Experience In Switzerland Research Articles

Suggestions on the Development of China’s Elderly Care Industries Based on the Experience of Switzerland

Suggestions on the Development of China’s Elderly Care Industries Based on the Experience of Switzerland

What matters to migrant women during labor and birth: Chinese mothers’ experiences in Switzerland

BackgroundIn Switzerland, foreigners account for 25.3% of the permanent resident population, and the fertility rate of migrant women is higher than that of Swiss women. However, migrant women from non-European countries are more likely to report having negative childbirth experiences than Swiss women. For example, during pregnancy, Chinese migrant mothers often felt dissatisfied with the follow-up pregnancy complications and lacked information on medical procedures and prenatal courses. In this paper, we explored their childbirth experiences in Swiss hospitals and how Swiss healthcare providers supported them.MethodA qualitative study employing in-depth, semi-structured interviews was conducted with 14 Chinese mothers and 13 family members. All interviews were audio-recorded, transcribed, and translated into English for data analysis. Thematic analysis was employed to generate a detailed description.ResultsThree main themes were extracted from the transcripts: (1) Sense of security, (2) Intrapartum care, and (3) Postpartum needs.ConclusionsOur study shows Chinese migrant mothers prioritized giving birth in a physically and psychologically safe environment, with pain control and practical and emotional support from their intimate partners. They desired a physiological labor and birth with minimal obstetric interventions. Our research also reveals their postpartum needs, emphasizing the importance of postpartum support and obtaining culturally sensitive care during their postpartum hospital stay. The study adds new knowledge of specific migrant studies in Switzerland, as called for by the Swiss Federal Office of Public Health. The results call for the transcultural care skills training of Swiss healthcare providers to enable migrant women to have a more positive childbirth experience.

Robotic-assisted percutaneous coronary intervention: experience in Switzerland.

Percutaneous coronary intervention (PCI) exposes operators to ionizing radiation. Robotic-assisted PCI (RA-PCI) is a novel technology that enables interventional cardiologists to operate coronary devices remotely from a radiation-shed cockpit. The aim of this study is to describe the experience and challenges during the initiation of a RA-PCI program and to report outcomes of the first 21 patients undergoing RA-PCI in Switzerland. All patients undergoing RA-PCI using the CorPath GRX Vascular Robotic System between 06/2021 and 12/2021 at Inselspital, Bern University Hospital were included in this retrospective registry study. Baseline, procedural and clinical follow-up data were prospectively assessed as part of the Cardiobase Bern PCI registry (NCT02241291). The two endpoints of interest were clinical success [defined as <30% residual diameter stenosis in the absence of in-hospital major adverse cardiovascular events (MACE: composite of death, periprocedural myocardial infarction, target-vessel revascularization, and stroke)] and robotic success (defined as clinical success and completion of RA-PCI without or with partial manual assistance). Additional outcome measures include clinical long-term outcomes at one year. Twenty-five lesions in 21 patients were treated with RA-PCI (age 62.4 ± 9.1 years, 24% female). Clinical success was achieved in 100%, and robotic success in 81% (17/21 procedures, including 4 procedures requiring partial manual assistance). Manual conversion (e.g. manual completion of the procedure) occurred in 19% (4 procedures). Reasons for manual assistance or conversion were poor guiding-catheter back-up or platform limitations (4), adverse events (2x transient slow-flow that was solved manually), safety decision (1x vasovagal reaction not related to robotic approach), and software error (1). No in-hospital MACE occurred. During 12 months of follow-up, one patient suffered a non-target-vessel myocardial infarction requiring repeat PCI. RA-PCI can safely be performed without clinically relevant robot-associated complications in selected patients with approximately 80% of procedures conducted without or with partial manual assistance.

Fetal RHD Screening in RH1 Negative Pregnant Women: Experience in Switzerland.

