IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i18p6869-d416359.html
   My bibliography  Save this article

The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians

Author

Listed:
  • Sheng-Yu Fan

    (Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan)

  • Jyh-Gang Hsieh

    (Department of Medical Humanities, Tzu Chi University, Hualien 970, Taiwan
    Heart Lotus Hospice, Hualien Tzu Chi Hospital, Hualien 970, Taiwan)

Abstract

Physicians have a responsibility to discuss do-not-resuscitate (DNR) decisions and end-of-life (EOL) care with patients and family members. The aim of this study was to explore the DNR and EOL care discussion experience among physicians in Taiwan. A qualitative study was conducted with 16 physicians recruited from the departments of hospice care, surgery, internal medicine, emergency, and the intensive care unit. The interview guidelines included their DNR experience and process and EOL care discussions, as well as their concerns, difficulties, or worries in discussions. Thematic analysis was used to analyze data. Four themes were identified. First, family members had multiple roles in the decision process. Second, the characteristics of the units, including time urgency and relationships with patients and family members, influenced physicians’ work. Third, the process included preparation, exploration, information delivery, barrier solution, and execution. Fourth, physicians shared reflections on their ability and the conflicts between law, medical professionals, and the best interests of patients. Physicians must consider not only patients’ but also family members’ opinions and surmount several barriers in decision-making. They also experienced negative and positive impacts from these discussions.

Suggested Citation

  • Sheng-Yu Fan & Jyh-Gang Hsieh, 2020. "The Experience of Do-Not-Resuscitate Orders and End-of-Life Care Discussions among Physicians," IJERPH, MDPI, vol. 17(18), pages 1-10, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6869-:d:416359
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/18/6869/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/18/6869/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Epstein, Ronald M. & Franks, Peter & Fiscella, Kevin & Shields, Cleveland G. & Meldrum, Sean C. & Kravitz, Richard L. & Duberstein, Paul R., 2005. "Measuring patient-centered communication in Patient-Physician consultations: Theoretical and practical issues," Social Science & Medicine, Elsevier, vol. 61(7), pages 1516-1528, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hui-Mei Lin & Chih-Kuang Liu & Yen-Chun Huang & Chieh-Wen Ho & Mingchih Chen, 2021. "Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent," IJERPH, MDPI, vol. 19(1), pages 1-9, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hyojung Tak & Gregory Ruhnke & Ya-Chen Shih, 2015. "The Association between Patient-Centered Attributes of Care and Patient Satisfaction," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(2), pages 187-197, April.
    2. Lee, Yin-Yang & Lin, Julia L., 2010. "Do patient autonomy preferences matter? Linking patient-centered care to patient-physician relationships and health outcomes," Social Science & Medicine, Elsevier, vol. 71(10), pages 1811-1818, November.
    3. Ishikawa, Hirono & Hashimoto, Hideki & Kiuchi, Takahiro, 2013. "The evolving concept of “patient-centeredness” in patient–physician communication research," Social Science & Medicine, Elsevier, vol. 96(C), pages 147-153.
    4. Murante, Anna Maria & Vainieri, Milena & Rojas, Diana & Nuti, Sabina, 2014. "Does feedback influence patient - professional communication? Empirical evidence from Italy," Health Policy, Elsevier, vol. 116(2), pages 273-280.
    5. Ling-Hsin Hsu & Yu-Hsiang Hsiao, 2019. "Facilitating Green Supply Chain in Dental Care through Kansei Healthscape of Positive Emotions," IJERPH, MDPI, vol. 16(19), pages 1-19, September.
    6. Mukherjee, Meghna, 2020. "The Management of Unequal Patient Status in Fertility Medicine: Donors' and Intended Parents’ Experiences of Participatory and Imposed Enrollment," Social Science & Medicine, Elsevier, vol. 247(C).
    7. Victoria A. Grunberg & Mira Reichman & Brenda C. Lovette & Ana-Maria Vranceanu & Jonathan Greenberg, 2022. "“No One Truly Understands What We Go through and How to Treat It”: Lived Experiences with Medical Providers among Patients with Orofacial Pain," IJERPH, MDPI, vol. 19(16), pages 1-10, August.
    8. Eduardo Pérez & David P. Dzubay, 2021. "A scheduling-based methodology for improving patient perceptions of quality of care in intensive care units," Health Care Management Science, Springer, vol. 24(1), pages 203-215, March.
    9. Dy, Sydney M. & Purnell, Tanjala S., 2012. "Key concepts relevant to quality of complex and shared decision-making in health care: A literature review," Social Science & Medicine, Elsevier, vol. 74(4), pages 582-587.
    10. Teal, Cayla R. & Street, Richard L., 2009. "Critical elements of culturally competent communication in the medical encounter: A review and model," Social Science & Medicine, Elsevier, vol. 68(3), pages 533-543, February.
    11. Stephen J. Aragon & Liana J. Richardson & Wanda Lawrence & Sabina B. Gesell, 2013. "Nurses’ Patient-Centeredness and Perceptions of Care among Medicaid Patients in Hospital Obstetrical Units," Nursing Research and Practice, Hindawi, vol. 2013, pages 1-7, August.
    12. Fatigante, Marilena & Heritage, John & Alby, Francesca & Zucchermaglio, Cristina, 2020. "Presenting treatment options in breast cancer consultations: Advice and consent in Italian medical care," Social Science & Medicine, Elsevier, vol. 266(C).
    13. Saul J. Weiner & Brendan Kelly & Naomi Ashley & Amy Binns-Calvey & Gunjan Sharma & Alan Schwartz & Frances M. Weaver, 2014. "Content Coding for Contextualization of Care," Medical Decision Making, , vol. 34(1), pages 97-106, January.
    14. Vrana, Scott R. & Vrana, Dylan T. & Penner, Louis A. & Eggly, Susan & Slatcher, Richard B. & Hagiwara, Nao, 2018. "Latent Semantic Analysis: A new measure of patient-physician communication," Social Science & Medicine, Elsevier, vol. 198(C), pages 22-26.
    15. Davenport, Nancy H.M., 2011. "Medical residents' use of narrative templates in storytelling and diagnosis," Social Science & Medicine, Elsevier, vol. 73(6), pages 873-881, September.
    16. Liberati, Elisa Giulia & Gorli, Mara & Moja, Lorenzo & Galuppo, Laura & Ripamonti, Silvio & Scaratti, Giuseppe, 2015. "Exploring the practice of patient centered care: The role of ethnography and reflexivity," Social Science & Medicine, Elsevier, vol. 133(C), pages 45-52.
    17. Lo, Ming-Cheng Miriam & Bahar, Roxana, 2013. "Resisting the colonization of the lifeworld? Immigrant patients' experiences with co-ethnic healthcare workers," Social Science & Medicine, Elsevier, vol. 87(C), pages 68-76.
    18. Bergen, Clara & McCabe, Rose, 2021. "Negative stance towards treatment in psychosocial assessments: The role of personalised recommendations in promoting acceptance," Social Science & Medicine, Elsevier, vol. 290(C).
    19. B. Mitchell Peck & Meredith Denney, 2012. "Disparities in the Conduct of the Medical Encounter," SAGE Open, , vol. 2(3), pages 21582440124, September.
    20. Meron Hirpa & Tinsay Woreta & Hilena Addis & Sosena Kebede, 2020. "What matters to patients? A timely question for value-based care," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-16, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6869-:d:416359. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.