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Nephrologists' Perspectives on Decision Making About Life-Sustaining Treatment and Palliative Care at End of Life: A Questionnaire Survey in Korea

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Author(s)
Yu Ah HongSungjin ChungWoo Yeong ParkEun Jin BaeJae Won YangDong Ho ShinSang Wook KimSung Joon ShinHyuk Man KwonHyun Soo KimHan RoChang Soo BuTae Yong SonByung Chul ShinSang Joo LeeJae Won LeeJun Seung LeeJung Hyun LimSung Won JungJae Sung JungHyuk Joon Jung
Keimyung Author(s)
Park, Woo Young
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of palliative medicine
Issued Date
2021
Volume
24
Issue
4
Keyword
dialysisend of lifepalliative carewithdrawalwithhold
Abstract
Background:
Nephrologists commonly engage in decision making regarding the withholding or withdrawal of dialysis and palliative care in patients at end of life (EoL). However, these issues remain an unsolved dilemma for nephrologists.

Objective:
To explore nephrologists' perceptions on the decision-making process about withholding or withdrawing dialysis and palliative care in Korea.

Design:
A nationwide 25-item questionnaire online survey via e-mail.

Setting/Subjects:
A total of 369 Korean nephrologists completed the survey.

Results:
The proportions of respondents who stated that withholding or withdrawing dialysis at EoL is ethically appropriate were 87.3% and 86.2%, respectively. A total of 72.4% respondents thought that withdrawal of dialysis in a maintenance dialysis patient is ethically appropriate. Responses regarding patient features that should be considered to withhold or withdraw dialysis were as follows: dialysis intolerance (84.3%), poor performance status (74.8%), patient's active request (47.2%), age (28.7%), very severe dementia (27.1%), and several comorbidities (16.5%). Among those nephrologists who responded to the question about the minimum age, at which dialysis should be withheld or withdrawn, most specified an age between 80 and 90 years (94.3%). Fifty-eight percent of respondents stated that terminally ill dialysis patients should be allowed to use palliative care facilities. In addition, a number of nephrologists thought that adequate palliative care facilities, specific treatment guidelines, enough time to manage patients, financial support, and adequate medical experts are necessary.

Conclusions:
Korean nephrologists thought that withholding or withdrawing dialysis at EoL is ethically appropriate, even in maintenance dialysis patients. Therefore, consensus guidelines for palliative care after withholding or withdrawal of dialysis are needed.
Keimyung Author(s)(Kor)
박우영
Publisher
School of Medicine (의과대학)
Citation
Yu Ah Hong et al. (2021). Nephrologists’ Perspectives on Decision Making About Life-Sustaining Treatment and Palliative Care at End of Life: A Questionnaire Survey in Korea. Journal of palliative medicine, 24(4), 527–535. doi: 10.1089/jpm.2020.0248
Type
Article
ISSN
1557-7740
Source
https://www.liebertpub.com/doi/10.1089/jpm.2020.0248
DOI
10.1089/jpm.2020.0248
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43191
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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