RH1 incompatibility between mother and fetus can cause hemolytic disease of the fetus and newborn. In Switzerland, fetal RHD genotyping from maternal blood has been recommended from gestational age 18 onwards since the year 2020. This facilitates tailored administration of RH immunoglobulin (RHIG) only to RH1 negative women carrying a RH1 positive fetus. Data from 30 months of noninvasive fetal RHD screening is presented. Cell-free DNA was extracted from 7192 plasma samples using a commercial kit, followed by an in-house qPCR to detect RHD exons 5 and 7, in addition to an amplification control. Valid results were obtained from 7072 samples, with 4515 (64%) fetuses typed RHD positive and 2556 (36%) fetuses being RHD negative. A total of 120 samples led to inconclusive results due to the presence of maternal or fetal RHD variants (46%), followed by women being serologically RH1 positive (37%), and technical issues (17%). One sample was typed false positive, possibly due to contamination. No false negative results were observed. We show that unnecessary administration of RHIG can be avoided for more than one third of RH1 negative pregnant women in Switzerland. This reduces the risks of exposure to a blood-derived product and conserves this limited resource to women in actual need.

Martti Siirala and Gaetano Benedetti – Friends in the dialogical and psychotherapeutic sharing of burdens

This article explores the dialogical collaboration and friendship between Martti Siirala and Gaetano Benedetti, particularly in the development of the psychotherapy of schizophrenia and the human psychotherapeutic attitude toward carrying and sharing burdens. Siirala and Benedetti outlined a psychotherapy that considers existential and philosophical dimensions alongside the clinical aspects of illness, without being bound by schools of thought, authorities, or doctrinal systems. The main material in the article is based on documents from the Martti Siirala archive, the most important of which is the German-language correspondence between Siirala and Benedetti after Siirala moved back to Finland from Switzerland at the end of 1957. Benedetti’s activities in Basel are also illuminated by descriptions sent to Siirala by nurse Aino Kärkkäinen of her experiences in Switzerland in the late 1950s.

Заңдардың сапасын қамтамасыз етудегі Швейцарияның заң шығару тәжірибесі

Бүгінгі таңда заңнаманың тұрақтылығы Қазақстан Республикасында тұтастай алғанда елдің саяси және әлеуметтік-экономикалық даму бағытының тұрақтылығын айқындайды. Қоғамдық қатынастарды құқықтық реттеудің тұрақтылығына нормашығарушы органдардың (лауазымды тұлғалардың), нормашығарушы қызметтің өзге де субъектілерінің нормативтік құқықтық актілердің тиісті сапасын, қоғамдық қатынастарды құқықтық реттеудің толықтығы мен тиімділігін қамтамасыз етуге, сондай-ақ нормативтік құқықтық актілерді жиі түзетулерді шектеуге бағытталған шаралар қабылдауы арқылы қол жеткізіледі. Қазақстан Республикасының Конституциясы оның бүкіл аумағында бірыңғай құқықтық кеңістікті қамтамасыз ету қажеттігін алдын ала белгіледі. Мұндай жағдайларда заң шығару бастамасы құқығына ие субъектілердің және Қазақстан Республикасының өзге де нормашығарушы органдарының нормативтік құқықтық актілерді құрудың негізгі қағидаларын сақтауы ерекше маңызды. Аталған міндетті тиімді іске асыру мақсатында заңнамалық техниканың білім жүйесін жетілдіру саласында барабар қайта құрулар және ең алдымен, онымен көзделген: нормативтік құқықтық актілерді әзірлеуге арналған арнайы заң құралдарын ретке келтіру және пайдалану бойынша талаптарды мүлтіксіз орындау қажет. Осыған орай заңдардың сапасын қамтамасыз ету бойынша Швейцарияның заң шығармашылығы қызығушылық тудырады, мұнда мысал ретінде көптілді заңнаманың ортақ шешімдері көрсетілген. Зерттеудің мақсаты Швейцарияда нормашығару қызметінің тәжірибесін зерттеу және Қазақстан Республикасындағы заңнаманың сапасын арттыруға бағытталған ұсыныстарды әзірлеу. Зерттеудің әдістемелік негізін әлеуметтік құбылыстар мен процестерді танудың жалпы ғылыми әдістері, ғылыми талдау және синтездеу әдістері құрайды.

