Universität zu Köln

Kremeike, Kerstin, Galushko, Maren, Frerich, Gerrit ORCID: 0000-0002-1109-0553, Romotzky, Vanessa ORCID: 0000-0002-5765-692X, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Rodin, Gary ORCID: 0000-0002-6626-6974, Pfaff, Holger ORCID: 0000-0001-9154-6575 and Voltz, Raymond ORCID: 0000-0002-4761-3395 (2018). The DEsire to DIe in Palliative care: Optimization of Management (DEDIPOM) - a study protocol. BMC Palliat. Care, 17. LONDON: BMC. ISSN 1472-684X

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Abstract

Background: A desire to die (DD) is frequent in palliative care (PC). However, uncertainty remains as to the appropriate therapeutic response. (Proactive) discussion of DD is not usually part of standard care. To support health practitioners' (HPs) reactions to a patient's DD, a training program has been developed, piloted and evaluated. Within this framework, a first draft of a semi-structured clinical interview schedule with prompts (CISP) has been developed, including recommendations for action to support HPs' self-confidence. The aim of this study is the further development of the CISP to support routine exploration of death and dying distress and proactive addressing of a DD. Methods: This observatory, prospective health services study comprises a three step study design: 1. Revision of the CISP and consensus finding based on semi-structured interviews with patients and a Delphi process with (inter-) national experts, patient representatives and relatives; 2. Increasing confidence in HPs through a 2 day-training program using the consented CISP; 3. A formative quantitative evaluation of conversations between HPs and patients (300 palliative patients at three time points) and a qualitative evaluation based on interview triads of patients, relatives and HPs. The evaluation of conversations will include patient-oriented outcomes, including perceived relationships with HPs and death and dying distress. We will also consider aspects of social inequality and gender. Discussion: The intervention can provide a framework for open discussion of DD and a basis for enhancing a trustful HP-patient relationship in which such difficult topics can be addressed. The benefits of this study will include (a) the creation of the first consented semi-structured approach to identify and address DD and to respond therapeutically, (b) the multi-professional enhancement of confidence in dealing with patients' DD and an intervention that can flexibly be integrated into other training and education programs and (c) an evaluation of effects of this intervention on patients, relatives and HPs, with attention to social inequality and gender.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kremeike, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Galushko, Maren UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerich, Gerrit UNSPECIFIED orcid.org/0000-0002-1109-0553 UNSPECIFIED Romotzky, Vanessa UNSPECIFIED orcid.org/0000-0002-5765-692X UNSPECIFIED Hamacher, Stefanie UNSPECIFIED orcid.org/0000-0003-2158-9101 UNSPECIFIED Rodin, Gary UNSPECIFIED orcid.org/0000-0002-6626-6974 UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Voltz, Raymond UNSPECIFIED orcid.org/0000-0002-4761-3395 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-195791
DOI:	10.1186/s12904-018-0279-3
Journal or Publication Title:	BMC Palliat. Care
Volume:	17
Date:	2018
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-684X
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Sonstiges > Zentrum für Versorgungsforschung Köln
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language PHYSICIAN-ASSISTED SUICIDE; DEATH-RELATED ANXIETY; HASTENED DEATH; ADVANCED CANCER; ADVANCE DIRECTIVES; GERMAN VERSION; MEDICAL-CARE; HEALTH; DEPRESSION; DISTRESS Multiple languages Health Care Sciences & Services; Health Policy & Services Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19579