Paramedics experiences and expectations concerning advance directives: A prospective, questionnaire-based, bi-centre study
| Autor: | T.W. Klier, Christoph H. R. Wiese, Stefan Kappus, Gerd G Hanekop, N. Meyer, Bernhard M. Graf, C.L. Lassen, D. Ruppert, Mahmoud Taghavi, Alfred Simon |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Resuscitation Health Knowledge Attitudes Practice Palliative care Attitude of Health Personnel prehospital emergency care media_common.quotation_subject medicine.medical_treatment MEDLINE Allied Health Personnel 610 Medizin Advance directives 03 medical and health sciences Young Adult 0302 clinical medicine Germany Surveys and Questionnaires Medicine Humans 030212 general & internal medicine Cardiopulmonary resuscitation Prospective Studies media_common Response rate (survey) Analysis of Variance Terminal Care ddc:610 palliative care business.industry 030208 emergency & critical care medicine General Medicine Middle Aged medicine.disease Emergency situations Cardiopulmonary Resuscitation Anesthesiology and Pain Medicine Female Medical emergency paramedics business Advance Directives Autonomy Prehospital Emergency Care |
| Popis: | Background: Advance directives and palliative crisis cards are means by which palliative care patients can exert their autonomy in end-of-life decisions. Aim: To examine paramedics’ attitudes towards advance directives and end-of-life care. Design: Questionnaire-based investigation using a self-administered survey instrument. Setting/participants: Paramedics of two cities (Hamburg and Goettingen, Germany) were included. Participants were questioned as to (1) their attitudes about advance directives, (2) their clinical experiences in connection with end-of-life situations (e.g. resuscitation), (3) their suggestions in regard to advance directives, ‘Do not attempt resuscitation’ orders and palliative crisis cards. Results: Questionnaires were returned by 728 paramedics (response rate: 81%). The majority of paramedics (71%) had dealt with advance directives and end-of-life decisions in emergency situations. Most participants (84%) found that cardiopulmonary resuscitation in end-of-life patients is not useful and 75% stated that they would withhold cardiopulmonary resuscitation in the case of legal possibility. Participants also mentioned that more extensive discussion of legal aspects concerning advance directives should be included in paramedic training curricula. They suggested that palliative crisis cards should be integrated into end-of-life care. Conclusions: Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics. |
| Databáze: | OpenAIRE |
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