Development of the Road Map of Research Infrastructures: Experience of Switzerland

Problem setting. The research is devoted to the analysis of legal support and the practice of developing and adopting a road map of research infrastructures, based on the analysis of the experience of the Swiss Confederation. Analysis of resent researches and publications. Today, aspects of the development of innovation systems and research infrastructures of the European Union are a topic for research of many domestic researchers. At the same time, the analysis of the development of Roadmaps of research infrastructures of other countries, in particular, Switzerland remains relevant. Target of the research is to analyze the development of the Roadmap of research infrastructures of the Swiss Confederation. Article’s main body. Research infrastructures means a research facility necessary for conducting comprehensive research and development with high financial and technology demands, approved by the Government and established to be also used by other research organizations. Research Infrastructures are facilities, resources and services, including: major scientific equipment (or sets of instruments); knowledge-based resources such as collections, archives and scientific data; e-infrastructures, such as data and computing systems and communication networks. The Swiss Roadmap for Research Infrastructures is a planning tool for research infrastructures. SERI produces the Swiss Roadmap for Research Infrastructures every four years. At Swiss level, the 2023 Roadmap will present the new national infrastructure projects that Swiss cantonal universities and research institutes within the ETH Domain intend to build between 2025 and 2028. In addition, the report will include information on the status of the national infrastructure projects covered in the 2015 and 2019 editions. At international level, the 2023 Roadmap will show the international infrastructures that Switzerland is already involved in and which new participations are planned. Only projects that have successfully passed all three selection and review phases will appear on the Swiss Roadmap. The aim of this process is to select priority infrastructure projects. Conclusions and prospects for the development. The innovative development and the Roadmap of Swiss research infrastructures should be of significant interest to the Ukrainian scientific community. At the same time, an important step for Ukraine was the approval by the Cabinet of Ministers of the Concept of the State Targeted Program for the Development of Research Infrastructures in Ukraine for the period until 2026, as well as the approval of the Roadmap for the integration of the scientific and innovative system of Ukraine into the European Research Area.

Ways to improve legal regulation in the field of logistics of territorial defense of Ukraine

The article analyzes some legal acts in the field of logistics of territorial defense of Ukraine in the modern period, details their problematic issues and offers proposals for improving legal regulation in this area.&#x0D; Сurrently, Ukraine's defense sector is being actively reformed, but it does not yet meet today's requirements. Modern problems and challenges arising in the field of defense require fundamentally new scientifically sound approaches to the formation of the military organization of the state, the search for effective ways and mechanisms to protect national interests from real and potential threats of a military nature.&#x0D; The purpose of the article is to analyze the regulations in the field of logistics of territorial defense of Ukraine in the modern period and provide suggestions for improving legal regulation in this area.&#x0D; The experience of Switzerland and Israel deserves to be borrowed for the Institute of Local Territorial Defense of Ukraine, as these countries maintain armies that operate on the principles of universal conscription. All men under the age of 19 to 50 undergo military (alternative) service. A small part of the regular professional army maintains modern equipment and weapons, systematically trains a large number of reservists, who are kept on the principle of the police system and keep light small arms, ammunition and equipment.&#x0D; That is, these countries, due to national and historical features, built national regular armies to conduct defense, including territorial. However, they in a special way effectively keep 95-98% of the army personnel in reserve. These are countries with a total system of general military service, that’s relevant at present for Ukraine in point of view of Russian military aggression.&#x0D; As for the institute of local territorial defense in Ukraine, we propose to prescribe in the Law of Ukraine "On Fundamentals of National Resistance" certain provisions on social motivation and logistics of "voluntary assistants" for a quality information motive to protect the sovereignty and territorial integrity of Ukraine.&#x0D; In addition, we propose to understand the logistical support of the territorial defense of Ukraine as a set of measures to ensure all the necessary activities related to ensuring the combat capability of territorial defense entities for the effective implementation of the assigned tasks.

