Views of Psychologists About Their Role in Hastened Death

2021 ◽  
pp. 003022282110451
Author(s):  
Sílvia Marina ◽  
Tony Wainwright ◽  
Miguel Ricou
Keyword(s):  
Terminal Illness ◽  
Active Role ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Psychological Practice ◽  
Open Questions ◽  
Patient Decision ◽  
Life Issues ◽  
Hastened Death ◽  
End Of Life Issues

Hastened death practices are legal in several countries. Psychologists are increasingly taking a more active role in end-of-life issues, but the role of psychologists in requests to hasten death is not established. This study aims to contribute guidance for psychological practice in the context of requests to hasten death. We conducted a cross-sectional and cross-cultural study with Psychologists from Portugal and Luxembourg who answer closed and open questions to provide views about their role in hastened death. Psychological assessment, psychological support to patient and family, the exploration of patient decision-making and reorientation of patients were viewed as roles for psychologists. However, these roles may differ depending whether the patient has a terminal or non-terminal illness.

scholarly journals A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Information ◽  
Health Professionals ◽  
Online Health Information ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Health Care Practitioners ◽  
Patient Decision ◽  
Decision Making Styles

BACKGROUND Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. OBJECTIVE This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. METHODS We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample <italic>t</italic> tests. RESULTS Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). CONCLUSIONS The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.

scholarly journals Public awareness of palliative care in Sweden

2018 ◽  
Vol 46 (4) ◽  
pp. 478-487 ◽  
Author(s):  
Caroline Westerlund ◽  
Carol Tishelman ◽  
Inger Benkel ◽  
Carl Johan Fürst ◽  
Ulla Molander ◽  
...  
Keyword(s):  
Palliative Care ◽  
Public Awareness ◽  
Population Sample ◽  
Healthcare Setting ◽  
Swedish Population ◽  
Lack Of Information ◽  
Open Questions ◽  
Life Issues ◽  
The Media ◽  
End Of Life Issues

Objective: The aim of this study was to investigate the awareness of palliative care (PC) in a general Swedish population. Design: We developed an e-survey based on a similar study conducted in Northern Ireland, consisting of 10 questions. Closed questions were primarily analyzed using descriptive statistics. Open questions were subject to inductive qualitative analysis. Subjects: The study utilized a population sample of 7684 persons aged 18–66, of which 2020 responded, stratified by gender, age and region. Results: Most participants reported ‘no’ ( n = 827, 41%) or ‘some’ ( n = 863, 43%) awareness of PC. Being female or older were associated with higher levels of awareness, as was a university-level education, working in a healthcare setting and having a friend or family member receiving PC. Most common sources of knowledge were the media, close friends and relatives receiving PC, as well as working in a healthcare setting. Aims of PC were most frequently identified as ‘care before death’, ‘pain relief’, ‘dignity’ and a ‘peaceful death’. The preferred place of care and death was one’s own home. The main barriers to raising awareness about PC were fear, shame and taboo, along with perceived lack of information and/or personal relevance. The term ‘palliative care’ was said to be unfamiliar by many. A number of strategies to enhance awareness and access to PC were suggested, largely reflecting the previously identified barriers. Conclusions: This survey found limited awareness of palliative care in an adult sample of the Swedish general public ≤ 66 years, and points to a more widespread disempowerment surrounding end-of-life issues.

Unmet needs of caregivers of severely affected multiple sclerosis patients: A qualitative study

2015 ◽  
Vol 13 (6) ◽  
pp. 1685-1693 ◽  
Author(s):  
Heidrun Golla ◽  
Stephanie Mammeas ◽  
Maren Galushko ◽  
Holger Pfaff ◽  
Raymond Voltz
Keyword(s):  
Multiple Sclerosis ◽  
Palliative Care ◽  
End Of Life ◽  
Unmet Needs ◽  
Qualitative Content Analysis ◽  
Self Care ◽  
Cross Sectional ◽  
Life Issues ◽  
End Of Life Issues ◽  
Multiple Sclerosis Patients

