Patients' and Healthcare Providers' Understanding of Life Sustaining Treatment : Are Perceptions of Goals Shared or Divergent ?  

Oleh:

Rodriguez, Keri L. ; Young, Amanda J.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 1 (Jan. 2006), page 125-133.
Topik: LIFE; USA; end of life care; life sustaining treatment; advance are planning; health care preferences; qualitative research; veterans

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.1 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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In this cross sectional qualitative study, researchers performed in depth, semistructured interviwes with 30 pairs of patients and their primary care providers in an outpatient clinic of a large, urban veterans affairs (VA) medical center in the united states. During audiotaped interviews to assess their understanding of advance directive concepts, participants were asked what life sustaining treatment means to them and why they think of it in the way they do. The findings indicate that patients and providers in the united states tend to view and discuss lif esustaining treatment in terms of four goals for end of life care : 1. extending the length of life 2. improving the quality of life 3. maintaining or improving specific biological functions, and 4. assisting the body for a temporary period of time. Patients thought providers were more concerned with extending the lenght of life than with quality based outcomes and patients often discussed life sustaining treatment as acceptable the length of life than with quality based outcomes, and patienst often discussed life sustaining treatment as acceptable means for short term but not long term use. Many providers indicated that they struggle with conflicting quality based and physiologic care goals. The findings highlight the importance of elicting patient preferences not only for specific types of treatment, such as cardiopulmonary resucitation, but also for end of life care goals or desired health related outcomes, such as maximizing the quantity of life. The findings also suggest that advance directives and patient provider discussions that focus on acceptable health states and valued life activities may be better suited to patients end of life care goals tha those that focus on specific medical interventions.

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