‘Nosce te ipsum’: An Italian national survey to explore choice's differences in End of Life (EoL) care between healthcare professionals and general public

Caruso, Rosario; Rocco, Gennaro; Dellafiore, Federica; Brognoli, Gloria; Magon, Arianna; Conte, Gianluca; Pittella, Francesco; Stıevano, Alessandro

doi:10.1016/j.apnr.2019.01.001

Cited by 2 publications

(3 citation statements)

References 35 publications

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“…The intensity of treatment desired by both healthcare professionals and members of the public is well described internationally. Previous studies in North America [5][6][7][8][9][10][11][12][13][14] , Europe 16 and Asia 15 have shown that healthcare professionals would choose to avoid high-intensity treatments should they be terminally unwell. This is consistent with our findings amongst UK doctors.…”

Section: Discussionmentioning

confidence: 99%

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A national survey of anaesthetists' preferences for their own end of life care

Blackwood

Vindrola‐Padros

Mythen

et al. 2020

British Journal of Anaesthesia

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Objectives: To develop a valid questionnaire to describe individual views, wishes and preferences for end of life care and report UK anaesthetists personal perspectives. Methods:The bigconversations questionnaire was developed by modifying an existing framework for end of life discussions. An online cross-sectional survey of UK anaesthetists was then conducted using the questionnaire in January 2019. Results:The bigconversations questionnaire was validated as measuring the important aspects of end of life care by an expert panel and was found to have moderate test-retest reliability.Responses were received from 760/1,913 (40%) of those invited to take part. 698/760 (92%) of respondents wished to be well informed about their condition and prognosis and 518/760 (68%) wanted to be heavily involved in decision making about their health. 639/760 (84%) respondents would choose to forego treatment aimed at prolonging life should that life be of poor quality. The desire to spend time with family was a theme which arose from the qualitative analysis. Conclusion:This study provides the first systematic description of UK doctors, specifically anaesthetists, personal preferences for end of life care. Broad trends were identified: to be well informed; to avoid high-intensity medical treatments if terminally unwell; to spend remaining time with family and friends; and to be symptom free and well cared for. However, a substantial minority expressed different, indeed opposite, opinions. This variation highlights that good quality end of life care must be driven by discussion of an individual's values, wishes and preferences.

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Section: Discussionmentioning

confidence: 99%

“…Reinforcing the views of Murray, Gawande and Kalanithi, international survey data from the US [5][6][7][8][9][10][11][12][13][14] , Singapore 15 and Italy 16 all suggest that as patients, most doctors and health professionals, would choose to avoid high-intensity treatments if terminally unwell or facing a poor prognosis.…”

Section: Introductionmentioning

confidence: 98%

A national survey of anaesthetists' preferences for their own end of life care

Blackwood

Vindrola‐Padros

Mythen

et al. 2020

British Journal of Anaesthesia

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“…32,33 Other barriers to the implementation of advance care plannings and advance directives are represented by a lack of knowledge about the normative context regulating end-of-life 34,35 and a lack of awareness about patient's desires and about possible choices in terms of the end-of-life decision making. 7,36 Finally, the absence of an electronic repository and the lack of availability of supporting information often prevented healthcare professionals acquiescing to and respecting patients' wishes, because sometimes these only existed in papers that the patients did not bring with them. 25 Lack of information and a discontinuity in the communication process are also linked to family caregivers' and healthcare professionals' paternalistic attitude which leads them to decide on behalf of the patient.…”

Section: Main Findings Of the Studymentioning

confidence: 99%

End-of-life care after the legal introduction of advance directives: A qualitative study involving healthcare professionals and family caregivers of patients with amyotrophic lateral sclerosis

Cipolletta

Reggiani

2020

Palliat Med

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Background: Advance care planning and advance directives play a key role in the care of life-threatening illnesses such as amyotrophic lateral sclerosis. Aim: The aim of the present study is to explore how the introduction of these features by law improves the experience of end-of-life care. Design: Five focus groups were conducted in Italy 1 year after the new law on advance directives was introduced. Setting/Participants: Purposive sampling was used to recruit 24 health professionals and 23 family caregivers of patients with amyotrophic lateral sclerosis, for a total of 47 participants. Results: The thematic analysis, conducted through the use of ATLAS.ti software, identified four thematic areas: best practices, managing difficulties, care relationships and proposals. The results indicated a lack of organization, collaboration and continuity on the part of healthcare services and professionals, a lack of information on palliative care, advance care planning, and advance directives. End-of-life care is often left to the good will of the individual professional. Difficulties can also derive from ethical dilemmas concerning end-of-life decision-making and from a lack of communication and relationships between health professionals, patients and their families. Conclusion: The introduction of advance directives by law has not been sufficient to improve end-of-life care. In order to make legal regulation effective, the organization of healthcare services needs to be improved and clearer procedures have to be implemented and shared with patients and families.

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‘Nosce te ipsum’: An Italian national survey to explore choice's differences in End of Life (EoL) care between healthcare professionals and general public

Cited by 2 publications

References 35 publications

A national survey of anaesthetists' preferences for their own end of life care

A national survey of anaesthetists' preferences for their own end of life care

End-of-life care after the legal introduction of advance directives: A qualitative study involving healthcare professionals and family caregivers of patients with amyotrophic lateral sclerosis

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