ArticleBMC palliative care2021
Physicians' decreased tendency to choose palliative care for patients with advanced dementia between 1999 and 2015.
Article in BMC palliative care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Physician-Related Gaps in Hospice Referral for Patients with Advanced Dementia.Clinical interventions in aging · 2025Article
- Does the role of family meetings important at the end-of-life? A retrospective national study in Taiwan.BMC palliative care · 2024Observational
- What care do people with dementia receive at the end of life? Lessons from a retrospective clinical audit of deaths in hospital and other settings.BMC geriatrics · 2024Article
- Cognitive biases and moral characteristics of healthcare workers and their treatment approach for persons with advanced dementia in acute care settings.Frontiers in medicine · 2023Article
- Do Perceptions about Palliative Care Affect Emergency Decisions of Health Personnel for Patients with Advanced Dementia?International journal of environmental research and public health · 2022Article
- Knowledge and Attitudes towards Palliative Care: Validation of the Spanish Version of Questionnaire on Palliative Care for Advanced Dementia.Healthcare (Basel, Switzerland) · 2022Article
- Needs and expectations of family caregivers of cancer patients in palliative care: A study protocol.Frontiers in psychology · 2022Article
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5 authors.
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Abstract
backgroundPhysicians' decision-making for seriously ill patients with advanced dementia is of high importance, especially as the prevalence of dementia is rising rapidly, and includes many challenging ethical, medical and juridical aspects. We assessed the change in this decision-making over 16 years (from 1999 to 2015) and several background factors influencing physicians' decision.
methodsA postal survey including a hypothetical patient-scenario representing a patient with an advanced dementia and a life-threatening gastrointestinal bleeding was sent to 1182 and 1258 Finnish physicians in 1999 and 2015, respectively. The target groups were general practitioners (GPs), surgeons, internists and oncologists. The respondents were asked to choose between several life-prolonging and palliative care approaches. The influence of physicians' background factors and attitudes on their decision were assessed.
resultsThe response rate was 56%. A palliative care approach was chosen by 57 and 50% of the physicians in 1999 and 2015, respectively (p = 0.01). This change was statistically significant among GPs (50 vs 40%, p = 0.018) and oncologists (77 vs 56%, p = 0.011). GPs chose a palliative care approach less often than other responders in both years (50 vs. 63% in 1999 and 40 vs. 56% in 2015, p < 0.001). In logistic regression analysis, responding in 2015 and being a GP remained explanatory factors for a lower tendency to choose palliative care. The impact of family's benefit on the decision-making decreased, whereas the influence of the patient's benefit and ethical values as well as the patient's or physician's legal protection increased from 1999 to 2015.
conclusionsPhysicians chose a palliative care approach for a patient with advanced dementia and life-threatening bleeding less often in 2015 than in 1999. Specialty, attitudes and other background factors influenced significantly physician decision-making. Education on the identification and palliative care of the patients with late-stage dementia are needed to make these decisions more consistent.
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