Evidence map›Paper›PMID 35148663›Full record

ArticleScandinavian journal of primary health care2022

Decision-making conversations for life-sustaining treatment with seriously ill patients using a Danish version of the US POLST: a qualitative study of patient and physician experiences.

Lone Doris Tuesen, Anne Sophie Ågård, Hans-Henrik Bülow, Erik K Fromme, Hanne Irene Jensen

Abstract read
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Article in Scandinavian journal of primary health care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

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0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Lone Doris TuesenDepartment of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, University Hospital of Southern Denmark, Vejle, Denmark.
Anne Sophie ÅgårdDepartment of Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Hans-Henrik BülowDepartment of Anaesthesiology and Intensive Care, Holbaek Hospital, Holbaek, Denmark.
Erik K FrommeAriadne Labs, A Joint Center for Health Systems Innovation at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Hanne Irene JensenDepartment of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, University Hospital of Southern Denmark, Vejle, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore patients' and physicians' perspectives on a decision-making conversation for life-sustaining treatment, based on the Danish model of the American Physician Orders for Life Sustaining Treatment (POLST) form.

designSemi-structured interviews following a conversation about preferences for life-sustaining treatment.

settingDanish hospitals, nursing homes, and general practitioners' clinics. SUBJECTS: Patients and physicians.

main outcome measuresQualitative analyses of interview data.

findingsAfter participating in a conversation about life-sustaining treatment using the Danish POLST form, a total of six patients and five physicians representing different settings and age groups participated in an interview about their experience of the process. Within the main research questions, six subthemes were identified: Timing, relatives are key persons, clarifying treatment preferences, documentation across settings, strengthening patient autonomy, and structure influences conversations. Most patients and physicians found having a conversation about levels of life-sustaining treatment valuable but also complicated due to the different levels of knowledge and attending to individual patient needs and medical necessities. Relatives were considered as key persons to ensure the understanding of the treatment trajectory and the ability to advocate for the patient in case of a medical crisis. The majority of participants found that the conversation strengthened patient autonomy.

conclusionPatients and physicians found having a conversation about levels of life-sustaining treatment valuable, especially for strengthening patient autonomy. Relatives were considered key persons. The timing of the conversation and securing sufficient knowledge for shared decision-making were the main perceived challenges.KEY POINTSConversations about preferences for life-sustaining treatment are important, but not performed systematically.When planning a conversation about preferences for life-sustaining treatment, the timing of the conversation and the inclusion of relatives are key elements.Decision-making conversations can help patients feel in charge and less alone, and make it easier for health professionals to provide goal-concordant care.Using a model like the Danish POLST form may help to initiate, conduct and structure conversations about preferences for life-sustaining treatment.

Indexed as

Advance Care PlanningPhysiciansTerminal CareDecision MakingDenmarkHumansNursing HomesPatient PreferencePhysician-Patient Relationsend-of-lifeinterviewslife-sustaining treatmentqualitative studyShared decision-making

Identifiers

PMID35148663
PMCPMC9090401

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.