Preferences of older inpatients and their family caregivers for life-sustaining treatments in South Korea

Hwang, Hyeyoung; Yang, Sook Ja; Jeong, Sarah

doi:10.1016/j.gerinurse.2017.12.015

Cited by 10 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most important reasons behind providing futile medical treatments that have been cited in the literature are “patients’/family members’ request and persistence”, “health care professionals’ personal emotions, beliefs, and attitudes”, and “organizational factors and fear over getting involved in medical litigation” [ 13 , 15 , 16 ]. It has been argued in the literature that family members (more particularly family caregivers) demonstrate stronger insistence for providing futile medical care than patients themselves [ 17 ]. Family members insist on providing futile care because they have unrealistically high expectations because they are not well informed by physicians (who may be unwilling or unskilled in discussing end-of-life issues) about the underlying conditions [ 16 , 18 ], have difficulty accepting the reality of an imminent death, and fear “loneliness and being neglected” [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The medical futility experience of nursing professionals in Greece

2021

View full text Add to dashboard Cite

Background Providing futile medical care is an ever-timely ethical problem in clinical practice. While nursing personnel are very closely involved in providing direct care to patients nearing the end of life, their role in end-of-life decision-making remains unclear. Methods This was a prospective qualitative study conducted with experienced nursing professionals from December 2020 through May 2021. Individual in-depth qualitative interviews were conducted with sixteen participants. We performed a thematic analysis of the data. Results Importantly, many participants were half-hearted in their attitude towards accepting or defining futile medical care. Furthermore, interestingly, a list of well-described circumstances emerged, under which the dying process is most likely to be a “bad and undignified” process. These circumstances reflected situations revolving around a) pain and suffering, b) treating patients with respect, c) the appearance and image of the patient body, and d) the interaction between patients and their relatives. Fear of legal action, the lack of a regulatory framework, physicians being pressured by (mostly uninformed) family members and physicians’ personal motives were reported as important reasons behind providing futile medical care. The nursing professional’s role as a participant in decisions on futile care and as a mediator between physicians and patients (and family members) was highlighted. Furthermore, the patient’s role in decisions on futile care was prioritized. The patient’s effort to keep themselves alive was also highlighted. This effort impacts nursing professionals’ willingness to provide care. Providing futile care is a major factor that negatively affects nursing professionals’ inner attitude towards performing their duties. Finally, the psychological benefits of providing futile medical care were highlighted, and the importance of the lack of adequately developed end-of-life care facilities in Greece was emphasized. Conclusions These findings enforce our opinion that futile medical care should be conceptualized in the strict sense of the term, namely, as caring for a brain-dead individual or a patient in a medical condition whose continuation would most likely go against the patient’s presumed preference (strictly understood). Our findings were consistent with prior literature. However, we identified some issues that are of clinical importance.

show abstract

Section: Discussionmentioning

confidence: 99%

The medical futility experience of nursing professionals in Greece

2021

View full text Add to dashboard Cite

show abstract

“…Given that self‐transcendence is one of the basic human strengths and that available resources were related specifically to women with chronic diseases (Haile, Landrum, Kotarba, & Trimble, ; Lundman et al, ), further study needs to include the relationship between the experience of gerotranscendence and chronic health conditions. The research literature indicates that past experience in making decisions on life‐sustaining treatments for a close family member (Hwang, Yang, & Jeong, ) and the impact of past experience with dying and death are strong predictors for how one might embrace death and dying and end‐of‐life care decision making (Jeong et al, ). However, there was no evidence in this study for the relationship between death in family and gerotranscendence.…”

Section: Discussionmentioning

confidence: 99%

Experience of gerotranscendence among community‐dwelling older people: A cross‐sectional study

