Journal of Hospice and Palliative Care

  • 제24권4호
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  • Pages.204-213
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  • 2021
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  • 2765-3072(pISSN)
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  • 2765-3080(eISSN)
한국호스피스완화의료학회 (Korean Society for Hospice and Palliative Care)
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Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong (Division of Hematology & Medical Oncology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Lee, Hyun Jung (Division of Hematology & Medical Oncology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Yu, Soo-Young (Department of Nursing Science, Jeonju University) ;
  • Kwon, Jung Hye (Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine) ;
  • Ahn, Hee Kyung (Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center) ;
  • Kim, Jee Hyun (Division of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Seo, Seyoung (Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Maeng, Chi Hoon (Division of Medical Oncology-Hematology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine) ;
  • Lim, Seungtaek (Department of Hemato-Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Do Yeun (Division of Hematology & Medical Oncology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Shin, Sung Joon (Division of Nephrology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine)
  • 투고 : 2021.04.11
  • 심사 : 2021.10.04
  • 발행 : 2021.12.01
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초록

Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

키워드

과제정보

This study was conducted with the support of the National Evidence-based Healthcare Collaborating Agency (NA19-008).

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