Po1487 Decisions And The Factors Affecting Them: Two Different Perspectives On End-Of-Life

Turgay Albayrak1, Omer Akca2, Adem BAHADIR2, Iskender Bülbül3, Tar?k Eren Y?lmaz3, Ismail Kasim4, Irfan Sencan4, Rabia Kahveci5 e Adem Ozkara6
1Sincik Government Hospital Adiyaman/Turkey; 2Department of Family Medicine Ankara Numune Training and Research Hospital; 3Department of Family Medicine Ankara Numune Training and Research Hospital Ankara/Turkey; 4Ankara Numune Training and Research Hospital, Department of Family Medicine; 5Department of Family Medicine, Numune Training and Research Hospital Ankara/Turkey; 6Hitit University Medical Faculty, Department of Family Medicine
Background: Medical decisions are provided by doctors most of the time in conventional medical model. An advanced health care directive, is a set of written instructions that a person gives that specify what actions should be taken for their health, if they are no longer able to make decisions due to illness or incapacity. There is limited literature on different perspectives on such directives and end of life decisions in Turkey.
Aim: The aim of this study is to determine the views and preferences of people about end-of-life decisions and the factors affecting these preferences. We also aim to compare perspectives of health care professionals and lay people.
Methods: This is a cross-sectional study. A survey is conducted with adults who accepted to join the study. Individuals below 20 and above 65, patients diagnosed with psychiatric disorders or serious life-threatening conditions were excluded. The first strand (S1) was health care professionals (HCPs) and the second strand (S2) was lay people; a questionnaire and Templer’s Death Anxiety Scale were conducted in both strands.
Findings: 445 were included in S1; 36,6% males and 63,6% females. 58,9% were physicians and 27,9% nurses. 340 participants were included in S2. 53,8% males and 46,2% females. 48% of S2 believed patient interventions in terminal period have a positive effect on survival, whereas 53% of S1 thought they don’t. 67% of S2 prefers that anybody should receive an intervention in the terminal period, where 82% prefer this intervention for their first degree relatives, but 55% prefers an intervention for himself. 39% of S1 are against an intervention at the terminal period to anybody, whereas 48% prefers for their first-degree relatives, but 65% don’t prefer for himself. Participants in both strands have similar Templer’s Scale death anxiety scores (60%- secondary). 77,3% of S1 and 79% of S2 want to decide on their end of life care. 55,4% of S1 and 50 % of S2 want to write these decisions as wills to family physicians.
Conclusions: All participants want to be involved in decision-making process to some extent, before they face a serious life-threatening condition. Decisions of the HCPs differ from the lay people. We also observe a difference in the decisions regarding the person himself, and the first-degree relative. The interest of the participants in our study and their received answers reflect the need for further discussion of the topic and the right timing of such discussions.
end-of-life decision; shared decision