Efforts to improve the quality of end-of-life decision-making have emphasized the principle of individual autonomy to better ensure that patients receive care consistent with their preferences. Advance directives (ADs) can be vehicles for in-depth and ongoing discussions among health care professionals, patients, and families. The aim of our study was to identify preferences and values expressed in ADs of 50 elderly patients with cancer. Main concerns of the patients were resuscitation and introduction of artificial nutrition. Very few patients had unrealistic expectation. Preferences about patient's symptom management were quite different from one to another. Content of ADs not only involved life-sustaining technology, but also psychosocial items and religious beliefs and values. All patients designated at least one surrogate. In conclusion, ADs should not be considered simply as another questionnaire, but more as a process to improve communication.
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http://dx.doi.org/10.1016/j.critrevonc.2009.04.007 | DOI Listing |
BMC Public Health
January 2025
Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Background: Advance care planning can help to align the care provided with the values, goals and preferences of patients at the end of life. Therefore, readiness for advanced care planning is considered a prerequisite and predictor of the patient's willingness to participate in the end of life conversation. The present study was conducted with the aim of investigating the factors affecting patients' readiness for advance care planning (RACP).
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1A8, Canada.
Background/objectives: Coercion in mental health is challenged, prompting reduction interventions. Among those, the Joint Crisis Plan (JCP), which aims to document individuals' treatment preferences in case of future de-compensation, regardless of the potential loss of discernment, has been identified as a key path to study. Identified challenges related to its implementation highlight the need to adapt this intervention to the local context.
View Article and Find Full Text PDFBMJ Open Qual
January 2025
Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Objective: Understanding patients' wishes and preferences during hospitalisation is a crucial component of care. We identified a gap related to documentation of advance directives and patient preferences for care and focused on ensuring appropriate goals of care discussions were occurring and documented. Our aim was to improve the documentation of advance care planning notes to include 80% of targeted hospitalised patients.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Objective: The project aimed to standardize advanced care planning (ACP) at an internal medicine clinic by initiating physician-patient communication regarding the patient's knowledge, understanding, and openness to pursuing advanced medical directives.
Methods: Data collection was conducted from February 1 to April 1, 2024, with the study concluding on April 24, 2024. ACP was facilitated through an initial standardized six-question pre-intervention survey in both English and Spanish.
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