Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care
ABSTRACT The objective of this study was to identify the variables that influence physicians to implement Advance Directives and assess their impact on end-of-life care. It is a narrative literature review of 25 articles published between 1997 and 2018, in the following databases: CAPES, EBSCOhost,...
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| Format: | Article |
| Language: | English |
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2019-10-01
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| Series: | Einstein (São Paulo) |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082020000100400&tlng=pt |
| _version_ | 1818743573250572288 |
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| author | Larissa Mont’Alverne de Arruda Kelline Paiva Bringel Abreu Laryssa Braga Cavalcante Santana Manuela Vasconcelos de Castro Sales |
| author_facet | Larissa Mont’Alverne de Arruda Kelline Paiva Bringel Abreu Laryssa Braga Cavalcante Santana Manuela Vasconcelos de Castro Sales |
| author_sort | Larissa Mont’Alverne de Arruda |
| collection | DOAJ |
| description | ABSTRACT The objective of this study was to identify the variables that influence physicians to implement Advance Directives and assess their impact on end-of-life care. It is a narrative literature review of 25 articles published between 1997 and 2018, in the following databases: CAPES, EBSCOhost, BDTD, VHL, Google Scholar, MEDLINE®/PubMed. The keywords utilized were: “advance directives”, “living wills”, “physicians”, “attitude”, “decision making”, “advance care planning”. The main factors that influenced physicians to implemente the directives were patients prognosis, medical paternalism, and patients understanding of their medical condition. Respect for autonomy, lack of knowledge and experience with directives, legal concerns, family influence, cultural and religious factors also contributed to medical decision. Most studies (86%) showed that having a directive led to lower rates of invasive interventions in the last days of patient´s life. Physicians were interested in respecting their patients’ autonomy and agreed that having an advance directive helped in the decision-making process; however, they stated other factors were also taken into account, mainly prognosis and reversibility conditions. Having directives contributed to reducing the use of life support therapies and adoption of comfort measures. |
| first_indexed | 2024-12-18T02:30:33Z |
| format | Article |
| id | doaj.art-7ab5f2cbaef44527bb98204a43af4344 |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-12-18T02:30:33Z |
| publishDate | 2019-10-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-7ab5f2cbaef44527bb98204a43af43442022-12-21T21:23:55ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852019-10-011810.31744/einstein_journal/2020rw4852Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life careLarissa Mont’Alverne de Arrudahttps://orcid.org/0000-0003-1116-9357Kelline Paiva Bringel Abreuhttps://orcid.org/0000-0003-2491-4272Laryssa Braga Cavalcante Santanahttps://orcid.org/0000-0002-7082-5273Manuela Vasconcelos de Castro Saleshttps://orcid.org/0000-0002-8178-9095ABSTRACT The objective of this study was to identify the variables that influence physicians to implement Advance Directives and assess their impact on end-of-life care. It is a narrative literature review of 25 articles published between 1997 and 2018, in the following databases: CAPES, EBSCOhost, BDTD, VHL, Google Scholar, MEDLINE®/PubMed. The keywords utilized were: “advance directives”, “living wills”, “physicians”, “attitude”, “decision making”, “advance care planning”. The main factors that influenced physicians to implemente the directives were patients prognosis, medical paternalism, and patients understanding of their medical condition. Respect for autonomy, lack of knowledge and experience with directives, legal concerns, family influence, cultural and religious factors also contributed to medical decision. Most studies (86%) showed that having a directive led to lower rates of invasive interventions in the last days of patient´s life. Physicians were interested in respecting their patients’ autonomy and agreed that having an advance directive helped in the decision-making process; however, they stated other factors were also taken into account, mainly prognosis and reversibility conditions. Having directives contributed to reducing the use of life support therapies and adoption of comfort measures.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082020000100400&tlng=ptAdvance directivesLiving willsPhysiciansAttitudeDecision makingAdvance care planning |
| spellingShingle | Larissa Mont’Alverne de Arruda Kelline Paiva Bringel Abreu Laryssa Braga Cavalcante Santana Manuela Vasconcelos de Castro Sales Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care Einstein (São Paulo) Advance directives Living wills Physicians Attitude Decision making Advance care planning |
| title | Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care |
| title_full | Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care |
| title_fullStr | Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care |
| title_full_unstemmed | Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care |
| title_short | Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care |
| title_sort | variables that influence the medical decision regarding advance directives and their impact on end of life care |
| topic | Advance directives Living wills Physicians Attitude Decision making Advance care planning |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082020000100400&tlng=pt |
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