1.Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals.
Guat Cheng ANG ; Di ZHANG ; Kim Hwa Jim LIM
Singapore medical journal 2016;57(1):22-28
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.
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