title: A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.
abstract: OBJECTIVE
  To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana.
  
  
  RESULTS
  A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group.
  
  
  CONCLUSIONS
  A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying.
authors.affiliation: Palliative Care Service, Korle Bu Teaching Hospital, Accra, Ghana Neiswanger Institute of Bioethics, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, USA amaedwin@gmail.com.
authors.forename: Ama Kyerewaa
authors.initials: AK
authors.lastname: Edwin
authors.affiliation: College of Business, University of New Haven, West Haven, CT, USA.
authors.forename: Summer
authors.initials: S
authors.lastname: Johnson McGee
authors.affiliation: Palliative Care Service, Korle Bu Teaching Hospital, Accra, Ghana Institute for Palliative Medicine, Ohio Health Kobacker House, Columbus, OH, USA.
authors.forename: Edwina Addo
authors.initials: EA
authors.lastname: Opare-Lokko
authors.affiliation: Palliative Care Service, Korle Bu Teaching Hospital, Accra, Ghana Ohio Health Kobacker House, Columbus, OH, USA University of Wisconsin Carbone Cancer Centre, Madison, WI, USA Faculty of Family Medicine, Ghana College of Physicians and Surgeons, Accra, Ghana.
authors.forename: Mawuli Kotope
authors.initials: MK
authors.lastname: Gyakobo
mesh_terms: D000328:Adult; D000368:Aged; D001293:Attitude to Death; D003657:Decision Making; D005190:Family / Q000523:psychology; D005260:Female; D005869:Ghana; D006784:Hospitals, Teaching; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010166:Palliative Care / Q000458:organization & administration*; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D013727:Terminal Care / Q000458:organization & administration*
keywords: end-of-life decision making; interdisciplinary team; outcome evaluation; palliative care; quality of care; teaching hospital in Ghana; terminal illness