Factors influencing the end-of-life decisionmaking process about care in hospitalized patients
Authors:
Alena Slezáčková 1,2; Kristýna Dvořáčková 1,3; Ondřej Kopecký 4; Kateřina Rusinová 4; Ondřej Sláma 1,5; David Černý 6; Adam Doležal 6; Tomáš Doležal 6; Václav Zvoníček 7; Libuše Čermáková 1; Petra Vysočanová 1,8; Ladislav Kabelka 9; Josef Kuře 1
Authors‘ workplace:
Ústav lékařské etiky LF MU v Brně
1; Ústav psychologie a psychosomatiky LF MU v Brně
2; Psychologický ústav FF MU v Brně
3; Klinika paliativní medicíny 1. LF UK a VFN v Praze
4; Klinika komplexní onkologické péče MOÚ, Brno
5; Ústav státu a práva AV ČR, v. v. i., Praha
6; Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha
7; Interní kardiologická klinika LF MU a FN Brno
8; Anesteziologicko-resuscitační klinika LF MU a FN u svaté Anny, Brno
9
Published in:
Čas. Lék. čes. 2021; 160: 176-184
Category:
Original Articles
Overview
The quality of end-of-life care of hospitalized patients is an important topic, but so far little explored in the Czech Republic. The aim of this study was to map the factors influencing the end-of-life care decision-making process in selected Czech hospitals and to describe it based on data from medical records and from the perspective of a doctor. The research included data obtained from the medical records of 240 deceased patients (mean age 76.9 years, 41.6% women). The research sample of medical doctors who commented on the decision-making about end-of-life care for these patients consisted of 369 physicians (mean age 35.9 years, 61% women). The results pointed to persistent deficiencies in the written recording of the care goals, prognosis, and possible decision to limit care. Medical doctors limit health care primarily based on consensus among physicians, the patient is usually not invited to the decision-making process. Patient preferences for the end-of-life period are in most cases not ascertained or this question is postponed. The institute of a previously stated wish did not appear in the examined group at all. It can be concluded that decisions about end-of-life care usually take place without knowledge of patients' values and preferences. The results indicate the need to improve the training of doctors and medical students, which should, in addition to building professional competencies, include training in effective communication with patients at the end of life.
Keywords:
communication – patient preferences – Decision making – End of life care – ethics – end of life – death – advance directives
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
2021 Issue 5
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