BACKGROUND: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer patients. OBJECTIVE: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. METHODS: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs were asked to register, using standardised forms, the extent of discussing 10 end-of-life issues with patients. RESULTS: We examined 252 patients who died nonsuddenly, 38% of whom died of cancer, and 86% of whose treatment goal was palliative care. Our findings show that GPs often waited until very close to death before they discussed end-of-life issues with patients, and discussed spiritual and social issues less than physical symptoms, diagnoses, and psychological problems. In 74% of cases, the GPs were informed of their patients' preferred place of death; and 8 out of 10 patients with known preferences for place of death, died there. Being diagnosed with cancer was associated with a higher frequency of discussing all 10 end-of-life issues than diagnosis with other (noncancer) conditions, but this is a state of mind we did not explore in this study. CONCLUSION: Promotion of timely discussion of all relevant end-of-life issues, in patients with cancer and noncancer diagnoses, is advisable based on systematic needs assessment.
BACKGROUND: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancerpatients. OBJECTIVE: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. METHODS: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs were asked to register, using standardised forms, the extent of discussing 10 end-of-life issues with patients. RESULTS: We examined 252 patients who died nonsuddenly, 38% of whom died of cancer, and 86% of whose treatment goal was palliative care. Our findings show that GPs often waited until very close to death before they discussed end-of-life issues with patients, and discussed spiritual and social issues less than physical symptoms, diagnoses, and psychological problems. In 74% of cases, the GPs were informed of their patients' preferred place of death; and 8 out of 10 patients with known preferences for place of death, died there. Being diagnosed with cancer was associated with a higher frequency of discussing all 10 end-of-life issues than diagnosis with other (noncancer) conditions, but this is a state of mind we did not explore in this study. CONCLUSION: Promotion of timely discussion of all relevant end-of-life issues, in patients with cancer and noncancer diagnoses, is advisable based on systematic needs assessment.
Authors: J A F Koekkoek; L Dirven; J C Reijneveld; E M Sizoo; H R W Pasman; T J Postma; L Deliens; R Grant; S McNamara; W Grisold; E Medicus; G Stockhammer; S Oberndorfer; B Flechl; C Marosi; M J B Taphoorn; J J Heimans Journal: J Neurooncol Date: 2014-07-20 Impact factor: 4.130
Authors: Annicka G M van der Plas; Kris C Vissers; Anneke L Francke; Gé A Donker; Wim J J Jansen; Luc Deliens; Bregje D Onwuteaka-Philipsen Journal: PLoS One Date: 2015-07-24 Impact factor: 3.240
Authors: Annicka Gm van der Plas; Anneke L Francke; Kris C Vissers; Wim Jj Jansen; Luc Deliens; Bregje D Onwuteaka-Philipsen Journal: BMC Palliat Care Date: 2015-07-02 Impact factor: 3.234
Authors: An Vandervoort; Dirk Houttekier; Robert Vander Stichele; Jenny T van der Steen; Lieve Van den Block Journal: PLoS One Date: 2014-03-10 Impact factor: 3.240
Authors: Maaike L De Roo; Guido Miccinesi; Bregje D Onwuteaka-Philipsen; Nele Van Den Noortgate; Lieve Van den Block; Andrea Bonacchi; Gé A Donker; Jose E Lozano Alonso; Sarah Moreels; Luc Deliens; Anneke L Francke Journal: PLoS One Date: 2014-04-08 Impact factor: 3.240