Dissonance on perceptions of end‐of‐life needs between health‐care providers and members of the public: Quantitative cross‐sectional surveys

Magnolia Cardona, Ebony T. Lewis, Shantiban Shanmugam, Margaret Nicholson, Margaret Williamson, Laura Hanly, Kenneth Hillman

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective
To investigate views, determinants and barriers to end‐of‐life discussions for doctors, nurses and members of the public (MoP) and their acceptability of risk prediction tools.

Methods
Concurrent surveys of 360 doctors and nurses and 497 MoP.

Results
Sixty per cent of clinicians reported high confidence in initiating end‐of‐life discussions, and 55.8% regularly engaged in them. Barriers to end‐of‐life communication reported by clinicians were uncertainty on the likely time to death (44.7%) and family requests to withhold information from patients (44.2%). By contrast, most (92.8%) MoP wanted information about life expectancy; 89.9% wanted involvement in treatment decisions if the likelihood of death was high; and 23.8% already had an advance care directive.

Conclusions
A dissonance exists between doctor/nurses perception of older peoples’ preference for receiving prognostic information and the public desire for involvement in decision‐making at the end of life. As public attitudes change, strategies for greater involvement of patients in shared end‐of‐life planning are warranted.
LanguageEnglish
JournalAustralasian Journal on Ageing
DOIs
Publication statusE-pub ahead of print - 13 Mar 2019

Fingerprint

Health Personnel
Cross-Sectional Studies
Nurses
Advance Directives
Life Expectancy
Uncertainty
Decision Making
Communication
Therapeutics

Funder Acknowledgement

This research was supported by the NHMRC Program funding scheme.

Cite this

Cardona, Magnolia ; Lewis, Ebony T. ; Shanmugam, Shantiban ; Nicholson, Margaret ; Williamson, Margaret ; Hanly, Laura ; Hillman, Kenneth. / Dissonance on perceptions of end‐of‐life needs between health‐care providers and members of the public: Quantitative cross‐sectional surveys. In: Australasian Journal on Ageing. 2019.
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abstract = "ObjectiveTo investigate views, determinants and barriers to end‐of‐life discussions for doctors, nurses and members of the public (MoP) and their acceptability of risk prediction tools.MethodsConcurrent surveys of 360 doctors and nurses and 497 MoP.ResultsSixty per cent of clinicians reported high confidence in initiating end‐of‐life discussions, and 55.8{\%} regularly engaged in them. Barriers to end‐of‐life communication reported by clinicians were uncertainty on the likely time to death (44.7{\%}) and family requests to withhold information from patients (44.2{\%}). By contrast, most (92.8{\%}) MoP wanted information about life expectancy; 89.9{\%} wanted involvement in treatment decisions if the likelihood of death was high; and 23.8{\%} already had an advance care directive.ConclusionsA dissonance exists between doctor/nurses perception of older peoples’ preference for receiving prognostic information and the public desire for involvement in decision‐making at the end of life. As public attitudes change, strategies for greater involvement of patients in shared end‐of‐life planning are warranted.",
author = "Magnolia Cardona and Lewis, {Ebony T.} and Shantiban Shanmugam and Margaret Nicholson and Margaret Williamson and Laura Hanly and Kenneth Hillman",
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Dissonance on perceptions of end‐of‐life needs between health‐care providers and members of the public: Quantitative cross‐sectional surveys. / Cardona, Magnolia; Lewis, Ebony T.; Shanmugam, Shantiban; Nicholson, Margaret; Williamson, Margaret; Hanly, Laura; Hillman, Kenneth.

In: Australasian Journal on Ageing, 13.03.2019.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Williamson, Margaret

AU - Hanly, Laura

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N2 - ObjectiveTo investigate views, determinants and barriers to end‐of‐life discussions for doctors, nurses and members of the public (MoP) and their acceptability of risk prediction tools.MethodsConcurrent surveys of 360 doctors and nurses and 497 MoP.ResultsSixty per cent of clinicians reported high confidence in initiating end‐of‐life discussions, and 55.8% regularly engaged in them. Barriers to end‐of‐life communication reported by clinicians were uncertainty on the likely time to death (44.7%) and family requests to withhold information from patients (44.2%). By contrast, most (92.8%) MoP wanted information about life expectancy; 89.9% wanted involvement in treatment decisions if the likelihood of death was high; and 23.8% already had an advance care directive.ConclusionsA dissonance exists between doctor/nurses perception of older peoples’ preference for receiving prognostic information and the public desire for involvement in decision‐making at the end of life. As public attitudes change, strategies for greater involvement of patients in shared end‐of‐life planning are warranted.

AB - ObjectiveTo investigate views, determinants and barriers to end‐of‐life discussions for doctors, nurses and members of the public (MoP) and their acceptability of risk prediction tools.MethodsConcurrent surveys of 360 doctors and nurses and 497 MoP.ResultsSixty per cent of clinicians reported high confidence in initiating end‐of‐life discussions, and 55.8% regularly engaged in them. Barriers to end‐of‐life communication reported by clinicians were uncertainty on the likely time to death (44.7%) and family requests to withhold information from patients (44.2%). By contrast, most (92.8%) MoP wanted information about life expectancy; 89.9% wanted involvement in treatment decisions if the likelihood of death was high; and 23.8% already had an advance care directive.ConclusionsA dissonance exists between doctor/nurses perception of older peoples’ preference for receiving prognostic information and the public desire for involvement in decision‐making at the end of life. As public attitudes change, strategies for greater involvement of patients in shared end‐of‐life planning are warranted.

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