Estimating the prevalence of paediatric chronic pain in Switzerland: an online survey among paediatricians.

Chronic pain is a frequent complaint in children and adolescents, with great international variation in prevalence. Paediatricians are usually the first-line contact for pain problems in children and might refer patients to other specialists or pain clinics where available. Prevalence estimates of paediatric chronic pain and paediatricians' care experiences in Switzerland are currently lacking. The aim of this study was to assess the prevalence of paediatric chronic pain in Swiss paediatrician practices and paediatricians' professional experience and confidence with, and care provision for patients with paediatric chronic pain. Data were collected in 2019 using a cross-sectional online questionnaire among Swiss paediatricians. Ordinary least square regression analyses and Monte Carlo simulations were applied to estimate the prevalence rate of paediatric chronic pain. Explorative multivariate logistic regression analyses investigated whether sociodemographic and professional factors were associated with paediatricians' confidence in treating and experience with paediatric chronic pain. We included 337 paediatricians in our anonymised analyses. The prevalence rate of paediatric chronic pain in our sample was estimated to be between 2.54% and 3.89%. Twenty percent of paediatricians reported feeling confident in treating paediatric chronic pain, 77.2% had referred patients with paediatric chronic pain to another specialist and more than half had at least some experience with paediatric chronic pain. Experience and confidence with treating paediatric chronic pain were associated with male gender. Our study is the first to estimate the prevalence of paediatric chronic pain by means of a sample of Swiss paediatricians. The prevalence rate was considerably lower than other estimates. Given the lack of training and confidence with treating paediatric chronic pain reported by paediatricians, absence of awareness and resulting under-diagnosis is possible.

Unilateral Lumbar Biportal Endoscopic (ULBE) surgery: single center first experiences in Switzerland

Unilateral Lumbar Biportal Endoscopic (ULBE) surgery: single center first experiences in Switzerland

An innovative cold storage system for donor heart transportation-lessons learned from the first experience in Switzerland.

BackgroundThe current standard for donor heart preservation consists of cold organ storage in three sequential plastic bags. This technique can cause freezing injuries of the donor heart as the temperature inside the transport box is not monitored routinely. The SherpaPak™ Cardiac Transport System (CTS) (Paragonix Technologies, Cambridge, MA, USA) aims to resolve this problem by maintaining a controlled preservation temperature between 4 and 8 °C. This study reports the first single-centre experience in Switzerland with this innovative single-use disposable device.MethodsBetween May and December 2020, four heart procurements using SherpaPak™ CTS were performed at our heart centre. Donor heart preservation fluid and ambient temperature were monitored using the InTempConnect® application (Onset Computer Corporation, Bourne, MA, USA). All patient data were collected retrospectively from the local hospital patient data capture system.ResultsFour recipients of a donor heart preserved with SherpaPak™ CTS were included in this study (3 male, 1 female). Mean transport distance was 86 km (range, 45–276 km). Mean storage time in the cooler was 73.5±19.33 minutes. Mean cold ischemic time was 199.25±11.67 minutes. The device kept the average organ temperature between 5.2 and 8.8 °C and hereby reached the recommended temperature range of 5–10 °C. Modifications of the procurement and storage process provided an optimization of the temperature course in the transportation box. There were no incidents during the transport. Organs transported with this novel storage system showed normal function after transplantation.ConclusionsThe SherpaPak™ CTS provides constant organ temperatures during transportation, prevents freezing injury and ensures mechanical protection of the graft.KeywordsHeart transplantation; organ procurement; cold storage; hypothermic injury; graft transport

The importance of ethno-confessional factors for the study of federalism

Ethno-confessional factors played far from the main role in the formulation of the first federations. However, their importance increases in the XX century and especially in the era of globalization. The experience of Switzerland and Germany speaks of the importance of competition between faiths. Canada demonstrates the negative effects of ethnic dualism, while India shows the possibility of ethno-linguistic demarcation in conditions of particularly high multi-ethnicity. Under these circumstances, it would hardly make sense to plan the transformation of the multinational Russian Federation according to a purely territorial-administrative principle.

