Background: Informing families of a patient's death is one of the most challenging responsibilities of clinicians who provide care for terminally ill patients. Although death pronouncement can be a highly stressful event for clinicians, no previous study has reported qualitative characteristics of the burden experienced by clinicians related to death pronouncements. Moreover, no scale has been developed to assess this burden.
Objective: This study sought to develop a scale to evaluate clinicians' burden related to death pronouncement (Death Pronouncement Burden Scale for oncology practice [DPBS-oncol]) and examine its reliability and validity in Japan.
Methods: We presented the DPBS-oncol to clinicians involved in oncology practice and examined its reliability and discriminant validity. To investigate the test-retest reliability of the scale, the DPBS-oncol was presented a second time to a subsample of the clinicians.
Results: Factor analysis required a grouping of the 15 DPBS-oncol items into one factor. Cronbach's α coefficient of the total score of DPBS-oncol was 0.94, and the intraclass correlation coefficient of the total score of DPBS-oncol was 0.89. Regarding discriminant validity, DPBS-oncol total score was moderately correlated with other available scales for assessing clinicians' attitudes to end-of-life care.
Conclusion: This study was the first to develop a scale to evaluate clinicians' burden related to death pronouncement. The DPBS-oncol, which includes 15 items, was validated and shown to have sufficient reliability.
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http://dx.doi.org/10.1089/pmr.2021.0082 | DOI Listing |
Sud Med Ekspert
December 2024
National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Moscow, Russia.
The study aimed to analyze the literature data on postmortem changes in the brain and their use to determine the time since death. The earliest manifestations of brain cell autolysis are detected by electron microscopy (15-20 minutes after death). The longer the postmortem period, the more morphofunctional changes in the brain are revealed by histological, histochemical, and immunohistochemical studies.
View Article and Find Full Text PDFEuroIntervention
October 2024
Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Cardiogenic shock (CS) is a devastating and fatal complication of acute myocardial infarction (AMI). CS can affect the pharmacokinetics and pharmacodynamics of medications. The unique properties of cangrelor make it the optimal P2Y12 inhibitor for CS-AMI, in terms of both efficacy and safety.
View Article and Find Full Text PDFGeriatr Gerontol Int
November 2024
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
We aimed to synthesize existing research to elucidate the underlying factors and causes responsible for the high prevalence of unwanted cardiopulmonary resuscitation (CPR) occurring outside a hospital setting in Japan despite patients' Do Not Attempt Resuscitation (DNAR) orders. We conducted a narrative review by searching PubMed, EMBASE, and Scopus for English literature, and Google Scholar for Japanese literature. The key factors we identified included lack of documentation of resuscitation preferences, variation in the perception of other life-sustaining measures associated with DNAR, non-inclusion of the patient in discussions of goals of care, unlegislated and unstandardized DNAR orders, emergency medical service activation by the family or facility, the Fire Service Act that mandates life-saving measures irrespective of the presence of advance directives, fire department protocols and CPR decision-making, and death pronouncement authorization limited to physicians.
View Article and Find Full Text PDFCirculation
November 2024
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany (D.V., L.L., M.B., F.M.).
Stroke
November 2024
Department of Vascular Surgery (G.J.B.), University Medical Center Utrecht, Utrecht University, the Netherlands.
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