Factors Influencing Potentially Futile Treatments at the End of Life in a Multiethnic Asian Cardiology Setting: A Qualitative Study.
| Autor: | Lo JJ; Saw Swee Hock School of Public Health, 37580National University of Singapore, Singapore, Singapore., Yoon S; Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore, Singapore., Neo SHS; Division of Supportive and Palliative Care, 68751National Cancer Centre Singapore, Singapore, Singapore., Sim DKL; 568577National Heart Centre Singapore, Singapore, Singapore., Graves N; Health Services and Systems Research, 121579Duke-NUS Medical School, Singapore, Singapore. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2022 Sep; Vol. 39 (9), pp. 1005-1013. Date of Electronic Publication: 2021 Dec 08. |
| DOI: | 10.1177/10499091211053624 |
| Abstrakt: | Background: Modern medicine enables clinicians to save lives and prolong time to death, yet some treatments have little chance of conferring meaningful benefits for patients nearing the end-of-life. What clinicians perceive as driving futile treatment in the non-Western healthcare context is poorly understood. Aim: This study aimed to explore clinicians' perceptions of the factors that influence futile treatment at the end of life within a tertiary hospital cardiac care setting. Design: We conducted semi-structured interviews with cardiologists, cardiac surgeons, and palliative care doctors from a large national cardiology center in Singapore. Interviews were transcribed verbatim and thematically analyzed. Results: A total of 32 clinicians were interviewed. We identified factors that contributed to the provision of potentially futile treatment in these theme areas: patient- and family-related, clinician-related, and institutional and societal factors. Family roles and cultural influences were most commonly cited by participants as affecting end-of-life decisions and altering the likelihood of futile treatment. Specialty-specific alignments within cardiology and availability of healthcare resources were also important factors underpinning futile treatment. Conclusion: Family-related factors were a primary driver for futile treatment in a non-Western, multicultural setting. Future interventions should consider a targeted approach accounting for cultural and contextual factors to prevent and reduce futile treatment. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|