Why We Continue to Need Energy Efficiency Programmes—A Critical Review Based on Experiences in Switzerland and Elsewhere

Energy efficiency programmes (EEPs) are schemes operated by utilities or other bodies in order to incentivize energy efficiency improvement, in particular by adoption of energy-efficient products and typically by means of an economic reward. Ample experience has been gained, especially in the U.S., where EEPs have been in use for decades, with the rationale of avoiding additional energy supply by improving energy efficiency. More recently, EEPs have been implemented in Europe and in Switzerland. This review paper presents insights from the U.S., the EU and especially from Switzerland, with a focus on levelised programme cost of saved energy (LPC) as a key performance indicator. These LPC values, which take the perspective of the programme operator, are typically low to very low compared to the cost of electricity supply, thereby representing an important argument in favour of their use. The country examples show that EEPs are being effectively and successfully put into practice, for example, in Switzerland both as (i) a national tender-based scheme (called ProKilowatt) and in the form of a (ii) utility-operated obligation-based scheme (in Geneva). EEPs not only call for diligent implementation but also for suitable legal settings, e.g., in the form of mandatory energy efficiency savings targets (as realised for energy efficiency obligations, EEOs) in combination with programme cost recovery. The main criticism of EEPs is the free-rider effect, which needs to be minimised. On the other hand, EEPs are accompanied by significant co-benefits (environmental, health-related and social) and spillover effects. In their currently prevalent form, EEPs allow one to effectively save energy at a (very) low cost (“low-hanging fruit”). They can hence play an important role in fostering the energy transition; however, they should be implemented as part of a policy portfolio, in combination with other policy instruments.

State Stimulation of Innovation Activities in Switzerland and Russia

The article explores the system of State Financing of Research and Development (R&amp;D) of small and medium-sized enterprises (SME) in Switzerland. Authors outlined the results of their analysis of key state institutions of financial support. The innovative vector of Swiss economy with a focus on its own financial resources, a developed national scientific and educational environment, as well as mechanisms of tax incentives for scientific and innovative activities of large, small and medium-sized enterprises at the regional level allowed Switzerland to become one of the leaders in the world innovation market. Russia can borrow the experience of Switzerland in the development of multichannel and targeted financial support for innovative activities of SMEs carrying out R&amp;D in areas of scientific and technological development and focus on the production of science-intensive products. A certain exemption from the income tax and a reduction in the rate of insurance tax to SME employees engaged in innovative activities in priority sectors of Russia, the introduction of tax incentives and tax deductions such as patent boxes and super deductions will ensure the increase of the number of SMEs and in their contribution to GDP, will boost a competitiveness of the manufactured high technology products. The Swiss case will help to improve the mechanisms for integrating academic and university science with government and non-government organizations and SMEs in order to accelerate the commercialization of scientific research and the development of international network cooperation. The development of forms of integration cooperation between financial investors and youth small enterprises, start-up leaders and technology start-ups adapted to the Russian realities will allow to increase the level of interaction between the state in the field of higher education and science with large business and SMEs and to solve the priority tasks of training qualified personnel in innovation-oriented sectors of the economy.

Blockchain in Startup Financing: ICOs and STOs in Switzerland

This paper provides a comparative analysis of the new blockchain-based start-up and small companies funding methods, namely, initial coin offerings (ICOs) and security token offerings (STOs) against the backdrop of traditional fundraising methods like venture capital and private equity building on the experience of Switzerland. In particular, the comparative analysis is based on a theoretical overview of the nature of these blockchain applications, the relevant legislative framework as well as recent market developments with a focus on Switzerland. The paper concludes that both ICOs and STOs are characterized by lower entry barriers for investors and higher cost efficiency as compared to traditional start-up fundraising methods. However, STOs provide more security to investors than ICOs due to their wider regulation.

