Background End-of-life (EOL) decision-making is often surrounded by clinical and ethical problems and a challenging process for patients, relatives and their caregiver team.
Aim The aim of this four-year intervention study is to develop a clinical practice guideline about limiting life-prolonging treatment and to evaluate its impact on medical practice in a pre-and post-implementation design. The pre-implementation part of the study investigates the perspectives of patients, physicians and nurses involved in the individual decision-making process in cancer patients that approach their last phase of life.
Methods This prospective, quantitative study is currently conducted at the Department of Haematology and Oncology at the LMU Hospital, Munich. Recruitment is ongoing since April 2014. Eligible are hospitalised cancer patients with limitations of life-prolonging treatment either being discussed or respective decisions already been taken. We have developed and adopted a set of instruments that is completed both from the patient and the respective physician and nurse in charge for this patient. Medical history, medication, supportive care, availability of advances directives and documentation of treatment limitations are recorded at time of inclusion.
Results Results of the first 50 patient-physician-nurse documentation sets will be presented in September 2015 including the proportion of patients involved in the decision process and factors that hinder communication and patient participation in end-of-life decisions.
Conclusion The pre-implementation results are fed into the process of developing a clinical guideline on decisions to limit treatment with the participation of physicians, nurses, quality management representative and psycho-oncologists.
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