Jeong

Moon

Lee

et al. 2019

Int J Older People Nursing

View full text Add to dashboard Cite

Aims and objectives: To investigate the experience of gerotranscendence among older people in community in Korea and the factors that influence their experience. Background: While the literature provides estimates of how many older people are affected by negative aspects of ageing, it is not known to what extent and why some older people experience gerotranscendence, despite the challenges they encounter throughout their lifetime. Design: A cross-sectional survey. Methods: A 55-item questionnaire was distributed to 109 older people between March and June 2017. Univariable and multivariable linear regressions were conducted on the four question group sum scores to identify factors associated with gerotranscendence. Results: Older people aged 65-93 who live in a community in Korea reported the experience of gerotranscendence. Age and religion showed a statistically significant association with gerotranscendence. Religiosity showed a statistically significant association with beliefs about death and dying. Age and beliefs about death and dying have significant relationship with the experience of gerotranscendence. Conclusions: Older people who have more positive views about death and dying are more likely to experience gerotranscendence. The study results provide nurses and other healthcare professionals with new understandings and insights about the factors potentially related to positive ageing process. Implications for practice: It is essential for nurses to investigate their own beliefs about death and dying, and their understanding of gerotranscendence which will contribute to developing education programs and practice guidelines as an essential part of promoting gerotranscendence and positive ageing. K E Y W O R D S beliefs about death and dying, community, gerotranscendence, old people, satisfaction with life, social support 2 of 11 | JEONG Et al.

show abstract

“…The most important reasons behind providing futile medical treatments which had been cited in the literature were: "Patients'/family members' request and persistence", "Healthcare professionals' personal emotions, beliefs, and attitudes", and "Organizational factors and fear over getting involved in medical litigation" [13,15,16]. It is argued in literature that family members (more particularly family caregivers) demonstrate stronger insistence for providing futile medical care than patients themselves [17]. Family members insist on providing futile care because they have unrealistically high expectations because they are not well informed by the physicians (who may be unwilling or unskilled in discussing end-of-life issues) about the underlying conditions [16,18], have di culty to accept the reality of an imminent death, and fear of "loneliness and being neglected" [16].…”

Section: The Reasons Behind Providing Futile Carementioning

confidence: 99%

The Medical Futility Experience of Nursing Professionals in Greece

Voultsos

Tsompanian

Tsaroucha

2021

Preprint

View full text Add to dashboard Cite

Background Providing futile medical care is an ever timely ethical problem in clinical practice. While nursing personnel are very closely involved in providing direct care to patients nearing the end of life, their role in end-of-life decision making remains unclear. Methods This is a prospective qualitative study conducted with experienced nursing professionals from December 2020 through May 2021. Individual in-depth qualitative interviews were conducted with sixteen participants. We performed a thematic analysis of the data. Results Importantly, many participants were half-hearted in their attitude towards accepting or defining futile medical care. Furthermore, interestingly, emerged a list of well-described circumstances, under which the dying process is most likely to be a “bad and undignified” process. These circumstances reflected situations revolving around: a) pain and suffering, b) treating patients with respect, c) the appearance and image of the patient body, and d) the interaction between patients and their relatives. Fear of legal action, lack of regulatory framework, physicians pressured from (mostly uninformed) family members and physicians’ personal motives were reported as important reasons behind providing futile medical care. It is highlighted the nursing professional’s role as participant in decisions on futile care and as mediator between physicians and patients (and family members). Furthermore, it is prioritized the patient’s role in decisions on futile care. It is highlighted the impact of patient’s effort to keep themselves alive on nursing professionals’ willingness to provide care. Providing futile care is a major factor that negatively affects the nursing professionals’ inner attitude towards performing their duties. Finally, the psychological benefits of providing a futile medical care are highlighted, and the importance of the lack of adequately developed end-of-life care facilities in Greece is emphasized. Conclusions These findings enforce our opinion that futile medical care should be conceptualized in the strict sense of the term, namely, as caring for a brain-dead individual or a patient in a medical condition whose continuation would most likely go against the patient’s presumed preference (strictly understood). For a great part, our findings were consistent with prior literature. However, we identified some issues that are of clinical importance.

show abstract

Preferences of older inpatients and their family caregivers for life-sustaining treatments in South Korea

Cited by 10 publications

References 27 publications

The medical futility experience of nursing professionals in Greece

The medical futility experience of nursing professionals in Greece

Experience of gerotranscendence among community‐dwelling older people: A cross‐sectional study

The Medical Futility Experience of Nursing Professionals in Greece

Contact Info

Product

Resources

About