Barriers and facilitators to culturally sensitive care in general practice: a reflexive thematic analysis.

Background: This study investigated the perceived barriers and potential facilitators for culturally sensitive care among general practitioners in Flanders. Understanding these dynamics is crucial for improving healthcare quality and equity.

Methodology: Twenty-one in-depth interviews were conducted with Flemish GPs.

"Trying to write a story together": general practitioners' perspectives on culturally sensitive care.

Background: Culturally sensitive care is integral to effective and equitable healthcare delivery, necessitating an understanding and acknowledgment of patients' cultural needs, preferences, and expectations. This study investigates the perceptions of cultural sensitivity among general practitioners (GPs), focusing on their intentions, willingness and perceived responsibilities in providing care tailored to cultural needs.

Methods: In-depth interviews were conducted with 21 Flemish GPs to explore their perspectives on culturally sensitive care.

Physicians' Experiences and Perceptions of Environmental Factors Affecting Their Practices of Continuous Deep Sedation until Death: A Secondary Qualitative Analysis of an Interview Study.

As previous research has paid little attention to environmental factors affecting the practice of continuous deep sedation until death (CDS), we aimed to explore these using physicians' experiences and perceptions. We performed an interpretative thematic analysis of primary data from a qualitative interview study conducted from February to May 2019 in Belgium with 47 physicians. Structural factors were identified: the lack of professional and/or technical support in monitoring sedated patients; the use of guidelines in team contexts; the time constraints for treating individual patients and work pressure; the structural knowledge gap in medical education; the legal context for assisted dying; and the lack of a clear legal context for CDS.

Intercountry and intracountry variations in opinions of palliative care specialist physicians in Germany, Italy, Japan and UK about continuous use of sedatives: an international cross-sectional survey.

Objectives: To explore intercountry and intracountry differences in physician opinions about continuous use of sedatives (CUS), and factors associated with their approval of CUS.

Settings: Secondary analysis of a questionnaire study.

Participants: Palliative care physicians in Germany (N=273), Italy (N=198), Japan (N=334) and the UK (N=111).

Control Measures for Continuous Deep Sedation Until Death: A Framing Analysis of the Views of Physicians.

Physicians have been subject to increasing external control to improve their medical practice, and scholars have theorized extensively about their opposition to such control. However, little empirical attention has been paid to the views and reasoning that lie behind this opposition. An in-depth understanding is necessary for enhancing the effectiveness and efficiency of external controls, and continuous deep sedation until death (CDS) is an interesting case in this regard.

Physicians' Opinion and Practice With the Continuous Use of Sedatives in the Last Days of Life.

Context: There are few international studies about the continuous use of sedatives (CUS) in the last days of life.

Objectives: We aim to describe the experiences and opinions regarding CUS of physicians caring for terminally ill patients in seven countries.

Methods: Questionnaire study about practices and experiences with CUS in the last days of life among physicians caring for terminally ill patients in Belgium (n = 175), Germany (n = 546), Italy (n = 214), Japan (n = 513), the Netherlands (n = 829), United Kingdom (n = 114) and Singapore (n = 21).

Continuous Palliative Sedation Until Death: The Development of a Practice Protocol for Nursing Homes.

Objectives: Challenges inherent in the practice of continuous palliative sedation until death appear to be particularly pervasive in nursing homes. We aimed to develop a protocol to improve the quality of the practice in Belgian nursing homes.

Methods: The development of the protocol was based on the Medical Research Council Framework and made use of the findings of a systematic review of existing improvement initiatives and focus groups with 71 health care professionals [palliative care physicians, general practitioners (GPs), and nursing home staff] identifying perceived barriers to the use of continuous palliative sedation until death in nursing homes.

A systematic review of quality improvement initiatives for continuous sedation until death.

Background: Extensive debate surrounds the practice of continuous sedation until death within end-of-life care.

Aim: To provide insight into existing initiatives to support the practice of continuous sedation until death and assess their feasibility and effectiveness.

Design: Systematic review and narrative synthesis, registered on PROSPERO (CRD42020149630).

Barriers in the Decision Making About and Performance of Continuous Sedation Until Death in Nursing Homes.

Background And Objectives: While decision making about and performance of continuous sedation involve many challenges, they appear to be particularly pervasive in nursing homes. This study aims to identify barriers to the decision making and performance of continuous sedation until death in Flemish nursing homes as experienced by the health care professionals involved.

Research Design And Methods: Ten focus groups were held with 71 health care professionals including 16 palliative care physicians, 42 general practitioners, and 13 nursing home staff.

The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study.

Background: Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent.

Aim: To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying.

International variations in clinical practice guidelines for palliative sedation: a systematic review.

Objectives: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument.

Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey.

Background: Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians' degree of palliative training.

End-of-life decisions in individuals dying with dementia in Belgium.

Objectives: To describe the prevalence and characteristics of end-of-life decisions in individuals dying with dementia in Belgium.

Design: Retrospective mail survey.

Setting: Brussels and Flanders, Belgium.