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dc.contributor.authorKingdon, Arjun
dc.contributor.authorSpathis, Anna
dc.contributor.authorAntunes, Bárbara
dc.contributor.authorBarclay, Stephen
dc.date.accessioned2022-07-01T18:00:12Z
dc.date.available2022-07-01T18:00:12Z
dc.date.issued2022-07
dc.identifier.issn0269-2163
dc.identifier.other10.1177_02692163221097309
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338668
dc.descriptionFunder: NIHR Applied Research Collaboration East of England
dc.descriptionFunder: Health Education East of England
dc.description.abstractBACKGROUND: The impact of assisted hydration on symptoms and survival at the end of life is unclear. Little is known about optimal strategies for communicating and decision-making about this ethically complex topic. Hydration near end of life is known to be an important topic for family members, but conversations about assisted hydration occur infrequently despite guidance suggesting these should occur with all dying people. AIM: To explore the views and experiences of doctors experienced in end-of-life care regarding communicating with patients and families and making decisions about assisted hydration at the end of life. DESIGN: Qualitative study involving framework analysis of data from semi-structured interviews. SETTING/PARTICIPANTS: Sixteen UK-based Geriatrics and Palliative Medicine doctors were recruited from hospitals, hospices and community services from October 2019 to October 2020. RESULTS: Participants reported clinical, practical and ethical challenges associated with this topic. The hospital setting provides barriers to high-quality communication with dying patients and their families about assisted hydration, which may contribute to the low incidence of documented assisted hydration-related conversations. Workplace culture in some hospices may make truly individualised decision-making about this topic more difficult. Lack of inclusion of patients in decision-making about assisted hydration appears to be common practice. CONCLUSIONS: Proactive, routine discussion with dying people about hydration-related issues is indicated in all cases. There is room for debate regarding the limits of shared decision-making and the benefits of routine discussion of assisted hydration with all dying people. Clinicians have to navigate multiple barriers as they strive to provide individualised care.
dc.languageen
dc.publisherSAGE Publications
dc.subjectOriginal Articles
dc.subjectDecision making
dc.subjectshared
dc.subjectcommunication
dc.subjectterminal care
dc.subjectdeath
dc.subjectfluid therapy
dc.titleMedical communication and decision-making about assisted hydration in the last days of life: A qualitative study of doctors experienced with end of life care.
dc.typeArticle
dc.date.updated2022-07-01T18:00:11Z
prism.endingPage1091
prism.issueIdentifier7
prism.publicationNamePalliat Med
prism.startingPage1080
prism.volume36
dc.identifier.doi10.17863/CAM.86080
dcterms.dateAccepted2022-04-02
rioxxterms.versionofrecord10.1177/02692163221097309
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.licenseref.startdate2022-05-21
dc.contributor.orcidKingdon, Arjun [0000-0002-2914-082X]
dc.contributor.orcidAntunes, Bárbara [0000-0003-1655-7391]
dc.identifier.eissn1477-030X
cam.issuedOnline2022-05-21
rioxxterms.freetoread.startdate2022-05-21
rioxxterms.freetoread.startdate2022-05-21


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