Discussing end-of-life issues in the last months of life : a nationwide study among general practitioners
Background: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer patients. Objective: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. Methods: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs w... Mehr ...
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Dokumenttyp: | journalarticle |
Erscheinungsdatum: | 2011 |
Schlagwörter: | Medicine and Health Sciences / CANCER-PATIENTS / HEART-FAILURE / PREFERENCES / COMMUNICATION / NETHERLANDS / INFORMATION NEEDS / SYMPTOM ASSESSMENT / DECISION-MAKING / PALLIATIVE CARE / TERMINALLY-ILL PATIENTS |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-26830529 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://biblio.ugent.be/publication/5827170 |
Background: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer patients. Objective: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. Methods: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs were asked to register, using standardised forms, the extent of discussing 10 end-of-life issues with patients. Results: We examined 252 patients who died nonsuddenly, 38% of whom died of cancer, and 86% of whose treatment goal was palliative care. Our findings show that GPs often waited until very close to death before they discussed end-of-life issues with patients, and discussed spiritual and social issues less than physical symptoms, diagnoses, and psychological problems. In 74% of cases, the GPs were informed of their patients' preferred place of death; and 8 out of 10 patients with known preferences for place of death, died there. Being diagnosed with cancer was associated with a higher frequency of discussing all 10 end-of-life issues than diagnosis with other (noncancer) conditions, but this is a state of mind we did not explore in this study. Conclusion: Promotion of timely discussion of all relevant end-of-life issues, in patients with cancer and noncancer diagnoses, is advisable based on systematic needs assessment.