Advance care planning for adolescent patients with life-threatening neurological conditions: A survey of Japanese paediatric neurologists

Title

Advance care planning for adolescent patients with life-threatening neurological conditions: A survey of Japanese paediatric neurologists

Creator

Yotani N;Kizawa Y;Shintaku H

Publisher

BMJ Paediatrics Open

Date

2017

Subject

Advance care planning;neurologic disease;neurologist;pediatrician;Adult;article;artificial ventilation;cross-sectional study;do not resuscitate order;Family;Female;health care survey;hematologist;Human;Japan;living will;Male;Middle Aged;priority journal;prognosis;terminal care

Description

Objective To evaluate current attitudes and barriers to advance care planning for adolescent patients with life-threatening conditions among paediatric neurologists. Design Cross-sectional study. A self-reported questionnaire was administered to assess the practice of advance care planning, advance directives and barriers to advance care planning for adolescent patients with life-threatening conditions. All board-certified paediatric neurologists in Japan were surveyed and those who had experience in taking care of adolescent patients with decision-making capacity were analysed. We compared the results with those of paediatric haematologists reported previously. results In total, 186 paediatric neurologists were analysed. If the patient's prognosis was <3 months, only about 30% of paediatric neurologists reported having discussions with patients, such as 'do not attempt resuscitation' orders (28%) and ventilator use (32%), whereas more than 70% did discuss these topics with patients' families. About half of the paediatric neurologists did not discuss advance directives at the end of life with their patients, whereas over 75% did discuss advance directives with patients' families. Compared with paediatric haematologists, paediatric neurologists had more end-of-life discussions with patients, such as where treatment and care will take place, do not attempt resuscitation orders, and the use of a ventilator, if the patient's prognosis was >>1 year. conclusion About half or less of the paediatric neurologists discussed advance care planning and advance directives with their adolescent patients who had life-threatening conditions, even if the patient's prognosis was <3 months. They tended to discuss advance care planning and advance directives more with families than with patients themselves.

Rights

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Citation List Month

November 2018 List

Collection

Citation

Yotani N;Kizawa Y;Shintaku H, “Advance care planning for adolescent patients with life-threatening neurological conditions: A survey of Japanese paediatric neurologists,” Pediatric Palliative Care Library, accessed August 2, 2021, https://pedpalascnetlibrary.omeka.net/items/show/15612.

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