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Family's Wishes (family + wish)
Selected AbstractsLong-term prognosis and satisfaction after percutaneous endoscopic gastrostomy in a general hospital,GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 3 2004Joji Onishi Background: Percutaneous endoscopic gastrostomy (PEG) has been widely acknowledged as a safer method for enteral feeding; however, its long-term impact on prognosis and quality of life in elderly patients is not sufficiently understood. There are issues still to be studied regarding the indications for PEG, due to the lack of convincing evidence that it reduces expected complications such as aspiration pneumonia or for improving the prognosis of patients with severe dementia. Method: In this study we investigated the survival rate after PEG and the families' satisfaction in 78 inpatients who underwent PEG. We conducted the investigation by sending questionnaires to the families. Results: The results for the 69 cases (88%) in which the patient recovered showed that the 1-year survival rate was 64.0%, and the 2-year survival rate was 55.5%. Fifty-three per cent of patients' families indicated overall satisfaction regarding of PEG. Conclusions: The survival rates were relatively higher than those from previously reported studies. This may be attributed to variations in patients' clinical, socio-economic, or cultural backgrounds in therapeutic interventions. We recognized the importance of clarifying factors that would affect the living and functional prognosis and quality of life in elderly patients who underwent PEG. The indications for PEG are based on a comprehensive assessment of the relevant factors in individual cases, and by taking patients' and families' wishes into consideration. [source] Individual and Family Decisions About Organ DonationJOURNAL OF APPLIED PHILOSOPHY, Issue 1 2007T. M. WILKINSON abstract This paper examines, from a philosophical point of view, the ethics of the role of the family and the deceased in decisions about organ retrieval. The paper asks: Who, out of the individual and the family, should have the ultimate power to donate or withhold organs? On the side of respecting the wishes of the deceased individual, the paper considers and rejects arguments by analogy with bequest and from posthumous bodily integrity. It develops an argument for posthumous autonomy based on the liberal idea of self-development and argues that this establishes a right of veto over donation. It claims, however, that whether the family's power to veto would conflict with posthumous autonomy rights depends on how it comes about. On the side of respecting the family's wishes, the paper first considers an argument from family distress. This supports a contingent, non-rights-based reason for the family's power that is trumped by the deceased's rights. It then outlines and criticises an argument based on family autonomy. The conclusion is that the individual has the right to veto the family's wish to donate and that, while the family has no right to veto the individual's wishes to donate, it can legitimately acquire this power and has done so in practice. [source] Relatives in end-of-life care , part 1: a systematic review of the literature the five last years, January 1999,February 2004JOURNAL OF CLINICAL NURSING, Issue 9 2006Birgitta Andershed PhD Aim., To review systematically research conducted during the past five years focusing on the relatives' situation and needs in end-of-life care. Background and aim., That relatives make a large contribution in the care of the dying is well-known. In this situation, relatives often have to solve many new practical problems in the care as well as dealing with the sorrow of both themselves and the dying person. In recent years, palliative care has been developed in many countries and many new studies have been carried out. Methods., A systematic search of the literature was performed in the CINAHL and Medline databases. Of the 94 papers analysed, there were 59 qualitative and 35 quantitative studies with differing designs. The studies were carried out in 11 countries and were published in 34 different journals. Results., The results were categorized in two main themes with several subthemes: (1) being a close relative , the situation: (i) exposed position , new responsibility, (ii) balance between burden and capacity and (iii) positive values; (2) being a close relative , needs: (i) good patient care, (ii) being present, (iii) knowing and communicating and (iv) support from and trusting relationship with the professional. The relative's feelings of security and trust in the professional were found to be of great importance. Conclusion., More than twice as many studies had a descriptive/explorative design, which is of importance in the assessment of evidence. However, different studies complement one another and in summary, it can be said that analytic evidence is unequivocal: good patient care, communication, information and the attitude of the professional are of decisive importance regarding relatives' situation. These results are also in accord with earlier review studies. Relevance to clinical practice., Staff members have a great deal of responsibility for assuring that the patient feels as good as possible, facilitating relatives' involvement based on the family's wishes and limiting the stress and difficulties experienced by the family. The results showed that the relative's satisfaction could depend on the attitude of the professional as well as on good communication, good listening and good information. This can also be viewed as a prerequisite for the professional to get to know the family and to provide ,care in the light'. [source] | ||||||||||