Universität zu Köln

Kremeike, Kerstin, Frerich, Gerrit, Romotzky, Vanessa, Bostroem, Kathleen, Dojan, Thomas, Galushko, Maren, Shah-Hosseini, Kija ORCID: 0000-0001-9616-6942, Juenger, Saskia, Rodin, Gary, Pfaff, Holger ORCID: 0000-0001-9154-6575, Perrar, Klaus Maria and Voltz, Raymond (2020). The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach. BMC Palliat. Care, 19 (1). LONDON: BMC. ISSN 1472-684X

Full text not available from this repository.

Abstract

Background Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients ' potential desire to die, a training program and a semi-structured clinical approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. Methods Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. Results 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was proactively addressing desire to die. Conclusions We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically - based on evidence, patients' views and consensus among professional experts.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kremeike, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerich, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Romotzky, Vanessa UNSPECIFIED UNSPECIFIED UNSPECIFIED Bostroem, Kathleen UNSPECIFIED UNSPECIFIED UNSPECIFIED Dojan, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Galushko, Maren UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah-Hosseini, Kija UNSPECIFIED orcid.org/0000-0001-9616-6942 UNSPECIFIED Juenger, Saskia UNSPECIFIED UNSPECIFIED UNSPECIFIED Rodin, Gary UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Perrar, Klaus Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-336927
DOI:	10.1186/s12904-020-00548-7
Journal or Publication Title:	BMC Palliat. Care
Volume:	19
Number:	1
Date:	2020
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-684X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BREAKING BAD-NEWS; HASTENED DEATH; ADVANCED DISEASE; CANCER-PATIENTS; COMMUNICATION; ATTITUDES; DISTRESS; ONCOLOGY; END; RECOMMENDATIONS Multiple languages Health Care Sciences & Services; Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33692