Prognostic decision-making about imminent death within multidisciplinary teams: a scoping review

被引:7
作者
Bruun, Andrea [1 ]
Oostendorp, Linda [1 ]
Bloch, Steven [2 ]
White, Nicola [1 ]
Mitchinson, Lucy [1 ]
Sisk, Ali-Rose [1 ]
Stone, Patrick [1 ]
机构
[1] UCL, Div Psychiat, Marie Curie Palliat Care Res Dept, London, England
[2] UCL, Div Psychol & Language Sci, Dept Language & Cognit, London, England
来源
BMJ OPEN | 2022年 / 12卷 / 04期
关键词
adult palliative care; organisation of health services; health services administration & management; palliative care; OF-LIFE CARE; SPECIALIST PALLIATIVE CARE; TERMINALLY-ILL PATIENTS; CANCER-PATIENTS; INFORMATION NEEDS; DYING PATIENTS; NURSING-HOMES; END; PATHWAY; NURSES;
D O I
10.1136/bmjopen-2021-057194
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To summarise evidence on how multidisciplinary team (MDTs) make decisions about identification of imminently dying patients. Design Scoping review. Setting Any clinical setting providing care for imminently dying patients, excluding studies conducted solely in acute care settings. Data sources The databases AMED, CINAHL, Embase, MEDLINE, PsychINFO and Web of Science were searched from inception to May 2021. Included studies presented original study data written in English and reported on the process or content of MDT discussions about identifying imminently dying adult patients. Results 40 studies were included in the review. Studies were primarily conducted using interviews and qualitative analysis of themes. MDT members involved in decision-making were usually doctors and nurses. Some decisions focused on professionals recognising that patients were dying, other decisions focused on initiating specific end-of-life care pathways or clarifying care goals. Most decisions provided evidence for a partial collaborative approach, with information-sharing being more common than joint decision-making. Issues with decision-making included disagreement between staff members and the fact that doctors were often regarded as final or sole decision-makers. Conclusions Prognostic decision-making was often not the main focus of included studies. Based on review findings, research explicitly focusing on MDT prognostication by analysing team discussions is needed. The role of allied and other types of healthcare professionals in prognostication needs further investigation as well. A focus on specialist palliative care settings is also necessary.
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页数:18
相关论文
共 90 条
[1]   Nurses' involvement in end-of-life care of patients after a do not resuscitate decision on general medical units in Saudi Arabia [J].
Abu-Ghori, Ibrahim K. ;
Bodrick, Mustafa M. E. ;
Hussain, Rafat ;
Rassool, G. Hussein .
INTENSIVE AND CRITICAL CARE NURSING, 2016, 33 :21-29
[2]   The information needs of partners and family members of cancer patients: A systematic literature review [J].
Adams, Eike ;
Boulton, Mary ;
Watson, Eila .
PATIENT EDUCATION AND COUNSELING, 2009, 77 (02) :179-186
[3]   Care professional's experiences about using Liverpool Care Pathway in end-of-life care in residential care homes [J].
Andersson, Sofia ;
Lindqvist, Olav ;
Furst, Carl-Johan ;
Brannstrom, Margareta .
SCANDINAVIAN JOURNAL OF CARING SCIENCES, 2018, 32 (01) :299-308
[4]  
[Anonymous], 2009, EUROPEAN J PALLIATIV, V16, P278
[5]   Team meetings in specialist palliative care: Asking questions as a strategy within interprofessional interaction [J].
Arber, Anne .
QUALITATIVE HEALTH RESEARCH, 2008, 18 (10) :1323-1335
[6]  
Arksey H., 2005, INT J SOC RES METHOD, V8, P19, DOI 10.1080/1364557032000119616
[7]   'Scoping the scope' of a cochrane review [J].
Armstrong, Rebecca ;
Hall, Belinda J. ;
Doyle, Jodie ;
Waters, Elizabeth .
JOURNAL OF PUBLIC HEALTH, 2011, 33 (01) :147-150
[8]  
Bern-Klug Mercedes, 2004, J Palliat Med, V7, P533, DOI 10.1089/jpm.2004.7.533
[9]   End-of-life care for older people in subacute care: A retrospective clinical audit [J].
Bloomer, Melissa J. ;
Botti, Mari ;
Runacres, Fiona ;
Poon, Peter ;
Barnfield, Jakqui ;
Hutchinson, Alison M. .
COLLEGIAN, 2019, 26 (01) :22-27
[10]   Communicating end-of-life care goals and decision-making among a multidisciplinary geriatric inpatient rehabilitation team: A qualitative descriptive study [J].
Bloomer, Melissa J. ;
Botti, Mari ;
Runacres, Fiona ;
Poon, Peter ;
Barnfield, Jakqui ;
Hutchinson, Alison M. .
PALLIATIVE MEDICINE, 2018, 32 (10) :1615-1623