Universität zu Köln

Raijmakers, Natasja J. H., van Zuylen, Lia ORCID: 0000-0002-7142-7605, Costantini, Massimo, Caraceni, Augusto ORCID: 0000-0002-0375-6204, Clark, Jean B., De Simone, Gustavo, Lundquist, Gunilla, Voltz, Raymond, Ellershaw, John E. and van der Heide, Agnes (2012). Issues and needs in end-of-life decision making: An international modified Delphi study. Palliat. Med., 26 (7). S. 947 - 954. LONDON: SAGE PUBLICATIONS LTD. ISSN 0269-2163

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Abstract

Background: end-of-life decision making is an important aspect of end-of-life care that can have a significant impact on the process of dying and patients' comfort in the last days of life. Aim: the aim of our study was to identify issues and considerations in end-of-life decision making, and needs for more evidence among palliative care experts, across countries and professions. Participants: 90 palliative care experts from nine countries participated in a modified Delphi study. Participants were asked to identify important issues and considerations in end-of-life decision making and to rate the need for more evidence. Results: experts mentioned 219 issues in end-of-life decision making related to the medical domain, 122 issues related to the patient wishes and 92 related to relatives' wishes, regardless of profession or country (p > 0.05). In accordance, more than 90% of the experts rated the comfort and wishes of the patient and the potential futility of treatment as important considerations in end-of-life decision making, although some variation was present. When asked about issues that are in need of more evidence, 87% mentioned appropriate indications for using sedatives and effects of artificial hydration at the end of life. A total of 83% mentioned adequate communication approaches. Conclusions: palliative care experts from different professions in different countries encounter similar issues in end-of-life decision making. Adequate communication about these issues is universally experienced as a challenge, which might benefit from increased knowledge. This shared experience enables and emphasizes the need for more international research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Raijmakers, Natasja J. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Zuylen, Lia UNSPECIFIED orcid.org/0000-0002-7142-7605 UNSPECIFIED Costantini, Massimo UNSPECIFIED UNSPECIFIED UNSPECIFIED Caraceni, Augusto UNSPECIFIED orcid.org/0000-0002-0375-6204 UNSPECIFIED Clark, Jean B. UNSPECIFIED UNSPECIFIED UNSPECIFIED De Simone, Gustavo UNSPECIFIED UNSPECIFIED UNSPECIFIED Lundquist, Gunilla UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Ellershaw, John E. UNSPECIFIED UNSPECIFIED UNSPECIFIED van der Heide, Agnes UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-481768
DOI:	10.1177/0269216311423794
Journal or Publication Title:	Palliat. Med.
Volume:	26
Number:	7
Page Range:	S. 947 - 954
Date:	2012
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	0269-2163
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 6 EUROPEAN COUNTRIES; RESEARCH PRIORITIES; ARTIFICIAL NUTRITION; MEDICAL-PRACTICE; NATIONAL-SURVEY; CARE; EUTHANASIA; BELGIUM; PRACTITIONERS; PHYSICIANS Multiple languages Health Care Sciences & Services; Public, Environmental & Occupational Health; Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48176