Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2011 February;77(2) > Minerva Anestesiologica 2011 February;77(2):172-9

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Estratti

MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,623


eTOC

 

ORIGINAL ARTICLES  FREEfree


Minerva Anestesiologica 2011 February;77(2):172-9

Copyright © 2011 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prehospital emergency physicians’ experiences with advance directives in Germany: A questionnaire-based multicenter study

Wiese C. H. R. 1, Bartels U. E. 2, Ruppert D. B. 3, Graf B. M. 1, Hanekop G. G. 4

¹ Department of Anesthesiology, University Medical Center Regensburg, Regensburg Germany; 2 Department of Cardiac Anesthesiology, University Medical Center Ulm, Ulm, Germany; 3 Department of Anesthesiology, Medical Center Lüneburg, Lüneburg, Germany; 4 Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, Göttingen, Germany


FULL TEXT  


BACKGROUND: Palliative medical emergencies and end-of-life decisions resulting from the exacerbation of cancer account for approximately 3% of all out-of-hospital emergency applications in Germany. Therefore, prehospital emergency physicians (EP) may be confronted with advance directives and ethical and end-of-life decisions. The purpose of the study was to identify EPs’ knowledge about ethical and end-of-life decisions and their legal education and experiences concerning advance directives.
METHODS: Over a six-month period, we questioned all 150 EPs from three emergency medical services (Braunschweig, Göttingen und Kaiserslautern). An anonymous, self-administered questionnaire with a mixed-methods design was used. The main outcome measures included responses regarding experiences related to advance directives and end-of-life decisions in palliative care patients. For statistical assessment, EPs were divided into three categories: competent, skilled, and unskilled.
RESULTS: A total of 104 EPs returned the questionnaire (response rate 69%). Eighty-nine percent of the respondents treated patients who had advance directives. The existence of an advance directive influenced the EP’s therapy decision in about 77% of their encounters. Eighty-seven percent of the EPs reported the need for defined end-of-life care pathways and/or standard operating procedures. Eighty-two percent desired educational training concerning end-of-life decisions and the validity of advance directives.
CONCLUSION: The prehospital emergency treatment of palliative care patients can be particularly challenging for any EP. A high percentage of the EPs in our study felt insecure in dealing with advance directives and ethical and end-of-life decisions in palliative care patients. Our results suggest that EPs may need more information and education about palliative medical care, legal issues and ethical and end-of-life decisions to provide adequate patient-oriented palliative care in prehospital emergency situations.

inizio pagina

Publication History

Per citare questo articolo

Corresponding author e-mail

christoph.wiese@klinik.uni-regensburg.de