Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals.
- Author:
Guat Cheng ANG
1
;
Di ZHANG
2
;
Kim Hwa Jim LIM
1
Author Information
- Publication Type:Journal Article
- Keywords: decisions; end-of-life care; options; surrogate
- MeSH: Adult; Aged; Aged, 80 and over; Attitude of Health Personnel; Attitude to Health; Cardiopulmonary Resuscitation; psychology; Cross-Sectional Studies; Decision Making; Family; psychology; Female; Health Personnel; psychology; Humans; Male; Middle Aged; Retrospective Studies; Surveys and Questionnaires; Terminal Care; psychology; Young Adult
- From:Singapore medical journal 2016;57(1):22-28
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONThis study explored and compared the differences in attitudes toward end-of-life care among patients, relatives and healthcare professionals, including doctors and nurses.
METHODSWe performed a descriptive study on a cross-section of the population of a tertiary hospital in Singapore. Data was collected using a questionnaire survey involving 50 participants from each of the four groups of patients, relatives, doctors and nurses.
RESULTSFamily members were the most commonly nominated surrogate decision-makers by the patient group (76%) and the majority of the relative group (74%) felt comfortable deciding on end-of-life care for their loved ones. However, the patient and relative groups differed significantly in their preferences on end-of-life care options, including cardiopulmonary resuscitation (CPR) (p = 0.001), intubation (p = 0.003), nasogastric tube feeding (p < 0.001) and the use of antibiotics (p = 0.023). Doctors, nurses and relatives demonstrated differences in preference between end-of-life care for themselves and for their loved ones, especially with regard to the use of nasogastric tube feeding. There was also a difference between patients and doctors in their decisions on CPR (p < 0.001) and intubation (p = 0.008).
CONCLUSIONThis study demonstrated the importance of early planning for end-of-life care. This must be initiated proactively by healthcare professionals to engage patients in a culturally sensitive manner to discuss their preferences, in order to facilitate open communication between the patient and family.