Physicians ne to understand what pa...

Physicians ne to understand what patients do or do not want when they are faced with terminal illness. fresh studies have focused on this issue from the perspective of family members, physicians, and ables in end-of-life care. Although these studies provided insight, other studies originate that patients, family members, and physicians interpret the experience of dying differently. Several studies evaluated individual perspectives upon death and dying. One of these studies limited the participants to patients with an estimated life expectancy of six month or les nevertheless it focused on relatively young patients with advanced acquired immunodeficiency syndrome (AIDS). Vig and Pearlman studied the perspective of older patients with habitual terminal illnesses, with the goal of determining what these patients believed would be a profitable or bad death.

The trial was a qualitative investigation with one-on-one interviews of men with terminal illnesses. Participants were from various clinics associated with sum of two units university-affiliated medical centers. To qualify for the cogitation participants had to have a life expectancy of six month or les and have terminal cancer or heart disease. Those who met the inclusion criteria had a one-on-one semistructured interview with individual of the authors. The first portion of the interview was open-end questions about by what means the patients would describe dutiful and bad deaths. This portion was recorded, transcribed, and analyzed using estateed theory methods. The second portion of the interview was closed-end questions about specific end-of-life scenarios.

There were 26 men who participated in the reflection There was heterogeneity in their rejoinders about good deaths, bad deaths, and preferr dying experiences. a of the more common remarks about a good death included, "In my be dead quick, painless, and without suffering." any of the components of a bad death included painful, lengthened suffering, and burdening others. The participants did not have uniform beliefs about the personality of others at the finis or the preferred location of death. Seventy-seven percent of the participants rated family as highly important at the present time, but only 45 percent rated neighborhood of family at the time of death as important or highly important. The main note about this issue was that it would be nice to have family not away but the participant would not want to state them through it.

The authors terminate that when discussing end-of-life care with terminal patients, it is important to identify what patients view as a fit or a bad death and what attributes contribute to a proper or a bad death. This allows the discussion to concentrate forward what might interfere with a righteous death and helps them achieve a death that is consistent with the patient's wishes.

Vig EK Pearlman RA. serviceable and bad dying from the perspective of terminally ill men Arch Intern M May 10 2004;164:977-81

EDITOR'S NOTE: Providing care at the fall of the curtain of life is a challenge that requires physicians to understand what patients perceive as a fit death. Vig and Pearlman base that what is considered a advantageous or bad death is a matter of individual opinion, and health care providers ne to understand what the patient considers important. Using the same research technique, Singer and colleagues (1) identified five domains of quality end-of-life care. These domains included receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a mind of control, relieving the carrying capacity and strengthening relationships with lov single in kinds These two studies point public that there are many aspects of end-of-life care, and physicians ne to understand what patients desire at this time in their lives.--K.E.M.

REFERENCE

(1) Singer PA, Martin DK Kelner M Quality end-of-life care. Patients' perspectives. JAMA 1999;281:163-8

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