Objective:: to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.
Method:: qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.
Results:: the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.
Conclusion:: limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.
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http://dx.doi.org/10.1590/0034-7167-2016-0085 | DOI Listing |
JAMA Netw Open
January 2025
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina.
Importance: Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated.
Objective: To compare the effects of geriatrics-focused primary care vs traditional primary care for older patients in the Veterans Affairs (VA) health care system.
Design, Setting, And Participants: In this cohort study, geriatrics-focused primary care and traditional primary care patient dyads matched on variables associated with geriatrics-focused primary care entry and outcomes were enrolled from VA medical centers with operational geriatrics-focused primary care clinics serving 500 or more patients annually in fiscal year 2016.
J Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
➢ Advanced care planning most commonly refers to the act of planning and preparing for decisions with regard to end-of-life care and/or serious illness based on a patient's personal values, life goals, and preferences.➢ Over time, advanced care planning and its formalization through advanced directives have demonstrated substantial benefits to patients, their families and caregivers, and the larger health-care system.➢ Despite these benefits, advanced care planning and advanced directives remain underutilized.
View Article and Find Full Text PDFBMJ Support Palliat Care
December 2024
National Children's Bureau, London, UK.
Background: Efforts to minimise inequity in palliative and end-of-life care (PEoLC) are well-researched. This is frequently explained by differences related to singular factors. The concept of intersectionality recognises that the combination of variables exacerbates disparities.
View Article and Find Full Text PDFJ Am Geriatr Soc
January 2025
Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands.
Background: To ensure appropriate care for the individual older adult, an ideal treatment should align with patients' values. However, healthcare professionals struggle with how to elucidate patient values effectively. To offer guidance to healthcare professionals, we performed a scoping review, thereby mapping and categorizing instruments specifically developed to elucidate values of older adults in clinical practice.
View Article and Find Full Text PDFBMC 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 PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!