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:
CreatorsEmailORCIDORCID Put Code
Raijmakers, Natasja J. H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Zuylen, LiaUNSPECIFIEDorcid.org/0000-0002-7142-7605UNSPECIFIED
Costantini, MassimoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Caraceni, AugustoUNSPECIFIEDorcid.org/0000-0002-0375-6204UNSPECIFIED
Clark, Jean B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Simone, GustavoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lundquist, GunillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voltz, RaymondUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ellershaw, John E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Heide, AgnesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
6 EUROPEAN COUNTRIES; RESEARCH PRIORITIES; ARTIFICIAL NUTRITION; MEDICAL-PRACTICE; NATIONAL-SURVEY; CARE; EUTHANASIA; BELGIUM; PRACTITIONERS; PHYSICIANSMultiple languages
Health Care Sciences & Services; Public, Environmental & Occupational Health; Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/48176

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