ABSTRACTObjective:Multiple sclerosis (MS) patients' caregivers are sometimes considered as “hidden patients.” How much more this might be true for caregivers of severely affected MS patients has so far been scarcely studied. Palliative care also addressing relatives' needs might therefore be very relevant for these caregivers. However, we do not yet know which unmet needs they have and how these could be met. Our aim was to gain an insight into the subjectively unmet needs of caregivers of severely affected MS patients in Germany.Method:The study employed a qualitative cross-sectional approach for assessing unmet needs. Twelve caregivers of severely affected MS patients were recruited using a convenience sampling approach. Face-to-face interviews were conducted, audiotaped, and transcribed verbatim, followed by qualitative content analysis.Results:Unmet needs were sorted into the following categories: “relationship to physician,” “individual support by the healthcare system,” “relationship to the individual severely affected by MS,” “end-of-life issues,” “self-care,” and “higher awareness of MS.” Caregivers tended to group the unmet needs of their care recipients with their own and rarely focused on their own wishes and restrictions.Significance of Results:A close patient–caregiver dyad makes it difficult to differentiate unmet caregiver needs. However, the palliative care approach might help caregivers of severely affected MS patients by answering questions on disease progress and end-of-life issues, as well as by offering respite care, support for self-care, and help in preserving one's identity, and also anticipating the time to come after the death.

scholarly journals A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study

10.2196/15332 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e15332 ◽  
Author(s):  
Mary Anne FitzPatrick ◽  
Alexandra Claudia Hess ◽  
Lynn Sudbury-Riley ◽  
Peter Johannes Schulz
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Information ◽  
Health Professionals ◽  
Online Health Information ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Health Care Practitioners ◽  
Patient Decision ◽  
Decision Making Styles

Background Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. Objective This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. Methods We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample t tests. Results Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). Conclusions The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.

scholarly journals Self-Assessment of Medical Interns on Their Ability to Management of Inpatients in the Internal Department at Shahid Sadoughi University of Medical Sciences

2021 ◽  
Author(s):  
M Mirzadeh ◽  
H Soleymani-Salehabadi ◽  
M Akhondi-Meybodi
Keyword(s):  
Clinical Skills ◽  
Medical Professional ◽  
Validity And Reliability ◽  
Self Assessment ◽  
Chi Square ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Chi Square Test ◽  
Medical Interns

Introduction: Knowledge of medical students is usually assessed by exams, but it is not related to their sense of readiness. Self-assessment is one of the methods for measuring medical professional readiness that has been less considered in medical education. This study aimed to determine the degree of acquisition of professional skills of medical interns in the management of inpatients through self-assessment in the internal ward. Methods: In this cross-sectional descriptive study, 115 selected medical interns of Shahid Sadoughi Medical School in Yazd participated by census in 2017. Ability to manage internal diseases was assessed by self-reported. The internist experts confirmed questionnaire validity and reliability (Cronbach's alpha: 0.76-0.93). Data were analyzed using descriptive statistics and chi-square test by SPSS. Result: The highest expressed ability by interns was for management of gastrointestinal (63.9%), respiratory (62.3%), and cardiovascular disease (56.1%). They had the lowest ability for endocrine diseases (49.8%). The highest ability to manage gastrointestinal bleeding (65.8%), chest pain (64.3%), abdominal pain and reflux (62.5%), nausea/vomiting (61.6%), and diabetes (61.4%) was stated. 94.7% have sufficient skills to take a history and 85.6% follow medical ethics. The least expressed ability was in drug prescribing and patient decision-making. Conclusion: In 23% of common diseases, 50% of interns can manage disorders independently, which indicates that interns do not consider themselves capable of managing them. The professors must consider Self-assessment and evaluation in prioritizing internship training topics, especially clinical skills.

scholarly journals Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent

10.2196/14436 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14436 ◽  
Author(s):  
Cody Lendon Mullens ◽  
J Andres Hernandez ◽  
Evan D Anderson ◽  
Lindsay Allen
Keyword(s):  
Educational Materials ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Pennsylvania Hospital ◽  
The Mean ◽  
Machine Readable ◽  
Sectional Analysis ◽  
Readable Format ◽  
Machine Readable Format

