"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care

In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for...

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Published in:PloS one 2021-09, Vol.16 (9), p.e0257382
Main Authors: Kremeike, Kerstin, Dojan, Thomas, Rosendahl, Carolin, Jünger, Saskia, Romotzky, Vanessa, Boström, Kathleen, Frerich, Gerrit, Voltz, Raymond
Format: Article
Language:English
Subjects:
Adult
Attitude to Death
Biology and Life Sciences
Communication
Criminal investigations
Data analysis
Data Interpretation, Statistical
Death
Death & dying
Delphi Technique
Evaluation
Female
Germany
Health Personnel
Humans
Information management
International Cooperation
Male
Medical care
Medical personnel
Medicine
Medicine and Health Sciences
Methods
Middle Aged
Palliation
Palliative care
Palliative Care - methods
Palliative Care - trends
Palliative treatment
Patients
Polls & surveys
Professional-Patient Relations
Professionals
Qualitative analysis
Qualitative Research
Quality management
Social Sciences
Suicides & suicide attempts
Surveys and Questionnaires
Uncertainty
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cited_by cdi_FETCH-LOGICAL-c692t-eadd11ee8757930d444d16a104532454ff05b9e634758eb9a0b4c6d1202c8bbc3
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Dojan, Thomas
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Jünger, Saskia
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Boström, Kathleen
Frerich, Gerrit
Voltz, Raymond
description In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: "outer framework", "extended care system" and "health-professional-patient-relationship". Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations-especially the proactive approach-are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.
doi_str_mv 10.1371/journal.pone.0257382
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source Open Access: PubMed Central; Publicly Available Content Database (Proquest) (PQ_SDU_P3)
subjects Adult
Attitude to Death
Biology and Life Sciences
Communication
Criminal investigations
Data analysis
Data Interpretation, Statistical
Death
Death & dying
Delphi Technique
Evaluation
Female
Germany
Health Personnel
Humans
Information management
International Cooperation
Male
Medical care
Medical personnel
Medicine
Medicine and Health Sciences
Methods
Middle Aged
Palliation
Palliative care
Palliative Care - methods
Palliative Care - trends
Palliative treatment
Patients
Polls & surveys
Professional-Patient Relations
Professionals
Qualitative analysis
Qualitative Research
Quality management
Social Sciences
Suicides & suicide attempts
Surveys and Questionnaires
Uncertainty
title "Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care
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