Decisional conflict in end-of-life cancer treatment among family surrogates: A cross-sectional survey

2018 ◽  
Vol 20 (4) ◽  
pp. 472-478
Author(s):  
Bo Min Jeon ◽  
Su Hyun Kim ◽  
Soo Jung Lee
Keyword(s):  
Cancer Treatment ◽  
End Of Life ◽  
Decisional Conflict ◽  
Cross Sectional Survey ◽  
Cross Sectional

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

scholarly journals Preferences for Advance Directives in Korea

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
So-Sun Kim ◽  
Won-Hee Lee ◽  
JooYoung Cheon ◽  
Jung-Eun Lee ◽  
KiSun Yeo ◽  
...  
Keyword(s):  
End Of Life ◽  
Advance Directives ◽  
End Of Life Care ◽  
Healthcare Providers ◽  
Tube Feeding ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Korean People ◽  
End Stage

Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea.Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0.Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care.Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.

Spiritual beliefs, practices, and needs at the end of life: Results from a New Zealand national hospice study

2016 ◽  
Vol 15 (2) ◽  
pp. 223-230 ◽  
Author(s):  
Richard Egan ◽  
Rod MacLeod ◽  
Chrystal Jaye ◽  
Rob McGee ◽  
Joanne Baxter ◽  
...  
Keyword(s):  
New Zealand ◽  
End Of Life ◽  
Organizational Support ◽  
Spiritual Care ◽  
Development Program ◽  
Spiritual Needs ◽  
International Studies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Peace Of Mind

AbstractObjective:International studies have shown that patients want their spiritual needs attended to at the end of life. The present authors developed a project to investigate people's understanding of spirituality and spiritual care practices in New Zealand (NZ) hospices.Method:A mixed-methods approach included 52 semistructured interviews and a survey of 642 patients, family members, and staff from 25 (78%) of NZ's hospices. We employed a generic qualitative design and analysis to capture the experiences and understandings of participants' spirituality and spiritual care, while a cross-sectional survey yielded population level information.Results:Our findings suggest that spirituality is broadly understood and considered important for all three of the populations studied. The patient and family populations had high spiritual needs that included a search for (1) meaning, (2) peace of mind, and (3) a degree of certainty in an uncertain world. The healthcare professionals in the hospices surveyed seldom explicitly met the needs of patients and families. Staff had spiritual needs, but organizational support was sometimes lacking in attending to these needs.Significance of results:As a result of our study, which was the first nationwide study in NZ to examine spirituality in hospice care, Hospice New Zealand has developed a spirituality professional development program. Given that spirituality was found to be important to the majority of our participants, it is hoped that the adoption of such an approach will impact on spiritual care for patients and families in NZ hospices.

scholarly journals Are registered nurses ready to take care at the end-of-life: crossectional survey

2020 ◽  
Author(s):  
Aurelija Blazeviciene ◽  
Lina Laurs ◽  
Jamesetta A Newland
Keyword(s):  
Registered Nurses ◽  
End Of Life ◽  
End Of Life Care ◽  
Spiritual Needs ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Settings ◽  
Correlational Design ◽  
Inadequate Knowledge

Abstract Background: End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason it is very important to assess all the obstacles to end-of-life care and to provide safe and quality services to patients. The main purpose of this study was to examine attitudes faced by registered nurses in providing end-of-life care and to explore obstacles and supportive behaviors for nurses. Methods: A descriptive, correlational design was applied in this study. Cross‐sectional survey of 1320 registered nurses within 7 hospitals in Lithuania. Results: Registered nurses working in the three different profiles emphasized safe and effective care andthe importance of meeting the patient's spiritual needs at the end of life. The main obstacles assigned by nurses caring for patients at the end of life were angry family membersthe inadequate understanding of nursing care by the patient's relatives; family members' inadequate knowledge about the situation and lack of time to talk to patients about their wishes, lack of nursing knowledge to deal with the bereaved patient's family, lack of evaluation of nurses' opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. Conclusions: Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related obstacles remain one of the main obstacles to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

scholarly journals Controversies in preparing for end-of-life in Nsukka town of Nigeria and suggestions for Nigerian based social work practice

2019 ◽  
Vol 20 (2) ◽  
pp. 95-112
Author(s):  
Uju Patricia Agbawodikeizu ◽  
Uju Patricia Agbawodikeizu ◽  
Prince Chiemeka Agwu ◽  
Uzoma Okoye ◽  
Uzoma Okoye ◽  
...  
Keyword(s):  
End Of Life ◽  
Social Protection ◽  
Cultural Practices ◽  
Cultural Beliefs ◽  
Social Work Practice ◽  
Natural Phenomenon ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Life Planning ◽  
End Of Life Planning

