Factors Associated With Implementation of the POLST Paradigm: Results From a Survey of Florida Physicians

2013 ◽  
Vol 14 (4) ◽  
pp. 247-253 ◽  
Author(s):  
Juliana J. Matthews ◽  
Carly Elizabeth Souther
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Planning Process ◽  
Treatment Options ◽  
Life Care ◽  
Cross Sectional ◽  
Advanced Directives ◽  
Life Planning ◽  
Barriers And Opportunities ◽  
June July

Objectives: To investigate physicians’ awareness and attitudes regarding the Physician Orders for Life-Sustaining Treatment (POLST) concept and to identify barriers and opportunities for its expansion.Design: Cross-sectional questionnaire, using electronic survey instrument.Setting: Community.Patients: 212 physicians from three Florida medical associations and the Florida State University College of Medicine clinical faculty responded to the survey. Of those, 67.9% were familiar with the concept of POLST.Measurements and Main Results: Data were collected using a web-based survey, completed in June–July 2012, consisting of qualitative and quantitative questions. Most (95.8%) agreed or strongly agreed that it was a physician’s responsibility to discuss end-of-life care and treatment options with patients. Satisfaction with current advanced directives was highly variable. However, a consensus about potential benefits of POLST exists, including assisting the discussion of end-of-life care, decreasing unwanted treatment, and lowering costs. More than 70% of respondents reported they would be more likely to use the POLST form if provided civil and criminal immunity; however, data analysis rendered the apparent association statistically insignificant. Qualitative data were also collected in the form of respondents’ recommendations and additional comments.Conclusions: Physicians vary in their knowledge and opinions regarding the POLST paradigm. Broad opportunities may exist to improve physician knowledge and attitudes toward POLST. Dissemination of educational materials to physicians involved in the end-of-life planning process may increase physician support and use of POLST.

Serious Mental Illness and Hospice Care

2021 ◽  
pp. 082585972110220
Author(s):  
Gwen Levitt
Keyword(s):  
Mental Health ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychiatric Illness ◽  
Hospice Care ◽  
Treatment Options ◽  
Life Care ◽  
Case Review ◽  
Health Community ◽  
End Stage

There are a small number of articles in the literature discussing palliative and end-of-life care in the SMI population. Most tackle the questions relating to competency to refuse care in end-stage anorexia or terminal medical conditions. This is a case review of a 55 year old patient with a complex psychiatric and medical history, who despite extensive treatment and long hospitalizations has failed to regain any ability to care for her basic needs. She has exhausted all available treatment options and her prognosis is extremely poor. The mental health community is resistant to discussing and/ or confronting the fact that such a patient faces with the need for end-of-life care directly related to chronic psychiatric illness.

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.

Neonatal Staff and Advanced Practice Nurses’ Perceptions of Bereavement/End-of-Life Care of Families of Critically Ill and/or Dying Infants

2004 ◽  
Vol 13 (6) ◽  
pp. 489-498 ◽  
Author(s):  
Arthur J. Engler ◽  
Regina M. Cusson ◽  
Renee T. Brockett ◽  
Charlene Cannon-Heinrich ◽  
Michelle A. Goldberg ◽  
...  
Keyword(s):  
End Of Life ◽  
Critically Ill ◽  
End Of Life Care ◽  
Survey Design ◽  
The United States ◽  
Influential Factors ◽  
Life Care ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Nurses Perceptions

• Background Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care. • Objective To describe neonatal nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. • Methods A cross-sectional, descriptive, correlational mailed survey design was used. The 55-item Bereavement End-of-Life Attitudes About Care: Neonatal Nurses Scale containing 4 sections (comfort, roles, involvement, and demographics) was mailed to 240 hospitals in the United States. • Results The final response rate was 52% (190 completed data sets from 125 hospitals). Respondents were comfortable with many aspects of bereavement/end-of-life care. Comfort and roles scores correlated significantly with number of years as a neonatal intensive care nurse. Respondents agreed about many important aspects of their roles with patients’ families, especially the importance of providing daily support to the families. Most respondents identified caring for a dying infant, the actual death of an infant, and language or cultural differences as influential factors in the level of their involvement with families. • Conclusions Education on bereavement/end-of-life care could affect nurses’ comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.

scholarly journals Undergraduate final year nursing students’ attitudes toward caring for dying patients: Bahrain’s experience

2018 ◽  
Vol 6 (4) ◽  
pp. 53
Author(s):  
Maryam Yaqoob ◽  
Husain Nasaif ◽  
Hana Kadhom
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
Curriculum Reform ◽  
End Of Life Care ◽  
Life Care ◽  
Gulf Region ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Dying Patients ◽  
Students Attitudes

