Patients' Autonomy at the End of Life: A Critical Review
| Autor: | Martin Loucka, Adam Houska |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
education.field_of_study
Palliative care Activities of daily living business.industry media_common.quotation_subject Population MEDLINE Context (language use) CINAHL PsycINFO 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Nursing 030220 oncology & carcinogenesis Medicine 030212 general & internal medicine Neurology (clinical) education business General Nursing Autonomy media_common |
| Zdroj: | Journal of Pain and Symptom Management. 57:835-845 |
| ISSN: | 0885-3924 |
| Popis: | Context The predominating definition of autonomy as a capacity to make an independent rational choice may not be suitable for patients in palliative care. Therefrom arises the actual need for more contextualized perspectives on autonomy to promote the quality of life and satisfaction with care of terminally ill patients. Objectives This review aimed to develop a theoretical structural model of autonomy at the end of life based on patients' end-of-life care preferences. Methods In this review, we used systematic strategy to integrate and synthesize findings from both qualitative and quantitative studies investigating patients' view on what is important at the end of life and which factors are related to autonomy. A systematic search of EMBASE (OVID), MEDLINE (OVID), Academic Search Complete (EBSCO), CINAHL (EBSCO), and PsycINFO (EBSCO) was conducted for studies published between 1990 and December 2015 providing primary data from patients with advanced disease. Results Of the 5540 articles surveyed, 19 qualitative and eight quantitative studies met the inclusion criteria. We identified two core structural domains of autonomy: 1) being normal and 2) taking charge. By analyzing these domains, we described eight and 13 elements, respectively, which map the conceptual structure of autonomy within this population of patients. Conclusion The review shows that maintaining autonomy at the end of life is not only a concern of making choices and decisions about treatment and care but that emphasis should be also put on supporting the patients' engagement in daily activities, in contributing to others, and in active preparation for dying. |
| Databáze: | OpenAIRE |
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