Physicians’ approach to end of life care: comparison of two tertiary care university hospitals in Lebanon

Dabar, Georges; Akl, Imad Bou; Sader, Mirella

doi:10.1186/s12909-021-03022-x

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Não é incomum a equipe de saúde acreditar que beneficia o paciente ao poupá-lo de decidir sobre sua própria vida. Uma ideia paternalista na qual acreditam afastar o paciente de uma situação traumática e geradora de ansiedade 13 . Paulatinamente, a tomada de decisão na prática clínica tem deixado de ser uma prática paternalista, na qual o médico tomava a decisão pelo paciente com a crença de ser o melhor para este, para uma prática focada na autonomia do indivíduo, na qual há o compartilhamento de informações de forma clara, discussão de preferências e valores do paciente e um consenso final para a decisão tomada 14 .…”

Section: Introductionunclassified

Tomada De Decisão Compartilhada Em Fim De Vida

Bahia¹,

Palácios²

2023

Rev. Contemp.

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Para avaliar a tomada de decisão compartilhada em fim de vida em hospitais, foi realizada uma revisão integrativa de literatura, a qual resultou em 23 artigos. A TDC consiste em um conceito abrangente para orientar as condutas médicas e da equipe de saúde em consonância com os pacientes, com ambas as partes participando ativamente do processo. Perpassa os desejos, valores e prioridades dos pacientes, suas opções e tratamento, com um consenso final entre equipe de saúde e pessoa afetada, incluindo o indivíduo como ser autônomo e responsável. Concluiu-se que os componentes do TDC ainda não são muito bem sentido na literatura e existem diversas formas de implementar um TDC na prática clínica.

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Section: Introductionunclassified

Tomada De Decisão Compartilhada Em Fim De Vida

Bahia¹,

Palácios²

2023

Rev. Contemp.

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Palliative team involvement in end-of-life care for Jewish and Muslim children in Jerusalem: A unique clinical and cultural context

2023

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Objectives Pediatric palliative care services improve the quality of life for children with life-limiting and life-threatening diseases, although little has been published about variation based on cultural and religious factors. This article sets out to describe clinical and cultural characteristics of pediatric end-of-life patients in a majority Jewish and Muslim country with religious and legal constraints around end-of-life care. Methods We conducted a retrospective chart review of 78 pediatric patients who died during a 5-year period and could potentially have utilized pediatric palliative care services. Results Patients reflected a range of primary diagnoses, most commonly oncologic diseases and multisystem genetic disorders. Patients followed by the pediatric palliative care team had less invasive therapies, more pain management and advance directives, and more psychosocial support. Patients from different cultural and religious backgrounds had similar levels of pediatric palliative care team follow-up but certain differences in end-of-life care. Significance of results In a culturally and religiously conservative context that poses constraints on decision-making around end-of-life care, pediatric palliative care services are a feasible and important means of maximizing symptom relief, as well as emotional and spiritual support, for children at the end of life and their families.

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Experiences of medical students and nursing trainees from unexpected death through simulation training

Hinzmann,

Wijnen-Meijer,

Corazza

et al. 2023

BMC Med Educ

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Background Dying in simulation training is controversially discussed. On the one hand, the danger of an emotional overload of the learners is pointed out. On the other hand, dying in simulation settings is addressed as an opportunity to prepare future health professionals to deal with patient death. The present study investigates how medical students and nursing trainees experience the sudden death of a simulated patient and how and under which conditions it can be valuable to simulate the patient’s death. Methods At the TUM School of Medicine in Munich, Germany, we developed an interprofessional, simulation-based course in which participants were unexpectedly confronted with a cardiac arrest scenario within which resuscitation had to be discontinued due to an advanced directive. After the course, focus groups were conducted with nine medical students and six nursing trainees. Data were analysed using Grounded Theory techniques. Results The participants reported low to high emotional involvement. The active renunciation of life-sustaining measures was felt to be particularly formative and caused a strange feeling and helplessness. Questions of what could have been done differently determined interviewees’ thoughts. The participants appreciated the opportunity to experience what it feels like to lose a patient. The course experience encouraged interviewees to reflect on dying and the interviewees explained that they feel better prepared to face death after the course. The unexpected character of the confrontation, presence of the advanced directive and debriefing positively affected the impact of the simulation. Conclusions The study recognises simulation training as a promising approach for preparing future health care professionals to encounter a patient’s death.

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Physicians’ approach to end of life care: comparison of two tertiary care university hospitals in Lebanon

Cited by 3 publications

References 34 publications

Tomada De Decisão Compartilhada Em Fim De Vida

Tomada De Decisão Compartilhada Em Fim De Vida

Palliative team involvement in end-of-life care for Jewish and Muslim children in Jerusalem: A unique clinical and cultural context

Experiences of medical students and nursing trainees from unexpected death through simulation training

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