Influence of the metropolitan environment on end-of-life decisions: A population-based study of end-of-life decision-making in the Brussels metropolitan region and non-metropolitan Flanders

Cohen, Joachim; Chambaere, Kenneth; Bilsen, Johan; Houttekier, Dirk; Mortier, Freddy; Deliens, Luc

doi:10.1016/j.healthplace.2010.04.003

Cited by 11 publications

(12 citation statements)

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“…Other topics related to MELDs included application of laws and other regulations, institutional written ethics policies, and opinions and attitudes [65], [83], [86], [101], [105], [108], [109], [110], [111], [112], [113], [114], [115], [116], [117], [118], [119], [120], [121], [122].…”

Section: Resultsmentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

et al. 2012

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Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

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Section: Resultsmentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

et al. 2012

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“…This may be explained by regional differences in general information provision and knowledge of palliative care or to differences in the social environment (e.g. lower social fragmentation in more rural areas) and national healthcare policy (concentration of large academic hospitals in metropolitan areas creating a pull factor towards end-of-life care in hospitals) [43].…”

Section: Discussionmentioning

confidence: 99%

Who finds the road to palliative home care support? A nationwide analysis on the use of supportive measures for palliative home care using linked administrative databases

et al. 2019

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BackgroundMany countries developed supportive measures for palliative home care, such as financial incentives or multidisciplinary palliative home care teams. For policy makers, it is important to evaluate the use of these national palliative home care supportive measures on a population level.Methods and findingsUsing routinely-collected data on all deaths in Belgium in 2012 (n = 107,847) we measured the use of four statutory supportive measures, specifically intended for patients who have obtained the legal palliative status, and three non-statutory supportive measures. Factors associated with uptake were analysed using multivariable logistic regression. Of all deaths of adult home-dwelling persons in Belgium (n = 87,007), 17.9 percent used at least one statutory supportive measure and 51.5 percent used at least one non-statutory supportive measure. In those who died of an illness indicative of palliative care needs 33.1 percent used at least one statutory supportive measure and 62.2 percent used at least one non-statutory supportive measure. Younger people and persons dying from cancer were more likely to use a statutory policy measure. Older people and persons dying from COPD were most likely to use a non-statutory policy measure. Women, non-single people, and those living in less urbanised areas were most likely to use any supportive measure.ConclusionsStatutory supportive measures for palliative home care are underused, even in a subpopulation of persons with potential palliative care needs. Policy makers should stimulate an equitable uptake, and reducing the observed inequalities is an important focus for health care policy.

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“…Other topics related to MELDs included application of laws and other regulations, institutional written ethics policies, and opinions and attitudes [65,83,86,101,105,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122].…”

Section: Belgiummentioning

confidence: 99%

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Gysels¹,

Evans²,

Meñaca³

et al. 2020

The Ethical Challenges of Emerging Medical Technologies

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Aim: Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods: We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results: A total of 868 papers were reviewed. The following themes facilitated crosscountry comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion: This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

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Influence of the metropolitan environment on end-of-life decisions: A population-based study of end-of-life decision-making in the Brussels metropolitan region and non-metropolitan Flanders

Cited by 11 publications

References 56 publications

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

Who finds the road to palliative home care support? A nationwide analysis on the use of supportive measures for palliative home care using linked administrative databases

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

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