End-of-life decisions in the intensive care unit-exploring the knowledge and attitude of nurses and doctors: a national survey

Abstract

Aim: In our country, there is a growing awareness regarding end-of-life practices. It has become evident that treatments in intensive care to end-stage patients, instead of honoring their previously made end-of-life decisions, significantly diminishes patients’ overall quality of life. The aim of study is drawing attention to end-of-life decision practices and to evaluate the knowledge and attitudes of intensive care physicians and nurses, who are decisive in end-of-life decision-making practices. Methods: The study was planned as a multi-center, cross-sectional, descriptive questionnaire. There were 21 questions about demographic data, definitions, and end-of-life decisions. 259 of 760 intensive care physicians and nurses who filled out the questionnaire were included. Results: Two hundred and fifty-nine participants were included. The rate of decision for terminal sedation and euthanasia was differentiating according to intensive care experience. Participants’ knowledge was insufficient regarding withholding and withdrawal approaches. Intensive care physicians, and patients at the terminal stage of chronic disease were recommended as decision makers with the highest rate. Conclusion: In this study, it was determined that the participants' knowledge about end-of-life decision concepts was not sufficient, and their approaches were differentiating due to experience. It is considered that there is a need for education and standardization about end-of-life decision-making process.