Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Sprung, CL; Jennerich, AL; Joynt, GM; Michalsen, A; Curtis, JR; Efferen, LS; Leonard, S; Metnitz, B; Mikstacki, A; Patil, N; McDermid, RC; Metnitz, P; Mularski, RA; Bulpa, P; Avidan, A.
The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study.
J Palliat Care. 2024; 39(4):316-324
Doi: 10.1177/08258597211002308
Web of Science
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- Co-Autor*innen der Med Uni Graz
- Metnitz Philipp
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- Abstract:
- OBJECTIVE: To evaluate the association between provider religion and religiosity and consensus about end-of-life care and explore if geographical and institutional factors contribute to variability in practice. METHODS: Using a modified Delphi method 22 end-of-life issues consisting of 35 definitions and 46 statements were evaluated in 32 countries in North America, South America, Eastern Europe, Western Europe, Asia, Australia and South Africa. A multidisciplinary, expert group from specialties treating patients at the end-of-life within each participating institution assessed the association between 7 key statements and geography, religion, religiosity and institutional factors likely influencing the development of consensus. RESULTS: Of 3049 participants, 1366 (45%) responded. Mean age of respondents was 45 ± 9 years and 55% were females. Following 2 Delphi rounds, consensus was obtained for 77 (95%) of 81 definitions and statements. There was a significant difference in responses across geographical regions. South African and North American respondents were more likely to encourage patients to write advance directives. Fewer Eastern European and Asian respondents agreed with withdrawing life-sustaining treatments without consent of patients or surrogates. While respondent's religion, years in practice or institution did not affect their agreement, religiosity, physician specialty and responsibility for end-of-life decisions did. CONCLUSIONS: Variability in agreement with key consensus statements about end-of-life care is related primarily to differences among providers, with provider-level variations related to differences in religiosity and specialty. Geography also plays a role in influencing some end-of-life practices. This information may help understanding ethical dilemmas and developing culturally sensitive end-of-life care strategies.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Terminal Care - administration & dosage
- Female - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Delphi Technique - administration & dosage
- Critical Illness - administration & dosage
- Adult - administration & dosage
- Surveys and Questionnaires - administration & dosage
- North America - administration & dosage
- Religion - administration & dosage
- South Africa - administration & dosage
- Find related publications in this database (Keywords)
- geography
- religion
- religiosity
- end-of-life decisions
- withholding and withdrawing life-sustaining treatment
- do not resuscitate orders
- cardiopulmonary resuscitation
- intensive care unit