Early Physical Therapist Interventions for Patients With COVID-19 in the Acute Care Hospital: A Case Report Series.

ObjectiveThe aim of this case series was to describe the experience of Swiss physical therapists in the treatment of patients with COVID-19 during their acute care hospital stay and to discuss challenges and potential strategies in the clinical management of these patients.MethodsWe report 11 cases of patients with COVID-19 from 5 Swiss hospitals that illustrate the various indications for physical therapy, clinical challenges, potential treatment methods, and short-term response to treatment.ResultsPhysical therapists actively treated patients with COVID-19 on wards and in the intensive care unit. Interventions ranged from patient education, to prone positioning, to early mobilization and respiratory therapy. Patients were often unstable with quick exacerbation of symptoms and a slow and fluctuant recovery. Additionally, many patients who were critically ill developed severe weakness, postextubation dysphagia, weaning failure, or presented with anxiety or delirium. In this setting, physical therapy was challenging and required specialized and individualized therapeutic strategies. Most patients adopted the proposed treatment strategies, and lung function and physical strength improved over time.ConclusionPhysical therapists clearly have a role in the COVID-19 pandemic. Based on our experience in Switzerland, we recommend that physical therapists routinely screen and assess patients for respiratory symptoms and exercise tolerance on acute wards. Treatment of patients who are critically ill should start as soon as possible to limit further sequelae. More research is needed for awake prone positioning and early breathing exercises as well as post-COVID rehabilitation.ImpactTo date, there are few data on the physical therapist management of patients with COVID-19. This article is among the first to describe the role of physical therapists in the complex pandemic environment and to describe the potential treatment strategies for countering the various challenges in the treatment of these patients.

Government Financial Support and SME Development in Switzerland

Purpose: The goal of the study is to analyze model of government financing for small and medium-sized enterprises (SMEs) in Switzerland in order to apply its advanced experience to improve the system of federal financial support for SMEs in Russia. Design/Methodology/Approach: Brewer and Hunter’s approach was used to carry out an analysis of state financial support. Findings: The findings suggest that the modern system of government financial support for SMEs in Switzerland is flexible and capable of effectively resisting financial crises and changes in global market conditions. Switzerland has one of the most powerful and secure banking systems in the world and modern scientific and educational capabilities based on its world famous universities. These conditions are self-sufficient in the innovative development of the economy, focusing on their own financial resources and the national scientific and educational environment. Practical Implications: The experience of Switzerland can be applied in Russia to develop effective mechanisms for integrating academic and university sciences with public and private commercial industrial partners in order to accelerate the commercialization of scientific research. Such government policy instruments will make it possible to increase the level of state interaction in the sphere of education and science with the business sector, resolve the shortage of qualified specialists and accelerate the process of commercialization of research and development (R&D). Originality/Value: The advanced approaches of the Swiss model of public financing for the SME sector can be applied in developing countries, especially in those with limited mineral and labor resources, and in implementing strategies to boost the ratio of SMEs in the economy and their contribution to it.

Uniportal VATS for pectus excavatum: the Southern Switzerland experience.

The Nuss procedure is a minimally invasive approach used to treat the pectus excavatum. One to three curved metal bars are inserted behind the sternum in order to push it into a normal position. A bilateral thoracoscopy, with 3 or 4 incisions on each side, has been reported as a safe method to repair the chest. The aim of this observational cohort study is to evaluate the safety and efficacy of the modified uniportal thoracoscopic Nuss procedure. A retrospective review on 248 consecutive patients treated in Southern Switzerland in the last 5 years for chest deformity was performed. Conservative treatment with vacuum bel or dinamic compression was performed in 235 cases. Thirteen patients with pectus excavatum were surgically treated with a modified single-incision thoracoscopic approach and introduction of a single retrosternal Nuss Bar. Demographics, clinical characteristics, surgical data and results were analyzed and discussed. The male/female ratio was 11/2, with mean age of 20.75 (±5.05) years. The Haller index was 3.65±0.5. The operative duration was 68. 2±13.3 min and hospitalization stay ranged from 2 to 10 days. There was no instance of intraoperative cardiac perforation or macrovascular injury. No pleural effusion or infection was reported. The overall complication rate after a postoperative follow-up of 24.6±3 months was 7.6%, without mortality, major bleeding, infectious complications, displacement or recurrence. Patients satisfaction and postoperative pain were also analyzed. The modified single-incision thoracoscopic Nuss procedure is both safe and effective for pectus excavatum correction with non-recurrence after two years.

