End-of-life decision making in the context of chronic life-limiting disease: a concept analysis and conceptual model

Levoy, Kristin; Tarbi, Elise; Santis, Joseph P. De

doi:10.1016/j.outlook.2020.07.008

Cited by 17 publications

(8 citation statements)

References 155 publications

(258 reference statements)

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“…In Asian culture, most people are uncomfortable talking about death and would prefer to avoid undertaking open‐ended conversations on their EOL issues (Deng et al., 2019 ). Research indicates that end‐of‐life decision‐making is a process spanning chronic diseases, which involves three phases: preparation, decisions and outcomes (Levoy et al., 2020 ). “Readiness” is a key indicator to predict patients’ participation in ACP (Simon et al., 2015 ), which is distinct from acceptance and can be conceptualized as the precursor to behaviours that are associated with adoption or resistance (Armenakis, 1993 ).…”

Section: Introductionmentioning

confidence: 99%

Readiness for advance care planning and its relationship to coping style in patients with chronic diseases in communities: A cross‐sectional study

Wang

Sheng

2022

Nursing Open

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Section: Introductionmentioning

confidence: 99%

Readiness for advance care planning and its relationship to coping style in patients with chronic diseases in communities: A cross‐sectional study

Wang

Sheng

2022

Nursing Open

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“…However, a complex set of variables interact to influence a person's end-of-life decisions-not race or ethnicity alone. 15,[33][34][35] Race's role in people's lived experiences and its impact on health and wellbeing 36,37 make race and ethnicity relevant non-causative social variables 38 when seeking to understand modifiable factors that create disparities. 12,15 Although research on goals-of-care consultation and advance care planning in racial and ethnic minority groups is growing, most data focuses on Black/African American patients compared to White patients.…”

Section: Introductionmentioning

confidence: 99%

“…However, a complex set of variables interact to influence a person’s end-of-life decisions—not race or ethnicity alone. 15,33-35 Race’s role in people’s lived experiences and its impact on health and wellbeing 36,37 make race and ethnicity relevant non-causative social variables 38 when seeking to understand modifiable factors that create disparities. 12,15…”

Section: Introductionmentioning

confidence: 99%

Hospice Enrollment, Future Hospitalization, and Future Costs Among Racially and Ethnically Diverse Patients Who Received Palliative Care Consultation

Starr

Ulrich

Pérez

et al. 2021

Am J Hosp Palliat Care

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Background: Palliative care consultation to discuss goals-of-care (“PCC”) may mitigate end-of-life care disparities. Objective: To compare hospitalization and cost outcomes by race and ethnicity among PCC patients; identify predictors of hospice discharge and post-discharge hospitalization utilization and costs. Methods: This secondary analysis of a retrospective cohort study assessed hospice discharge, do-not-resuscitate status, 30-day readmissions, days hospitalized, ICU care, any hospitalization cost, and total costs for hospitalization with PCC and hospitalization(s) post-discharge among 1,306 Black/African American, Latinx, White, and Other race PCC patients at a United States academic hospital. Results: In adjusted analyses, hospice enrollment was less likely with Medicaid (AOR = 0.59, P = 0.02). Thirty-day readmission was less likely among age 75+ (AOR = 0.43, P = 0.02); more likely with Medicaid (AOR = 2.02, P = 0.004), 30-day prior admission (AOR = 2.42, P < 0.0001), and Black/African American race (AOR = 1.57, P = 0.02). Future days hospitalized was greater with Medicaid (Coefficient = 4.49, P = 0.001), 30-day prior admission (Coefficient = 2.08, P = 0.02), and Black/African American race (Coefficient = 2.16, P = 0.01). Any future hospitalization cost was less likely among patients ages 65-74 and 75+ (AOR = 0.54, P = 0.02; AOR = 0.53, P = 0.02); more likely with Medicaid (AOR = 1.67, P = 0.01), 30-day prior admission (AOR = 1.81, P = 0.0001), and Black/African American race (AOR = 1.40, P = 0.02). Total future hospitalization costs were lower for females (Coefficient = −3616.64, P = 0.03); greater with Medicaid (Coefficient = 7388.43, P = 0.01), 30-day prior admission (Coefficient = 3868.07, P = 0.04), and Black/African American race (Coefficient = 3856.90, P = 0.04). Do-not-resuscitate documentation (48%) differed by race. Conclusions: Among PCC patients, Black/African American race and social determinants of health were risk factors for future hospitalization utilization and costs. Medicaid use predicted hospice discharge. Social support interventions are needed to reduce future hospitalization disparities.

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“…The invented, illegitimate, and contrary cases were unnecessary for the concept analysis because the illustrated cases provided the reader with a clear understanding of the concept. Methodological modifications have been accepted and utilized in recent concept analyses 16,17 . The concept analysis was an iterative process with ongoing reflection and revision.…”

Section: Methodsmentioning

confidence: 99%

A concept analysis of decision regret in women with breast cancer

Tyner

Freysteinson

2021

Nursing Forum

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The aim of this article is to understand the components of decision regret for women making breast cancer treatment decisions. Patient‐centered care models encourage women to become more active in the decision‐making process, inadvertently exposing them to the risk of experiencing decision regret. Enhancing the understanding of the concept of decision regret can offer insight into ways to mitigate this phenomenon. The Walker and Avant method was used to analyze this concept. Using PubMed, CINAHL, ERIC, Academic Search Complete, PsychINFO, SocINDEX, Joanna Briggs Institute of EBP Database, and an online dictionary, articles from 2011 to 2021 were analyzed to identify concept uses, attributes, antecedents, and consequences. Decision regret in women making breast cancer healthcare decisions is a negative cognitive‐emotional response to a treatment decision that involves counterfactual thinking with three targets of regret: outcome regret, chosen option regret, and process regret. Experiencing decision regret can reduce a woman's quality of life, inflict psychological distress, and impact future decision‐making. Unfavorable outcomes, decision uncertainty, and breakdowns in the decision‐making process can lead to decision regret. Findings provide information on identifying women experiencing decision regret and illustrate opportunities to address causative factors through patient education and support to promote optimal patient outcomes.

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End-of-life decision making in the context of chronic life-limiting disease: a concept analysis and conceptual model

Cited by 17 publications

References 155 publications

Readiness for advance care planning and its relationship to coping style in patients with chronic diseases in communities: A cross‐sectional study

Readiness for advance care planning and its relationship to coping style in patients with chronic diseases in communities: A cross‐sectional study

Hospice Enrollment, Future Hospitalization, and Future Costs Among Racially and Ethnically Diverse Patients Who Received Palliative Care Consultation

A concept analysis of decision regret in women with breast cancer

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