Death is regarded as a natural phenomenon of life, but its consequences for the bereaved are often times very bitter. One way to circumvent this bitter experience is through making plans before dying. However, not everyone seems to appreciate this, which has generated lots of controversies. Thus, end-of-life planning attitude among adult residents in one of Nigeria’s Igbo area was examined using cross-sectional survey. Data was collected from 587 adults and also analyzed using a combination of quantitative and qualitative tools. Age, level of education, marital status and sex were shown to have statistically significant relationships with attitude toward end-of-life planning, while cultural beliefs were discovered to also exercise overbearing influence. The study further discovered some cultural practices that deter people from planning for end-of-life and therefore advocates for social protection and reorientation which should principally involve social workers. Suggestions were made for introduction of end-of-life planning education in the curriculum of institutions of secondary and tertiary learning in Nigeria, as a measure to help reform attitudes of persons toward preparing for end-of-life in future. 

scholarly journals Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

2020 ◽  
Author(s):  
Aurelija Blazeviciene ◽  
Lina Laurs ◽  
Jamesetta A Newland
Keyword(s):  
Registered Nurses ◽  
End Of Life ◽  
Family Involvement ◽  
Nursing Care ◽  
End Of Life Care ◽  
Spiritual Needs ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Settings

Abstract Background: End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason why it is very important to assess all barriers to end-of-life care and to provide safe and quality services to patients. This study was aimed at describing nurses' attitudes in providing end-of-life care and exploring barriers and facilitating behaviors of nurses in multi-profile hospitals in Eastern Europe.Methods: A descriptive, correlational design was applied in this study, using a cross-sectional survey of 1,320 registered nurses within 7 hospitals in Lithuania. Results: Registered nurses working in the three different profiles emphasized safe and effective care and the importance of meeting the patient's spiritual needs at the end of life. The main barriers assigned by nurses caring for patients at the end of life were angry family members, inadequate understanding of nursing care by the patient's relatives; lack of time to talk to patients, lack of nursing knowledge to deal with the bereaved patient's family, lack of evaluation of nurses' opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. The main facilitating behaviors to improve nursing care were end-of-life training, volunteering, and family involvement.Conclusions: Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related barriers remain one of the main barriers to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

scholarly journals End-of-life Care Preferences among Cancer Patients in Southern Thailand: A University Hospital-based Cross-Sectional Survey

2021 ◽  
Author(s):  
Jarurin Pitanupong ◽  
Sahawit Janmanee
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
University Hospital ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
At Home

Abstract Background: End-of-life care preferences may be highly individual, heterogenic, and variable according to culture and belief. This study aimed to explore preferences and factors associated with end-of-life care among Thai cancer patients with the goal of helping optimize their quality of life.Methods: A cross-sectional study surveyed cancer outpatients at Songklanagarind Hospital from August to November 2020. The questionnaires inquired about: 1) personal and demographic information, 2) experiences with end-of-life care received by relatives, and 3) end-of-life care preferences. To determine end-of life preferences, the data were analyzed using descriptive statistics. The data concerning patient demographics and end-of-life care preferences were compared using Fisher’s exact test. Results: The majority of the 96 cancer outpatients were female (65.6%), and the overall mean age was 55.8 ±11.6 years. More than half of them had an experience of observing someone die (68.8%), and they were predominantly satisfied with the care received by their relatives in passing away at home surrounded by family (47.0%) and being conscious until the time of death (68.2%). Most participants preferred receiving the full truth regarding their illness (99.0%), being free of uncomfortable symptoms (96.9%), having their loved ones around (93.8%), being mentally aware at the last hour (93.8%), and having the sense of being meaningful in life (92.7%). Their 3 most important end-of-life care wishes were receiving the full truth regarding their illness, disclosing the full truth regarding their illness to family members, and passing away at home. Conclusion: In order to optimize the quality of life of terminal patients, end-of-life care should ensure they receive the full truth regarding their illness, experience no distress symptoms, remain mentally aware at the last hour of life, feel meaningful in life, and pass away comfortably with loved ones around.

scholarly journals Competency in End-of-Life Care among ENT – HNS Consultants and Residents: A Multi-Center Study

2008 ◽  
Vol 23 (2) ◽  
pp. 5-13
Author(s):  
Arnelle Y. Quiambao ◽  
Flordelina E. Pio-Gulapan
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Neck Surgery ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Knowledge Domain ◽  
Cross Sectional ◽  
Metro Manila ◽  
Tertiary Hospitals ◽  
Multi Center Study

Objectives: To determine the competency in end of life care of Ear, Nose, Throat – Head and Neck Surgery (ENT-HNS) consultants and residents using the domains of knowledge, skills and attitudes as measures of competency and to identify opportunities for improvement in end of life care education   Method: Design:  Cross- sectional survey Setting:  Five tertiary hospitals in Metro Manila Subjects: 52 ENT-HNS consultants and residents   Results: The majority of the respondents scored low across the knowledge, attitude and skills domains. Majority the respondents (67%) were low in the knowledge domain. More than half of the respondents (58%) demonstrated negative attitudes towards end- of-life care while majority of the respondents (56%) had low skills scores. Similarly, more than half (67%) of the respondents showed low over-all competence in end of life care.   Conclusion: The majority of the respondents scored low across all three domains that were used to measure the competency in end of life care. These findings may suggest a need to strengthen the ENT- HNS practitioners’ education in end-of-life care.   Keywords: end of life care, palliative care, terminal care

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