Factors considered in end-of-life care decision making by health care professionals.
OBJECTIVE
To explore the importance of factors influencing the end-of-life care decision making of health care professionals (HCPs) in Singapore.


METHODS
This cross-sectional survey encompassed facets of patient, family, and HCP-related care considerations. In total, 187 questionnaires were distributed to physicians and nurses and had a response rate of 78.6%.


RESULTS
The respondents rated patients' wishes (96.6%), their clinical symptoms (93.9%), and patients' beliefs (91.1%) very high. In all, 94.6% of the HCPs would respect a competent patient's wishes over the family's wishes when goals conflict. However, 59.9% of HCPs would abide by the family's wishes when the patient loses capacity even if the patient's previously expressed wishes are known.


CONCLUSIONS
End-of-life care decision making by HCPs appears largely patient centered, although familial determination still wields significant influence with implications for advance care planning.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Wei Ting
WT
Foo
Yiliang
Y
Zheng
Ann K
AK
Kwee
Grace M
GM
Yang
Lalit
L
Krishna
D000328:Adult; D024362:Advance Directive Adherence / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D000368:Aged; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001293:Attitude to Death / Q000208:ethnology; D002173:Cancer Care Facilities / Q000458:organization & administration / Q000592:standards; D003430:Cross-Sectional Studies; D003657:Decision Making; D005190:Family / Q000208:ethnology / Q000523:psychology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology* / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000592:standards* / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D012846:Singapore; D013727:Terminal Care / Q000523:psychology* / Q000592:standards; D014342:Truth Disclosure; D000078329:Workforce; D055815:Young Adult