Background: Nursing students are frequently exposed to dying patients during their clinical placement. Research studies that examined nursing students’ attitudes toward caring for dying patients were limited in the Gulf Region, including Bahrain.Objective: The purpose of this study is to examine the attitudes of fourth-year baccalaureate nursing students regarding caring for dying patients.Methods: A descriptive cross-sectional design was utilized to recruit a convenience sample of fifty-four nursing students. Frommelt’s Attitudes towards Caring of the Dying (FATCOD) five Likert scale was used.Results: The overall findings revealed that participants had a neutral attitude toward caring for dying patients. The overall attitudes mean score was 3.4 ± 0.3. The majority of participants were female (83%, n = 45). The difference in the mean score in relation to gender was statistically significant (p = .049). Although the majority of all participants (80%) reported having dealt with the terminally ill people in the past, the association between previous experience and reported attitudes was not statistically significant (p = .31).Conclusions and recommendations: Literature revealed that students who received end of life education where found to have positive attitudes. Therefore, it’s crucial to introduce a standalone educational module regarding end of life care early on in the undergraduate curriculum. It is recommended that future studies recruit nursing students from other baccalaureate year levels to reassess the attitudes and level of preparedness following a curriculum reform and implementation of end of life care education. Additionally, a qualitative research method is recommended to explore the lived experience of the nursing students when they are caring for dying patients.

scholarly journals Nursing home staff’s perspective on end-of-life care of German nursing home residents: a cross-sectional survey

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Anke Strautmann ◽  
Katharina Allers ◽  
Alexander Maximilian Fassmer ◽  
Falk Hoffmann
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Nursing Staff ◽  
End Of Life Care ◽  
Nursing Home Residents ◽  
Hospital Death ◽  
Life Care ◽  
Cross Sectional

Abstract Background Nursing homes are becoming more important for end-of-life care. Within the industrialised world, Germany is among the countries with the most end-of-life hospitalizations in nursing home residents. To improve end-of-life care, investigation in the status quo is required. The objective was to gain a better understanding of the perspectives of nursing home staff on the current situation of end-of-life care in Germany. Methods A cross-sectional study was conducted as a postal survey among a random sample of 1069 German nursing homes in 2019. The survey was primarily addressed to nursing staff management. Data was analyzed using descriptive statistics. Staff was asked to rate different items regarding common practices and potential deficits of end-of-life care on a 5-point-Likert-scale. Estimations of the proportions of in-hospital deaths, residents with advance directives (AD), cases in which documented ADs were ignored, and most important measures for improvement of end-of-life care were requested. Results 486 (45.5%) questionnaires were returned, mostly by nursing staff managers (64.7%) and nursing home directors (29.9%). 64.4% of the respondents rated end-of-life care rather good, the remainder rated it as rather bad. The prevalence of in-hospital death was estimated by the respondents at 31.5% (SD: 19.9). Approximately a third suggested that residents receive hospital treatments too frequently. Respondents estimated that 45.9% (SD: 21.6) of the residents held ADs and that 28.4% (SD: 26.8) of available ADs are not being considered. Increased staffing, better qualification, closer involvement of general practitioners and better availability of palliative care concepts were the most important measures for improvement. Conclusions Together with higher staffing, better availability and integration of palliative care concepts may well improve end-of-life care. Prerequisite for stronger ties between nursing home and palliative care is high-quality education of those involved in end-of-life care.

Burnout and psychiatric morbidity among physicians engaged in end-of-life care for cancer patients: a cross-sectional nationwide survey in Japan

2007 ◽  
Vol 16 (5) ◽  
pp. 421-428 ◽  
Author(s):  
Mariko Asai ◽  
Tatsuya Morita ◽  
Tatsuo Akechi ◽  
Yuriko Sugawara ◽  
Maiko Fujimori ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Psychiatric Morbidity ◽  
Nationwide Survey ◽  
Life Care ◽  
Cross Sectional

scholarly journals Update on End-of-Life Care Training During Nephrology Fellowship: A Cross-sectional National Survey of Fellows

2015 ◽  
Vol 65 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Sara A. Combs ◽  
Stacey Culp ◽  
Daniel D. Matlock ◽  
Jean S. Kutner ◽  
Jean L. Holley ◽  
...  
Keyword(s):  
End Of Life ◽  
National Survey ◽  
End Of Life Care ◽  
Life Care ◽  
Cross Sectional ◽  
Care Training
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