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What do Georgia's health care providers think about end-of-life care?

Over 700 healthcare providers completed an eight-page survey on institutional practices and individual practices and attitudes related to end-of-life care. Kathy Kinlaw and Karen Trotochaud– with statistical assistance from Nancy Thompson, PhD and Amy Sandul, MPH from the Rollins School of Public Health—are currently analyzing responses to this survey, mailed out earlier this semester to doctors, nurses, social workers, and healthcare chaplains throughout the state of Georgia.

Intending to discern both the frequency and the effectiveness of institutional practices included in caring for the dying patients and the individual practices, attitudes, beliefs, and experiences of healthcare providers, the survey contains questions in several broad areas. These broad areas include patient involvement in decision-making; pain assessment and management; and withdrawal, withholding and hastening death. Although analysis is just beginning, the survey hopes to describe the current state of end-of-life care within our healthcare settings as well as to begin to identify areas that may benefit from increased attention.

One of the areas addressed under the broad topic of patient involvement in decision-making is the use and effectiveness of Living Wills. In the state of Georgia the Living Will is the original legal form of advance directive, allowing a patient to document her wishes about end of life care in three clinical conditions. Only 54.5% of respondents agree that institutional practices related to Living Wills are mostly or very effective. Availability of directives is a concern, as only 38% of respondents report that completed Living Wills are mostly or always immediately accessible at their institutions and 23% report that they are never or infrequently available.

When Living Wills are available, 74.5% of respondents report that patient instructions as recorded in the document are frequently or always followed. However, when family or physician disagree with patients instructions in a Living Will, respondents report that the patient instructions are less likely to be followed.

Analysis of the survey should provide important information to patients and providers throughout Georgia as well as present a methodology and instrument that could be replicated in other states. Publication of the final report is anticipated later this spring.

[ Posted by Kathy Kinlaw at March 1, 2002 06:05 PM | More HCECG articles ]

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