Behavioural science sheds light on patient perceptions of impact of disease and quality of life, creates ethical challenges

Advanced veterinary care (AVC) of companion animals may yield improved clinical outcomes, improved animal welfare, improved satisfaction of veterinary clients, improved satisfaction of veterinary team members, and increased practice profitability. However, it also raises ethical challenges. Yet, what counts as AVC is difficult to pinpoint due to continuing advancements. We discuss some of the challenges in defining advanced veterinary care (AVC), particularly in relation to a standard of care (SOC). We then review key ethical challenges associated with AVC that have been identified in the veterinary ethics literature, including poor quality of life, dysthanasia and caregiver burden, financial cost and accessibility of veterinary care, conflicts of interest, and the absence of ethical review for some patients undergoing AVC. We suggest some strategies to address these concerns, including prospective ethical review utilising ethical frameworks and decision-making tools, the setting of humane end points, the role of regulatory bodies in limiting acceptable procedures, and the normalisation of quality-of-life scoring. We also suggest a role for retrospective ethical review in the form of ethics rounds and clinical auditing. Our discussion reenforces the need for a spectrum of veterinary care for companion animals.

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Patient Perceptions and Quality of Life After Colon and Rectal Surgery

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001078 ◽

2018 ◽

pp. 1 ◽

Cited By ~ 2

Author(s):

Sean M. Wrenn ◽

Antonio Cepeda-Benito ◽

Diego I. Ramos-Valadez ◽

Peter A. Cataldo

Keyword(s):

Quality Of Life ◽

Rectal Surgery ◽

Patient Perceptions ◽

Colon And Rectal Surgery

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AI-based clinical decision-making systems in palliative medicine: ethical challenges

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-002948 ◽

2021 ◽

pp. bmjspcare-2021-002948

Author(s):

Ludovica De Panfilis ◽

Carlo Peruselli ◽

Silvia Tanzi ◽

Carlo Botrugno

Keyword(s):

Quality Of Life ◽

Decision Making ◽

Palliative Care ◽

Clinical Decision Making ◽

Ethical Decision Making ◽

Clinical Decision ◽

Point Of View ◽

Ethical Challenges ◽

Palliative Care Consultation

BackgroundImproving palliative care (PC) is demanding due to the increase in people with PC needs over the next few years. An early identification of PC needs is fundamental in the care approach: it provides effective patient-centred care and could improve outcomes such as patient quality of life, reduction of the overall length of hospitalisation, survival rate prolongation, the satisfaction of both the patients and caregivers and cost-effectiveness.MethodsWe reviewed literature with the objective of identifying and discussing the most important ethical challenges related to the implementation of AI-based data processing services in PC and advance care planning.ResultsAI-based mortality predictions can signal the need for patients to obtain access to personalised communication or palliative care consultation, but they should not be used as a unique parameter to activate early PC and initiate an ACP. A number of factors must be included in the ethical decision-making process related to initiation of ACP conversations, among which are autonomy and quality of life, the risk of worsening healthcare status, the commitment by caregivers, the patients’ psychosocial and spiritual distress and their wishes to initiate EOL discussionsConclusionsDespite the integration of artificial intelligence (AI)-based services into routine healthcare practice could have a positive effect of promoting early activation of ACP by means of a timely identification of PC needs, from an ethical point of view, the provision of these automated techniques raises a number of critical issues that deserve further exploration.

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Patient Perceptions of Quality of Life With Diabetes-Related Complications and Treatments

Diabetes Care ◽

10.2337/dc07-0499 ◽

2007 ◽

Vol 30 (10) ◽

pp. 2478-2483 ◽

Cited By ~ 145

Author(s):

E. S. Huang ◽

S. E.S. Brown ◽

B. G. Ewigman ◽

E. C. Foley ◽

D. O. Meltzer

Keyword(s):

Quality Of Life ◽

Patient Perceptions

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Hubungan Persepsi dengan Kualitas Hidup Pasien Hipertensi Lanjut Usia di RSUD Sultan Syarif Mohamad Alkadrie Pontianak

JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) ◽

10.22146/jmpf.45579 ◽

2020 ◽

Vol 10 (2) ◽

pp. 118

Author(s):

Nabilla Putri Pratiwi ◽

Eka Kartika Untari ◽

Robiyanto Robiyanto

Keyword(s):

Quality Of Life ◽

Survey Design ◽

Illness Perception ◽

The Elderly ◽

Patient Perceptions ◽

Five Dimensions ◽

Exact Test ◽

Illness Perception Questionnaire ◽

The Relationship

Hypertension is still a health problem for the elderly group. The misperception about hypertension still occurs to the elderly. They often ignore hypertension and it impact their quality of life. The aim of this study is to obtain patient perceptions and the elderly’s quality of life who are experiencing hypertension, also the relationship between patient perceptions and the elderly’s quality of life who are experiencing hypertension at Sultan Syarif Mohamad Alkadrie Hospital Pontianak. This study was observational with analytival survey design. EQ-5D-3L (EuroQol five dimensions and B-IPQ (Brief Illness Perception Questionnaire) Indonesian version are instruments used which were valid and reliable. The subjects were hypertensive outpatient attending Sultan Syarif Mohamad Alkadrie Hospital Pontianak at aged> 60 years. The sample size was 118 respondents which were obtained from purposive technique sampling. Data was collected through B-IPQ instruments to measure patient perceptions, and EQ-5D-3L to measure patients' quality of life. The relationship between perception and quality of life was analyzed using Fisher's Exact Test with a 95% confidence level (α = 0.05). The results showed the percentage of respondents who had a positive perception was 74.22%, and good quality of life was 76.56%. The results of statistical analysis show there is a significant relationship between patient perceptions and the quality of life of elderly patients who experience hypertension at Sultan Syarif Mohamad Alkadrie Hospital Pontianak with value of p = 0,000.

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Patient Perceptions and Quality of Life in Pacemaker Recipients

Journal of Innovations in Cardiac Rhythm Management ◽

10.19102/icrm.2021.121103 ◽

2021 ◽

Vol 12 (11) ◽

pp. 4769-4779

Author(s):

MARIA POLIKANDRIOTI

Keyword(s):

Quality Of Life ◽

Patient Perceptions

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The Problem with Measuring Patient Perceptions of Outcome with Existing Outcome Measures in Foot and Ankle Surgery

Foot & Ankle International ◽

10.1177/107110070302400109 ◽

2003 ◽

Vol 24 (1) ◽

pp. 56-60 ◽

Cited By ~ 50

Author(s):

Jan Parker ◽

Christopher J. Nester ◽

Andrew F. Long ◽

Jim Barrie

Keyword(s):

Quality Of Life ◽

Outcome Measures ◽

Patient Perceptions ◽

Foot And Ankle ◽

General Health Status ◽

Foot Surgery ◽

Ankle Surgery ◽

Surgery Research ◽

The Many

Quality outcome measures are the cornerstone of clinical research. A review of outcome measures used in foot and ankle surgery research reveals that the issues of validity, reliability and responsiveness of outcome measures have not been addressed. Most reports in the literature have attempted to evaluate patient perceptions of outcome following foot surgery. Underlying the many difficulties with these outcome measures is a lack of understanding of what patients perceive to be important in terms of outcome. Consequently none of the existing outcome measures can claim to be valid measures of patient perceptions of outcome, as there has been no research uncovering these perceptions. In addition, measures of general health status and quality of life in relation to outcome of foot and ankle surgery have been largely ignored to date.

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