Advance directives and the impact of timing
PRINCIPLES: Advance directives are seen as an important tool for documenting the wishes of patients who are no longer competent to make decisions in regards to their medical care. Due to their nature, approaching the subject of advance directives with a patient can be difficult for both the medica...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2014-09-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1908 |
| _version_ | 1797979548065726464 |
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| author | Ina Otte Corinna Jung Bernice Elger Klaus Bally |
| author_facet | Ina Otte Corinna Jung Bernice Elger Klaus Bally |
| author_sort | Ina Otte |
| collection | DOAJ |
| description |
PRINCIPLES: Advance directives are seen as an important tool for documenting the wishes of patients who are no longer competent to make decisions in regards to their medical care. Due to their nature, approaching the subject of advance directives with a patient can be difficult for both the medical care provider and the patient. This paper focuses on general practitioners’ perspectives regarding the timing at which this discussion should take place, as well as the advantages and disadvantages of the different moments.
METHODS: In 2013, 23 semi-structured face-to-face interviews were performed with Swiss general practitioners. Interviews were analysed using qualitative content analysis.
RESULTS: In our sample, 23 general practitioners provided different options that they felt were appropriate moments: either (a) when the patient is still healthy, (b) when illness becomes predominant, or (c) when a patient has been transferred to a long-term care facility. Furthermore, general practitioners reported uncertainty and discomfort regarding initiating the discussion.
CONCLUSION: The distinct approaches, perspectives and rationales show that there is no well-defined or “right” moment. However, participants often associated advance directives with death. This link caused discomfort and uncertainty, which led to hesitation and delay on the part of general practitioners. Therefore we recommend further training on how to professionally initiate a conversation about advance directives. Furthermore, based on our results and experience, we recommend an early approach with healthy patients paired with later regular updates as it seems to be the most effective way to inform patients about their end-of-life care options.
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| first_indexed | 2024-04-11T05:40:24Z |
| format | Article |
| id | doaj.art-b1590281e5624e589494f4fd81a100e0 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:40:24Z |
| publishDate | 2014-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-b1590281e5624e589494f4fd81a100e02022-12-22T04:42:32ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-09-01144394010.4414/smw.2014.14035Advance directives and the impact of timingIna OtteCorinna JungBernice ElgerKlaus Bally PRINCIPLES: Advance directives are seen as an important tool for documenting the wishes of patients who are no longer competent to make decisions in regards to their medical care. Due to their nature, approaching the subject of advance directives with a patient can be difficult for both the medical care provider and the patient. This paper focuses on general practitioners’ perspectives regarding the timing at which this discussion should take place, as well as the advantages and disadvantages of the different moments. METHODS: In 2013, 23 semi-structured face-to-face interviews were performed with Swiss general practitioners. Interviews were analysed using qualitative content analysis. RESULTS: In our sample, 23 general practitioners provided different options that they felt were appropriate moments: either (a) when the patient is still healthy, (b) when illness becomes predominant, or (c) when a patient has been transferred to a long-term care facility. Furthermore, general practitioners reported uncertainty and discomfort regarding initiating the discussion. CONCLUSION: The distinct approaches, perspectives and rationales show that there is no well-defined or “right” moment. However, participants often associated advance directives with death. This link caused discomfort and uncertainty, which led to hesitation and delay on the part of general practitioners. Therefore we recommend further training on how to professionally initiate a conversation about advance directives. Furthermore, based on our results and experience, we recommend an early approach with healthy patients paired with later regular updates as it seems to be the most effective way to inform patients about their end-of-life care options. https://www.smw.ch/index.php/smw/article/view/1908primary health caregeneral practiceadvance directivesdecision makingadvance care planningpatient-centred care |
| spellingShingle | Ina Otte Corinna Jung Bernice Elger Klaus Bally Advance directives and the impact of timing Swiss Medical Weekly primary health care general practice advance directives decision making advance care planning patient-centred care |
| title | Advance directives and the impact of timing |
| title_full | Advance directives and the impact of timing |
| title_fullStr | Advance directives and the impact of timing |
| title_full_unstemmed | Advance directives and the impact of timing |
| title_short | Advance directives and the impact of timing |
| title_sort | advance directives and the impact of timing |
| topic | primary health care general practice advance directives decision making advance care planning patient-centred care |
| url | https://www.smw.ch/index.php/smw/article/view/1908 |
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