The impact of tourists' emotions on satisfaction and destination loyalty – an integrative moderated mediation model: tourists' experience in Switzerland

PurposeThe purpose of this paper is to investigate the effect of tourists' emotional responses toward a particular destination on tourists' satisfaction and destination loyalty. Perceived quality adds as a moderator variable.Design/methodology/approachThis study adopted a quantitative data collection method, with distributing the questionnaire to 346 tourists of 43 nationalities in four main tourist attractions in Switzerland. The structural equation modeling approach and bootstrapping technique were used to empirically test the study hypotheses.FindingsThe results confirm the negative impact of negative emotions. The mediating role of the tourists' satisfaction was documented. As expected, perceived quality dampened the negative effect of negative emotions on tourists' satisfaction. However, surprisingly, it does not serve as a moderator in the relationship between positive emotions and tourists' satisfaction.Practical implicationsThis study resulted in a set of practical marketing recommendations. Tourism marketers are encouraged to keep positive emotions high among tourists, aimed to increase their satisfaction toward the destination and revisit it again in the future and also, pay more attention to the quality of the destination as an essential tool to reduce the impact of negative emotions.Originality/valueMany studies in tourism literature studied associations between positive emotions and tourists' behavior. The present study is drawing more attention to negative emotions. In addition, this study tries to address the gap in the tourism literature regarding the modified impact of perceived quality on the relationship between emotions and tourists' satisfaction.

Social, cultural and experiential patterning of attitudes and behaviour towards assisted suicide in Switzerland: evidence from a national population-based study.

Switzerland has the longest history of the legal practice of non-physician assisted suicide of any country. Assisted suicide is not very tightly regulated in Switzerland, and almost all assisted suicides are supported by a right-to-die organisation. Our study investigates older adults&rsquo; attitudes and behaviour towards assisted suicide, and the associations of these with the individuals&rsquo; sociodemographic and cultural characteristics, as well as with their own health status and healthcare-related experiences in Switzerland. We performed weighted prevalence and multivariable logistic regression estimation on a nationally representative sample of adults aged 55 and over from wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland (n = 2168). Overall, 81.7% of respondents supported the legality of assisted suicide, as is currently the case in Switzerland, and 60.9% stated that they would potentially consider asking for assisted suicide under certain circumstances; 28.2% of respondents reported either that they are already or that they are likely to become a member of a right-to-die organisation, with 4.9% of respondents reporting to already be a member of such an organisation at the time of the survey. Higher levels of education and previous experience as a healthcare proxy were positively associated with more favourable attitudes and behaviour towards assisted suicide. Compared to individuals aged 55&ndash;64, adults aged 65&ndash;74 generally showed more favourable attitudes and behaviour towards assisted suicide. By contrast, religious persons displayed more negative attitudes and behaviour towards assisted suicide. Attitudes towards assisted suicide were also more negative in the oldest age group (75+) in comparison to adults aged 55&ndash;64, and among persons living in French- and Italian-speaking Switzerland compared to those living in German-speaking Switzerland. While approval for assisted suicide is high overall in Switzerland, more vulnerable population groups, such as older or less educated individuals, have less favourable attitudes towards assisted suicide. In addition, cultural sensitivities to and personal experiences with death and dying are likely to shape the approval or rejection of assisted suicide as it is currently implemented in Switzerland.