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The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study.

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Title: The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study.
Authors: Sprung, Charles L., Jennerich, Ann L., Joynt, Gavin M., Michalsen, Andrej, Curtis, J. Randall, Efferen, Linda S., Leonard, Sara, Metnitz, Barbara, Mikstacki, Adam, Patil, Namrata, McDermid, Robert C., Metnitz, Philipp, Mularski, Richard A., Bulpa, Pierre, Avidan, Alexander
Source: Journal of Palliative Care; Oct2024, Vol. 39 Issue 4, p316-324, 9p
Subject Terms: DO-not-resuscitate orders, CRITICALLY ill patient care, INFORMED consent (Medical law), TERMINAL care, INTENSIVE care units, INSTITUTIONAL care
Abstract: Objective: To evaluate the association between provider religion and religiosity and consensus about end-of-life care and explore if geographical and institutional factors contribute to variability in practice. Methods: Using a modified Delphi method 22 end-of-life issues consisting of 35 definitions and 46 statements were evaluated in 32 countries in North America, South America, Eastern Europe, Western Europe, Asia, Australia and South Africa. A multidisciplinary, expert group from specialties treating patients at the end-of-life within each participating institution assessed the association between 7 key statements and geography, religion, religiosity and institutional factors likely influencing the development of consensus. Results: Of 3049 participants, 1366 (45%) responded. Mean age of respondents was 45 ± 9 years and 55% were females. Following 2 Delphi rounds, consensus was obtained for 77 (95%) of 81 definitions and statements. There was a significant difference in responses across geographical regions. South African and North American respondents were more likely to encourage patients to write advance directives. Fewer Eastern European and Asian respondents agreed with withdrawing life-sustaining treatments without consent of patients or surrogates. While respondent's religion, years in practice or institution did not affect their agreement, religiosity, physician specialty and responsibility for end-of-life decisions did. Conclusions: Variability in agreement with key consensus statements about end-of-life care is related primarily to differences among providers, with provider-level variations related to differences in religiosity and specialty. Geography also plays a role in influencing some end-of-life practices. This information may help understanding ethical dilemmas and developing culturally sensitive end-of-life care strategies. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Palliative Care is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study.
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  Data: Journal of Palliative Care; Oct2024, Vol. 39 Issue 4, p316-324, 9p
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  Data: <searchLink fieldCode="DE" term="%22DO-not-resuscitate+orders%22">DO-not-resuscitate orders</searchLink><br /><searchLink fieldCode="DE" term="%22CRITICALLY+ill+patient+care%22">CRITICALLY ill patient care</searchLink><br /><searchLink fieldCode="DE" term="%22INFORMED+consent+%28Medical+law%29%22">INFORMED consent (Medical law)</searchLink><br /><searchLink fieldCode="DE" term="%22TERMINAL+care%22">TERMINAL care</searchLink><br /><searchLink fieldCode="DE" term="%22INTENSIVE+care+units%22">INTENSIVE care units</searchLink><br /><searchLink fieldCode="DE" term="%22INSTITUTIONAL+care%22">INSTITUTIONAL care</searchLink>
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  Data: Objective: To evaluate the association between provider religion and religiosity and consensus about end-of-life care and explore if geographical and institutional factors contribute to variability in practice. Methods: Using a modified Delphi method 22 end-of-life issues consisting of 35 definitions and 46 statements were evaluated in 32 countries in North America, South America, Eastern Europe, Western Europe, Asia, Australia and South Africa. A multidisciplinary, expert group from specialties treating patients at the end-of-life within each participating institution assessed the association between 7 key statements and geography, religion, religiosity and institutional factors likely influencing the development of consensus. Results: Of 3049 participants, 1366 (45%) responded. Mean age of respondents was 45 ± 9 years and 55% were females. Following 2 Delphi rounds, consensus was obtained for 77 (95%) of 81 definitions and statements. There was a significant difference in responses across geographical regions. South African and North American respondents were more likely to encourage patients to write advance directives. Fewer Eastern European and Asian respondents agreed with withdrawing life-sustaining treatments without consent of patients or surrogates. While respondent's religion, years in practice or institution did not affect their agreement, religiosity, physician specialty and responsibility for end-of-life decisions did. Conclusions: Variability in agreement with key consensus statements about end-of-life care is related primarily to differences among providers, with provider-level variations related to differences in religiosity and specialty. Geography also plays a role in influencing some end-of-life practices. This information may help understanding ethical dilemmas and developing culturally sensitive end-of-life care strategies. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Palliative Care is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1177/08258597211002308
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      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 316
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      – SubjectFull: DO-not-resuscitate orders
        Type: general
      – SubjectFull: CRITICALLY ill patient care
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      – SubjectFull: INFORMED consent (Medical law)
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      – SubjectFull: TERMINAL care
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      – SubjectFull: INSTITUTIONAL care
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      – TitleFull: The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study.
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              Text: Oct2024
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