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Decision-making in general practice settings at the end of life

 

Decision-making in the primary care of terminally ill and dying persons is a complex situation. This study will develop recommendations for education and training and for improving the structures of outpatient palliative care.

Project description (completed research project)

Primary care physicians (general practitioners) play an important role in the support of terminally ill or dying patients. Together with patients, family members and nursing staff, they have to make decisions when it comes to admission to hospital or hospice, symptom relief or with-drawing treatment. Today we still know little about the prerequisites and challenges of decision-making on palliative care in general practice settings.

Aim

The study aims to investigate decision-making at the end of life, taking into consideration the primary care physician–patient relationship, communication with family members and co-operation with nursing staff, family members and hospitals. In addition, it will examine how important legal regulations, different supply structures across the cantons, patient advance directives and normative notions of "good dying" are for decisions at the end of life. In addition to analysis of the framework conditions of primary care at the end of life at the cantonal and national levels, the research team will interview health policy actors, patient organisations and representative primary care physicians and nursing staff. Further, primary care physicians, nursing staff and family members of dying persons from the German-, French-, and Italian-speaking parts of Switzerland will be surveyed in group discussions on the conditions and processes of decision-making at the end of life. The analysis of the interviews will uncover central factors and indicators for successful decision-making on palliative care in general practice settings.

Relevance

The results of the study will contribute towards improving palliative care in general practice settings in Switzerland by identifying the necessary competencies on the part of primary care physicians for optimal decision-making and by describing the conditions and challenges of palliative support at the end of life.

Original title

Decision Making Practice at the End of Life. The Case of General Practice.

Project leader

  • Prof. Dr. Brigitte Liebig, Institut für Kooperationsforschung und -entwicklung Hochschule für Angewandte Psychologie FHNW
  • Prof. Dr. Peter Voll, Haute ecole spécialisée de suisse occidentale, HES-SO, Wallis
  • Antonella Carassa, Institute of Psychology and Sociology Faculty of Communication Sciences, University of Lugano
  • Dr. Heike Gudat, Hospiz im Park, Klinik für Palliative Care
  • Dr. Klaus Bally, Institut für Hausarztmedizin, Universität Basel

Institutionelle Zusammenarbeit

  • Institute für Hausarztmedizin in der Schweiz

 

 

Further information on this content

 Contact

Prof. Dr. Brigitte Liebig Hochschule für Angewandte Psychologie FHNW
Institut für Kooperationsforschung und -entwicklung
Riggenbachstr. 16 4600 Olten +41 62 286 03 21 brigitte.liebig@fhnw.ch

Products of the project