Cargando…
Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany
PURPOSE: Providing state-of-the-art palliative care is crucial in all areas of in- and outpatient settings. Studies on the implementation of palliative care standards for dying patients are rare. METHODS: N = 141 physicians from all internal departments were polled anonymously about the treatment of...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881441/ https://www.ncbi.nlm.nih.gov/pubmed/33950342 http://dx.doi.org/10.1007/s00432-021-03652-0 |
_version_ | 1784659466237509632 |
---|---|
author | Heerde, Nicole Hofmann, Wolf-Karsten Hofheinz, Ralf-Dieter Büttner, Sylvia Gencer, Deniz |
author_facet | Heerde, Nicole Hofmann, Wolf-Karsten Hofheinz, Ralf-Dieter Büttner, Sylvia Gencer, Deniz |
author_sort | Heerde, Nicole |
collection | PubMed |
description | PURPOSE: Providing state-of-the-art palliative care is crucial in all areas of in- and outpatient settings. Studies on the implementation of palliative care standards for dying patients are rare. METHODS: N = 141 physicians from all internal departments were polled anonymously about the treatment of dying patients using a self-designed questionnaire. Furthermore, we evaluated the terminal care of n = 278 patients who died in internal medicine departments at University Hospital Mannheim between January and June, 2019 based on clinical data of the last 48 h of life. We defined mandatory criteria for good palliative practice both regarding treatment according to patients' records and answers in physicians' survey. RESULTS: Fifty-six physicians (40%) reported uncertainties in the treatment of dying patients (p < 0.05). Physicians caring for dying patients regularly stated to use sedatives more frequently and to administer less infusions (p < 0.05, respectively). In multivariate analysis, medical specialization was identified as an independent factor for good palliative practice (p < 0.05). Physicians working with cancer patients regularly were seven times more likely to use good palliative practice (p < 0.05) than physicians who did not. Cancer patients received good palliative practice more often than patients dying from non-malignant diseases (p < 0.05). CONCLUSION: Guideline-based palliative care for dying patients was found to be implemented more likely and consistent within the oncology department. These results point to a potential lack of training of fellows in non-oncological departments in terms of good end-of-life care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00432-021-03652-0. |
format | Online Article Text |
id | pubmed-8881441 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-88814412022-03-02 Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany Heerde, Nicole Hofmann, Wolf-Karsten Hofheinz, Ralf-Dieter Büttner, Sylvia Gencer, Deniz J Cancer Res Clin Oncol Original Article – Clinical Oncology PURPOSE: Providing state-of-the-art palliative care is crucial in all areas of in- and outpatient settings. Studies on the implementation of palliative care standards for dying patients are rare. METHODS: N = 141 physicians from all internal departments were polled anonymously about the treatment of dying patients using a self-designed questionnaire. Furthermore, we evaluated the terminal care of n = 278 patients who died in internal medicine departments at University Hospital Mannheim between January and June, 2019 based on clinical data of the last 48 h of life. We defined mandatory criteria for good palliative practice both regarding treatment according to patients' records and answers in physicians' survey. RESULTS: Fifty-six physicians (40%) reported uncertainties in the treatment of dying patients (p < 0.05). Physicians caring for dying patients regularly stated to use sedatives more frequently and to administer less infusions (p < 0.05, respectively). In multivariate analysis, medical specialization was identified as an independent factor for good palliative practice (p < 0.05). Physicians working with cancer patients regularly were seven times more likely to use good palliative practice (p < 0.05) than physicians who did not. Cancer patients received good palliative practice more often than patients dying from non-malignant diseases (p < 0.05). CONCLUSION: Guideline-based palliative care for dying patients was found to be implemented more likely and consistent within the oncology department. These results point to a potential lack of training of fellows in non-oncological departments in terms of good end-of-life care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00432-021-03652-0. Springer Berlin Heidelberg 2021-05-05 2022 /pmc/articles/PMC8881441/ /pubmed/33950342 http://dx.doi.org/10.1007/s00432-021-03652-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article – Clinical Oncology Heerde, Nicole Hofmann, Wolf-Karsten Hofheinz, Ralf-Dieter Büttner, Sylvia Gencer, Deniz Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title | Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title_full | Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title_fullStr | Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title_full_unstemmed | Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title_short | Analysis of end-of-life treatment and physician perceptions at a university hospital in Germany |
title_sort | analysis of end-of-life treatment and physician perceptions at a university hospital in germany |
topic | Original Article – Clinical Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881441/ https://www.ncbi.nlm.nih.gov/pubmed/33950342 http://dx.doi.org/10.1007/s00432-021-03652-0 |
work_keys_str_mv | AT heerdenicole analysisofendoflifetreatmentandphysicianperceptionsatauniversityhospitalingermany AT hofmannwolfkarsten analysisofendoflifetreatmentandphysicianperceptionsatauniversityhospitalingermany AT hofheinzralfdieter analysisofendoflifetreatmentandphysicianperceptionsatauniversityhospitalingermany AT buttnersylvia analysisofendoflifetreatmentandphysicianperceptionsatauniversityhospitalingermany AT gencerdeniz analysisofendoflifetreatmentandphysicianperceptionsatauniversityhospitalingermany |