A comparative survey on potentially futile treatments between Japanese nurses and laypeople

Abstract

In the issue of futile treatments, patients and healthcare professionals tend to disagree. We conducted an Internet questionnaire survey and explored the Japanese nurses' attitude toward this topic, comparing with that of laypeople. In total, 522 nurses and 1134 laypeople completed the questionnaire. Nurse respondents were significantly less in favor of providing potentially futile treatments in hypothetical vignettes and stressed quality of life of the patient for judging the futility of a certain treatment. Of them, 85.4% reported having experienced providing such treatments. Reasons for providing them included factors related to not only patients but also healthcare teams. Our results indicate that attitudes among Japanese nurses toward the issue of futile treatments are different from patients and that their actual practice is influenced by several situational factors.

Nurses' Perceptions of Futile Care

“…In other words, a certain type of care that may be considered futile for one patient may be especially needed and effective for another one. Previous studies have shown that factors such as contradiction between physicians' objective findings and patients and families' beliefs; differences in patients, families, and health care professionals' values and preferences 4,16,17,44 ; the likelihood of committing errors in diagnosing patients' underlying problems and identifying their prognoses 8,45 ; cultural and religious beliefs such as expecting a miracle to happen 9,15,45,46 ; emotional issues 4,7,41,46 ; and patients and their families' social, financial, and political positions 41 can affect individuals' perceptions of futility. In line with the findings of the previous studies, 11,46-48 our findings also showed that medical futility is directly related to the aims of treatment plans.…”

“…The inclusion criterion was having a minimum of 2 year work experience in nursing. As futile care is mainly related to critical and end-of-life care, 7,8,14,16,17 we primarily recruited nurses from critical care units. After that, we used the maximum variation sampling technique to recruit a heterogeneous sample of nurses from different hospitals, hospital wards, as well as from different groups of gender, age, work experience, and education.…”

“…Consequently, they normally have different insights about and perceptions of the futility of treatment and care. 8,17,18 Nurses constitute the largest group of health care professionals and most care outcomes directly depend on their care practice. On the contrary, care is considered as the essence and the core of nursing and it differentiates nursing from other fields of health care delivery.…”

Passer à l’action : une exploration des actions des infirmières et infirmiers en oncologie exemplaires dans les situations où un sentiment d’impuissance et de futilité est éprouvé par le personnel infirmier dans le cadre du diagnostic, du traitement et de la phase palliative

“…Ce nouveau savoir pourrait déboucher sur de nouveaux travaux de recherche s'inté-ressant au développement de stratégies d'intervention fondés sur des données probantes dans le cas de patients vivant des situations pénibles où règne un sentiment d'impuissance et de futilité. Les infirmières et infirmiers occupent une position privilégiée et ont une excellente compréhension de ce qu'est la futilité (Kadooka et al, 2012). Les participantes de l'étude disaient systématiquement de leurs collègues qu'elles renonçaient quand elles étaient confrontées à la futilité.…”

Moral distress and the Australian aged care worker: A mixed methods study

“…Provision of care perceived to be futile occurs often, with over 84% of acute care nurses in one study reporting having provided futile care (Kadooka, Asai, Fukuyama, & Bito, 2014).…”