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Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?

Background  The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients’ autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance...

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Autores principales: Klemmt, Malte, Neuderth, Silke, van Oorschot, Birgitt, Henking, Tanja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8514265/
https://www.ncbi.nlm.nih.gov/pubmed/34544195
http://dx.doi.org/10.1055/a-1576-6894
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author Klemmt, Malte
Neuderth, Silke
van Oorschot, Birgitt
Henking, Tanja
author_facet Klemmt, Malte
Neuderth, Silke
van Oorschot, Birgitt
Henking, Tanja
author_sort Klemmt, Malte
collection PubMed
description Background  The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients’ autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance for nursing home residents, not only against the background of the COVID-19 pandemic. Methods  We conducted a survey of all resident-documents in 13 nursing homes of different sizes and service providers in the city and district of Wuerzburg. The documents were analysed according to a deductive-inductive procedure using categorical summaries and descriptive frequency counts. Results  In 265 recorded living wills, 2072 treatment situations and 1673 treatment measures could be identified. Residents largely agree to symptom-relieving and nursing measures and often reject life-prolonging or life-substaining treatment measures, the latter mostly being limited to specific, defined situations. The reference to certain treatment situations regarding resuscitation attempts, both in the form of refusal and consent, was identified in 88.6 % of the living wills. 62 % of the living wills could be assigned to a template. Discussion  The study provides information about the content of living wills of nursing home residents. It thus provides information on medical treatment preferences in the case of incapacity to consent and shows that treatment measures (including resuscitation) are mostly related to specific treatment situations.
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spelling pubmed-85142652021-10-15 Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt? Klemmt, Malte Neuderth, Silke van Oorschot, Birgitt Henking, Tanja Dtsch Med Wochenschr Background  The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients’ autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance for nursing home residents, not only against the background of the COVID-19 pandemic. Methods  We conducted a survey of all resident-documents in 13 nursing homes of different sizes and service providers in the city and district of Wuerzburg. The documents were analysed according to a deductive-inductive procedure using categorical summaries and descriptive frequency counts. Results  In 265 recorded living wills, 2072 treatment situations and 1673 treatment measures could be identified. Residents largely agree to symptom-relieving and nursing measures and often reject life-prolonging or life-substaining treatment measures, the latter mostly being limited to specific, defined situations. The reference to certain treatment situations regarding resuscitation attempts, both in the form of refusal and consent, was identified in 88.6 % of the living wills. 62 % of the living wills could be assigned to a template. Discussion  The study provides information about the content of living wills of nursing home residents. It thus provides information on medical treatment preferences in the case of incapacity to consent and shows that treatment measures (including resuscitation) are mostly related to specific treatment situations. Georg Thieme Verlag KG 2021-09-20 /pmc/articles/PMC8514265/ /pubmed/34544195 http://dx.doi.org/10.1055/a-1576-6894 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Klemmt, Malte
Neuderth, Silke
van Oorschot, Birgitt
Henking, Tanja
Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title_full Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title_fullStr Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title_full_unstemmed Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title_short Patientenverfügungen von Bewohnenden in Pflegeeinrichtungen – welche Behandlungssituationen und Behandlungsmaßnahmen werden vorausverfügt?
title_sort patientenverfügungen von bewohnenden in pflegeeinrichtungen – welche behandlungssituationen und behandlungsmaßnahmen werden vorausverfügt?
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8514265/
https://www.ncbi.nlm.nih.gov/pubmed/34544195
http://dx.doi.org/10.1055/a-1576-6894
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