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Therapeutic decisio...
Therapeutic decisions in ALS patients : cross-cultural differences and clinical implications
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- Andersen, Peter M., 1962- (författare)
- Umeå universitet,Klinisk neurovetenskap
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Kuzma-Kozakiewicz, Magdalena (författare)
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Keller, Jürgen (författare)
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visa fler...
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Aho-Oezhan, Helena E. A. (författare)
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Ciecwierska, Katarzyna (författare)
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Szejko, Natalia (författare)
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Vázquez, Cynthia (författare)
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Böhm, Sarah (författare)
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Badura-Lotter, Gisela (författare)
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Meyer, Thomas (författare)
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Petri, Susanne (författare)
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Linse, Katharina (författare)
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Hermann, Andreas (författare)
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- Semb, Olof, 1968- (författare)
- Umeå universitet,Professionell utveckling
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Stenberg, Erica (författare)
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- Nackberg, Simona (författare)
- Umeå universitet,Professionell utveckling
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Dorst, Johannes (författare)
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Uttner, Ingo (författare)
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Häggström, Ann-Cristin (författare)
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Ludolph, Albert C. (författare)
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Lulé, Dorothée (författare)
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(creator_code:org_t)
- 2018-05-04
- 2018
- Engelska.
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Ingår i: Journal of Neurology. - : Springer Berlin/Heidelberg. - 0340-5354 .- 1432-1459. ; 265:7, s. 1600-1606
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: Quantitative analysis of decision-making on therapeutic options in different sociocultural context in amyotrophic lateral sclerosis (ALS).Methods: ALS patients (n = 244) were consecutively recruited in Germany (n = 83), Poland (n = 83), and Sweden (n = 78) in a prospective cross-cultural study (www.NEEDSinALS.com). They were interviewed on preferences for therapeutic techniques including invasive (IV) and non-invasive ventilation (NIV), as well as percutaneous endoscopic gastrostomy (PEG) and on hypothetical termination of these using quantitative questions. Using standardized questionnaires, religiousness, personal values, quality of life, and depressiveness were assessed.Results: NIV was most frequently used in Germany and PEG in Sweden. Swedish patients were most liberal on initiation and termination of PEG, NIV and IV. Polish patients were mostly undecided and were least likely to consider discontinuing supportive management. Current use was partly associated with age, gender and state of physical function; also, financial support explained some variance. Future preferences on therapeutic options from the patient’s perspective were also closely associated with cultural factors. The more oriented towards traditional and conservative values, the less likely patients were to decide for invasive therapeutic devices (IV, PEG), the least likely to have ideations to discontinue any device and the more likely to have an undecided attitude.Conclusions: Current use of therapeutic options is determined by medical condition in analogy to clinical guidelines. For future considerations, other factors such as cultural background are crucial, yielding hurdles to be regarded in the implementation of advanced directives in a multicultural environment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Decision
- Amyotrophic lateral sclerosis
- Palliative care
- Quality of life
- Medical care
- Culture
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Andersen, Peter ...
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Kuzma-Kozakiewic ...
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Keller, Jürgen
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Aho-Oezhan, Hele ...
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Ciecwierska, Kat ...
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Szejko, Natalia
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visa fler...
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Vázquez, Cynthia
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Böhm, Sarah
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Badura-Lotter, G ...
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Meyer, Thomas
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Petri, Susanne
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Linse, Katharina
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Hermann, Andreas
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Semb, Olof, 1968 ...
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Stenberg, Erica
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Nackberg, Simona
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Dorst, Johannes
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Uttner, Ingo
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Häggström, Ann-C ...
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Ludolph, Albert ...
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Lulé, Dorothée
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visa färre...
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