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Swedish intensivists’ experiences and attitudes regarding end‐of‐life decisions
Author(s) -
Nordenskjöld Syrous Alma,
Ågård Anders,
Kock Redfors Maria,
Naredi Silvana,
Block Linda
Publication year - 2020
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13549
Subject(s) - intensivist , medicine , end of life care , intensive care , qualitative research , family medicine , nursing , palliative care , intensive care medicine , social science , sociology
Background To make end‐of‐life (EOL) decisions is a complex and challenging task for intensive care physicians and a substantial variability in this process has been previously reported. However, a deeper understanding of intensivists’ experiences and attitudes regarding the decision‐making process is still, to a large extent, lacking. The primary aim of this study was to address Swedish intensivists’ experiences, beliefs and attitudes regarding decision‐making pertaining to EOL decisions. Second, we aimed to identify underlying factors that may contribute to variability in the decision‐making process. Method This is a descriptive, qualitative study. Semi‐structured interviews with nineteen intensivists from five different Swedish hospitals, with different ICU levels, were performed from 1 February 2017 to 31 May 2017. Results Intensivists strive to make end‐of‐life decisions that are well‐grounded, based on sufficient information. Consensus with the patient, family and other physicians is important. Concurrently, decisions that are made with scarce information or uncertain medical prognosis, decisions made during on‐call hours and without support from senior consultants cause concern for many intensivists. Underlying factors that contribute to the variability in decision‐making are lack of continuity among senior intensivists, lack of needed support during on‐call hours and disagreements with physicians from other specialties. There is also an individual variability primarily depending on the intensivist's personality. Conclusion Swedish intensivists’ wish to make end‐of‐life decisions based on sufficient information, medically certain prognosis and consensus with the patient, family, staff and other physicians. Swedish intensivists’ experience a variability in end‐of‐life decisions, which is generally accepted and not questioned.