Cross-Cultural Adaptation of the Physician Orders for Life-Sustaining Treatment Form in Greece; a pilot cross-sectional descriptive study

Résumé fourni par la source

ABSTRACT The current legal framework in Greece does not permit withholding medical interventions to allow natural death, leading to a lack of documented advance directives to guide clinical practice. The aim of this pilot descriptive study is to culturally adapt the Physician Orders for Life-Sustaining Treatment (POLST) form, and use it as a framework with which to assess the readiness of Greek residents for discussions on medical care near the end of life. Patients with severely limited prognosis and/or their family members were interviewed by attending physicians who then recorded their wish with regards to Do-Not-Resuscitate (DNR) status on the adapted POLST form, as well as their level of agreement with signing a similar form. Thirty-one patients with an age range of 18 to 109 years old participated. All had severe prognosis due to various end-stage diseases. Sixteen patients (51.6%) wished for DNR status and didn’t wish for further intervention in case they suffered cardio-respiratory arrest. Presence of an end-stage malignancy was associated with a higher chance of DNR preference (OR: 8.8, 95%CI 1.5-50, p = 0.017) or comfort measures only (OR: 5.6, 95%CI 1.1-30, p = 0.05). This pilot study of patients with severe prognosis hospitalized in a tertiary care center in Greece showed preliminary evidence of high acceptance of natural death and DNR status. POLST forms could be used as a framework for advance care planning through shared decision-making, thus reducing unwarranted treatments and enhancing trust between healthcare professionals and patients at the end of life.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.