Practice patterns and perceptions about parenteral hydration in the last weeks of life: a survey of palliative care physicians in Latin America.
Context: Parenteral hydration at the end of life is controversial and has generated considerable debate for decades.Objectives: To identify palliative care physician parenteral hydration prescribing patterns and factors that influence prescribing levels (PLs) for patients during their last weeks of...
| Publicado en: | Journal of Pain & Symptom Management Vol. 43; no. 1; pp. 47 - 59 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Jan2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104623599&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104623599 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08853924 4CB jtl: Journal of Pain & Symptom Management issn: 08853924 maglogo: N pubinfo: dt: Jan2012 vid: 43 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104623599 NLM21835577 2011421896 10.1016/j.jpainsymman.2011.03.016 NLM21835577 PMC3217122 104623599 ppf: 47 ppct: 12 formats: tig: atl: Practice patterns and perceptions about parenteral hydration in the last weeks of life: a survey of palliative care physicians in Latin America. aug: au: Torres-Vigil I Mendoza TR Alonso-Babarro A De Lima L Cárdenas-Turanzas M Hernandez M de la Rosa A Bruera E Torres-Vigil, Isabel Mendoza, Tito R Alonso-Babarro, Alberto De Lima, Liliana Cárdenas-Turanzas, Marylou Hernandez, Mike de la Rosa, Allison Bruera, Eduardo affil: Graduate College of Social Work, University of Houston, Houston, Texas, USA sug: subj: Attitude of Health Personnel Fluid Therapy Utilization Palliative Care Utilization Parenteral Nutrition Utilization Practice Patterns Statistics and Numerical Data Terminal Care Statistics and Numerical Data Terminally Ill Patients Statistics and Numerical Data Adult Aged Aged, 80 and Over Attitude to Health Chronic Disease Mortality Chronic Disease Nursing Chronic Disease Psychosocial Factors Female Fluid Therapy Ethical Issues Latin America Middle Age Palliative Care Psychosocial Factors Parenteral Nutrition Psychosocial Factors Terminal Care Psychosocial Factors Terminally Ill Patients Psychosocial Factors Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female ab: Context: Parenteral hydration at the end of life is controversial and has generated considerable debate for decades.Objectives: To identify palliative care physician parenteral hydration prescribing patterns and factors that influence prescribing levels (PLs) for patients during their last weeks of life.Methods: A cross-sectional, representative online survey of Latin American palliative care physicians was conducted in 2010. Physicians were asked to report the percentage of their terminally ill patients for whom they prescribed parenteral hydration. Predictors of parenteral hydration PLs were identified using logistic regression analysis.Results: Two hundred thirty-eight of 320 physicians completed the survey (74% response rate). Sixty percent of physicians reported prescribing parenteral hydration to 40%-100% of their patients during the last weeks of life. Factors influencing moderate/high PLs were the following: agreeing that parenteral hydration is clinically and psychologically efficacious (odds ratio [OR] 3.5; 95% confidence interval [CI] 1.5-8.3), disagreeing that withholding parenteral hydration alleviates symptoms (OR 3.3, 95% CI 1.3-8.1), agreeing that parenteral hydration is essential for meeting the minimum standards of care (OR 3.2, 95% CI 1.4-7.5), preferring the subcutaneous route of parenteral hydration for patient comfort and home use (OR 2.9, 95% CI 1.3-6.5), and being younger than 45 years of age (OR 2.6, 95% CI 1.3-5.2).Conclusion: The strongest determinant of prescribing patterns was agreement with the clinical/psychological efficaciousness of parenteral hydration. Our results reflect parenteral hydration prescribing patterns and perceptions that substantially differ from the conventional/traditional hospice philosophy. These findings suggest that the decision to prescribe or withhold parenteral hydration is largely based on clinical perceptions and that most palliative care physicians from this region of the world individualize treatment decisions. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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