Consideration points in the decision making in chronic respiratory diseases

Wakae Maeda; KM Saif-ur-rahman; Tsukasa Muraya; Yoshihisa Hirakawa

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Consideration points in the decision making in chronic respiratory diseases

VernacularTitle:Consideration points in the decision making in chronic respiratory diseases
Author: Wakae MAEDA ¹ ; KM SAIF-UR-RAHMAN ² ; Tsukasa MURAYA ³ ; Yoshihisa HIRAKAWA ⁴
Author Information

1. Department of Healthcare Quality and Patient Safety, Nagoya University Graduate School of Medicine, Japan
2. College of Medicine, Nursing and Health Sciences, University of Galway, Ireland
3. Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Ireland
4. Faculty of Contemporary Social Studies, Chikushi Jogakuen University, Japan
Keywords: decision-making; chronic respiratory diseases; qualitative content analysis
From:Journal of Rural Medicine 2024;19(3):158-165
CountryJapan
Language:English
Abstract: Objective: Even though dynamic multidisciplinary team discussions are crucial for end-of-life care management and decisions concerning chronic obstructive pulmonary disease (COPD), the details of the discussion contents remain poorly understood. This study aimed to identify essential considerations in decision-making for patients with chronic respiratory diseases to enhance a consensus-based approach.Materials and Methods: A qualitative content analysis of focus group conversations on published clinical case reports in the Japanese community about end-of-life care for patients with chronic respiratory disorders was conducted. The cases were searched through Igaku Chuo Zasshi (ICHUSHI) and Google in February 2021, using the keywords: “COPD”, “chronic respiratory diseases”, and “end-of-life care”. A total of 41 healthcare professionals participated in the focus group discussions.Results: Four major themes evolved from the qualitative content analysis: unpredictable disease prognosis and stages, low awareness of patients on disease severity, acute exacerbations, and home oxygen therapy (HOT). The participants perceived that assessment of severity and prognosis in chronic respiratory diseases such as COPD was a core discussion point to enhance patients’ decision-making. The study’s findings also indicated that healthcare providers evaluate the influence of acute aggravation of the condition on patients’ perceived health status and decision-making.Conclusion: The study reaffirms the significance of informed consent in patients with chronic respiratory disease. It details how, after a thorough assessment of disease severity, patients are given personalized explanations of standardized HOT. This approach ensures they fully understand the unpredictable nature and various stages of their condition resulting from acute exacerbations.