Academic Journal
Life‐Sustaining Treatment Decision in Palliative Care Based on Electronic Health Records Analysis
| Title: | Life‐Sustaining Treatment Decision in Palliative Care Based on Electronic Health Records Analysis |
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| Authors: | Sanghee Kim, Arum Lim, Hyoeun Jang, Misun Jeon |
| Contributors: | Sanghee Kim, Arum Lim, Hyoeun Jang, Misun Jeon, Kim, Sang Hee |
| Source: | J Clin Nurs |
| Publisher Information: | Wiley, 2022. |
| Publication Year: | 2022 |
| Subject Terms: | Adult, Terminal Care, Palliative Care, Decision Making, decision-making, Original Articles, life-sustaining treatment, 3. Good health, terminal care, 03 medical and health sciences, 0302 clinical medicine, Terminal Care* / methods, Hospice and Palliative Care Nursing, Humans, Electronic Health Records, 0305 other medical science, Retrospective Studies |
| Description: | Aims and objectivesThis study sought to explore the present status of life‐sustaining treatment decisions in a tertiary hospital to improve the life‐sustaining treatment decision‐making process.BackgroundLife‐sustaining treatment decisions are crucial for palliative care because they encompass decisions to withdraw treatments when patients cannot articulate their values and preferences. However, surrogate decisions have settled many life‐sustaining treatment cases in South Korea, and this trend is prevalent.DesignWe conducted a retrospective, descriptive study employing a review of electronic health records.MethodsWe extracted and analysed electronic health records of a tertiary hospital. Our inclusion criteria included adult patients who completed life‐sustaining treatment forms in 2019. A total of 2,721 patients were included in the analysis. We analysed the decision‐maker, the timing of the decision, and patients’ health status a week before the decision. We followed the STROBE checklist.ResultsAmong 1,429 deceased patients, those whose families had made life‐sustaining treatment decisions totalled 1,028 (70.6%). The median interval between life‐sustaining treatment documentation completion to death was three days, more specifically, two days in the family decision group and 5.5 days in the patient decision group. As the decision day neared, there were marked changes in patients’ vital signs and laboratory test results, and the need for nursing care increased.ConclusionsLife‐sustaining treatment decisions were made when death was imminent, suggesting that the time required to discuss end‐of‐life care was generally insufficient among patients, family, and healthcare professionals in Korea.Relevance to clinical practiceMonitoring changes in laboratory test results and symptoms could help screen the patients who need the life‐sustaining treatment discussion. As improving the quality of death is imperative in palliative care, institutional efforts, such as clinical ethics support services, are necessary to improve the life‐sustaining treatment decision‐making process for patients, families, and healthcare providers. |
| Document Type: | Article Other literature type |
| Language: | English |
| ISSN: | 1365-2702 0962-1067 |
| DOI: | 10.1111/jocn.16206 |
| Access URL: | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jocn.16206 https://pubmed.ncbi.nlm.nih.gov/35023248 |
| Rights: | CC BY NC ND URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
| Accession Number: | edsair.doi.dedup.....bda786dbc36e40f8a6b050a2b116724d |
| Database: | OpenAIRE |
| ISSN: | 13652702 09621067 |
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| DOI: | 10.1111/jocn.16206 |