Background The Centers for Medicare and Medicaid Services (CMS) recently mandated that all hospitals publish their charge description masters (CDMs) online, in a machine-readable format, by January 1, 2019. In addition, CMS recommended that CDM data be made available in a manner that was consumer friendly and accessible to patients. Objective This study aimed to (1) examine all hospitals across the state of Pennsylvania to understand policy compliance and (2) use established metrics to measure accessibility and consumer friendliness of posted CDM data. Methods A cross-sectional analysis was conducted to quantify hospital website compliance with the recent CMS policies requiring hospitals to publish their CDM. Data were collected from all Pennsylvania hospital websites. Consumer friendliness was assessed based on searchability, number of website clicks to data, and supplemental educational materials accompanying CDMs such as videos or text. Results Most hospitals (189/234, 80.1%) were compliant, but significant variation in data presentation was observed. The mean number of website clicks to the CDM was 3.7 (SD 1.3; range: 1-8). A total of 23.1% of compliant hospitals provided no supplemental educational material with their CDM. Conclusions Although disclosure of charges has improved, the data may not be sufficient to meaningfully influence patient decision making.

scholarly journals Concordance between Experiences of Bereaved Relatives, Physicians, and Nurses with Hospital End-of-Life Care: Everyone Has Their “Own Truth”

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
F. E. Witkamp ◽  
L. van Zuylen ◽  
Y. Vergouwe ◽  
C. C. D. van der Rijt ◽  
A. van der Heide
Keyword(s):  
End Of Life ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Quality Of Dying ◽  
Impending Death ◽  
Life Issues ◽  
End Of Life Issues ◽  
End Of Life Communication

When patients die relatives and healthcare professionals may appreciate the quality of the dying phase differently, but comparisons are rare. In a cross-sectional study (June 2009–July 2012) the experiences of bereaved relatives, physicians, and nurses concerning the quality of dying in a large Dutch university hospital were compared, and the relation to communication was explored. Measurements were concordance on the quality of dying (QOD) (0–10 scale), awareness of impending death, and end-of-life communication. Results. Data on all three perspectives were available for 200 patients. Concordance in general was poor. Relatives’ scores for QOD (median 7; IQR 5–8) were lower than physicians and nurses’ (both median 7; IQR 6–8) (P=0.002). 48% of the relatives, 77% of the physicians, and 73% of the nurses had been aware of impending death. Physicians more often reported to have informed patients and relatives of end-of-life issues than relatives reported. When both physicians and relatives reported about such discussion, relatives’ awareness of impending death and presence at the patient’s deathbed were more likely. Conclusion. Relatives, physicians, and nurses seem to have their “own truth” about the dying phase. Professionals should put more emphasis on the collaboration with relatives and on verification of relative’s understanding.

scholarly journals Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent (Preprint)

2019 ◽  
Author(s):  
Cody Lendon Mullens ◽  
J Andres Hernandez ◽  
Evan D Anderson ◽  
Lindsay Allen
Keyword(s):  
Educational Materials ◽  
Cross Sectional ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Pennsylvania Hospital ◽  
The Mean ◽  
Machine Readable ◽  
Sectional Analysis ◽  
Readable Format ◽  
Machine Readable Format

BACKGROUND The Centers for Medicare and Medicaid Services (CMS) recently mandated that all hospitals publish their charge description masters (CDMs) online, in a machine-readable format, by January 1, 2019. In addition, CMS recommended that CDM data be made available in a manner that was consumer friendly and accessible to patients. OBJECTIVE This study aimed to (1) examine all hospitals across the state of Pennsylvania to understand policy compliance and (2) use established metrics to measure accessibility and consumer friendliness of posted CDM data. METHODS A cross-sectional analysis was conducted to quantify hospital website compliance with the recent CMS policies requiring hospitals to publish their CDM. Data were collected from all Pennsylvania hospital websites. Consumer friendliness was assessed based on searchability, number of website clicks to data, and supplemental educational materials accompanying CDMs such as videos or text. RESULTS Most hospitals (189/234, 80.1%) were compliant, but significant variation in data presentation was observed. The mean number of website clicks to the CDM was 3.7 (SD 1.3; range: 1-8). A total of 23.1% of compliant hospitals provided no supplemental educational material with their CDM. CONCLUSIONS Although disclosure of charges has improved, the data may not be sufficient to meaningfully influence patient decision making.

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