or their existential interpretation of the situation and other expressions for person-centered care 45 Vmaking sense is facilitated. 49 For patients receiving palliative treatment, the conflict between living in wait and living in the present will be of particular significance to preserving the person's dignity. To start with, arbitrary information provision masks previously reported variations in type, amount, and sources of knowledge in patients' information-seeking behavior.…”

Section: N Conclusionmentioning

confidence: 99%

Making Sense of Receiving Palliative Treatment

2013

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“…The American Academy of Nursing (2013) and the HPNA (2013b) have published position statements on advance planning, stating that it is essential to providing care for those with life-limiting conditions. Lavoie, Blondeau, and Picard-Morin (2011) demonstrated that those with advanced illness attach great importance to their providers' respect for autonomy. Healthcare professionals must be educated about the principles of palliative care to empower their patients to facilitate autonomy (see Figure 1).…”

Section: Implications For Nursingmentioning

confidence: 99%

The Use of Palliative Care to Promote Autonomy in Decision Making

Zalonis¹,

Slota²

2014

Clinical Journal of Oncology Nursing

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This article explores barriers to informed decision making in health care, and it proposes palliative care as one means of responding to the challenge of a widespread lack of autonomy in decision making. Through an exploration of research in the fields of autonomy and palliative care, the advantages of informed decision making and advance care planning by patients with advanced illness are discussed, and the implications for clinical practice and patient outcomes are described. Continuity, collaboration, and communication have a synergistic effect on autonomy. The expectation that the palliative care team will be in constant communication with the attending physician, nurses, and other specialists also promotes autonomous decision making. Patients who receive palliative care may have multiple advantages, including increased survival, improved quality of life, and opportunities for the exercise of autonomy.

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The Autonomy Experience of Patients in Palliative Care

Cited by 22 publications

References 23 publications

The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study

Making Sense of Receiving Palliative Treatment

The Use of Palliative Care to Promote Autonomy in Decision Making

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