Factors considered in end-of-life care decision making by health care professionals

Am J Hosp Palliat Care. 2013 Jun;30(4):354-8. doi: 10.1177/1049909112453193. Epub 2012 Jul 16.

Abstract

Aim: To explore the importance of factors influencing the end-of-life care decision making of health care professionals (HCPs) in Singapore.

Methods: This cross-sectional survey encompassed facets of patient, family, and HCP-related care considerations. In total, 187 questionnaires were distributed to physicians and nurses and had a response rate of 78.6%.

Results: The respondents rated patients' wishes (96.6%), their clinical symptoms (93.9%), and patients' beliefs (91.1%) very high. In all, 94.6% of the HCPs would respect a competent patient's wishes over the family's wishes when goals conflict. However, 59.9% of HCPs would abide by the family's wishes when the patient loses capacity even if the patient's previously expressed wishes are known.

Conclusion: End-of-life care decision making by HCPs appears largely patient centered, although familial determination still wields significant influence with implications for advance care planning.

Keywords: Asian; decision making; end-of-life care; familial determination; health care professionals; patient centered.

MeSH terms

  • Adult
  • Advance Directive Adherence / psychology*
  • Advance Directive Adherence / standards
  • Advance Directive Adherence / statistics & numerical data
  • Aged
  • Attitude of Health Personnel / ethnology*
  • Attitude to Death / ethnology
  • Cancer Care Facilities / organization & administration
  • Cancer Care Facilities / standards
  • Cross-Sectional Studies
  • Decision Making
  • Family / ethnology
  • Family / psychology*
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Patient Preference / psychology*
  • Patient Preference / statistics & numerical data
  • Patient-Centered Care / standards*
  • Patient-Centered Care / statistics & numerical data
  • Professional-Family Relations
  • Singapore
  • Terminal Care / psychology*
  • Terminal Care / standards
  • Truth Disclosure
  • Workforce
  • Young Adult