Difficulties Doctors Experience during Life-Sustaining Treatment Discussion after Enactment of the Life-Sustaining Treatment Decisions Act: A Cross-Sectional Study

被引:9
作者
Yoo, Shin Hye [1 ]
Choi, Wonho [1 ]
Kim, Yejin [1 ]
Kim, Min Sun [1 ,2 ]
Park, Hye Yoon [1 ,3 ]
Keam, Bhumsuk [1 ,4 ]
Heo, Dae Seog [1 ,4 ]
机构
[1] Seoul Natl Univ Hosp, Ctr Palliat Care & Clin Eth, 101 Daehak Ro, Seoul 03080, South Korea
[2] Seoul Natl Univ Hosp, Dept Pediat, Seoul, South Korea
[3] Seoul Natl Univ Hosp, Dept Psychiat, Seoul, South Korea
[4] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea
来源
CANCER RESEARCH AND TREATMENT | 2021年 / 53卷 / 02期
关键词
End-of-life care; Terminal cancer; Discussion; Decision making; Life-sustaining treatment; END-OF-LIFE; CANCER-PATIENTS; CARE; COMMUNICATION; ONCOLOGISTS; RESIDENTS; ORDERS; TRUTH;
D O I
10.4143/crt.2020.735
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose This study aimed to investigate difficulties doctors experience during life-sustaining treatment (LST) discussion with seriously ill patients and their families after enactment of the LST Decisions Act in February 2018. Materials and Methods A cross-sectional survey was conducted in a tertiary hospital in the Republic of Korea in August 2019. Six hundred eighty-six doctors who care for seriously ill patients were given a structured questionnaire, and difficulties during the discussion were examined. Results One hundred thirty-two doctors completed the questionnaire. Eighty-five percent answered they treat cancer patients. Most (86.4%) experienced considerable difficulties during LST discussions (mean score, 7.4 +/- 1.6/10). The two most common difficulties were communication with patients and family and determining when to discuss LST. Two-thirds of doctors found direct discussions with the patient difficult and said they would initiate LST discussions only with family. LST discussions were actually initiated later than considered appropriate. When medically assessing whether the patient is imminently dying, 56% of doctors experienced disagreements with other doctors, which could affect their decisions. Conclusion This study found that most doctors experienced serious difficulties regarding communication with patients and family and medical assessment of dying process during LST discussions. To alleviate these difficulties, further institutional support is needed to improve the LST discussion between doctors, patients, and family.
引用
收藏
页码:584 / 592
页数:9
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