Patient autonomy, wishes and treatment for end-of-life
In 2017-2020 a Danish version of the POLST document (an advanced care document) was developed and tested with the aim to make sure that patients' and nursing home residents' wishes for end-of- life care were known and documented.
This study is a follow-up to evaluate the effect of the Danish POLST-document and the benefits of the POLST-document experienced by the relatives.
Nurses and other healthcare professionals often experience that patients' and nursing home resi-dents' wishes for end-of-life are unknown. Due to this lack of knowledge, patients and nursing home residents may risk resuscitation attempts and intensive care treatment against their wishes.
A number of international studies have shown that most patients with serious illnesses want to discuss level of life-sustaining treatment with health care professionals. However, studies have also show that conversations about wishes for end-of-life treatment often do not take place.
Therefore, in 2017 the Danish POLST-project was initiated aiming to develop and test a document which could help to ensure that patients' and nursing home residents' wishes for end-of- life care are known, documented and legally binding.
The main purpose of this study is a two years follow-up to see if the POLST-document has helped patients' and nursing home residents' in receiving treatment according to their wishes documented in the POLST-document. Furthermore are family members being interviewed on their experiences of the benefits of the POLST-document.
As a third study we want to examine the reasons why patients are being rejected from intensive care therapy to help the co-work between the Intensive Care Unit and the bedwards.
And as a fourth project we try to examine what promotes and inhibits physicians conducting the conversation about end-of-life decisions.
Description of the cohort
Patients included in the Danish POLST-project and their relatives, who accepted being contacted.
Patients refused intensive care therapy at Kolding Hospital in the period from the 1th of December 2020 to the 30th of November 2021.
Doctors, both general praticioners and at hospitals, in the region of Southern Denmark, who agree to receive a survey.
Data and biological material
Retrospective journal examination on patients included in the Danish POLST-project.
Patient record data: treatment, hospital admissions, and mortality in a two-year follow-up period.
Interview data: family members
Retrospective journal examination on patients refused intensive care therapy.
Data from questionnaires on doctors willingness to conduct the conversation of wishes for treatment in end of life.