Dataset Information

Clinical Practice Guideline for Care in the Last Days of Life.

ABSTRACT: A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

SUBMITTER: Shin J

PROVIDER: S-EPMC10332720 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Clinical Practice Guideline for Care in the Last Days of Life.

Shin Jinyoung J Chang Yoon Jung YJ Park So-Jung SJ Choi Jin Young JY Kim Sun-Hyun SH Choi Youn Seon YS Kim Nam Hee NH Yum Ho-Kee HK Nam Eun Mi EM Park Myung Hee MH Moon Nayeon N Moon Jee Youn JY Kang Hee-Taik HT Kang Jung Hun JH Park Jae-Min JM Lee Chung-Woo CW Kim Seon-Young SY Lee Eun Jeong EJ Koh Su-Jin SJ Kim Yonghwan Y Cho Myongjin Agnes MA Song Youhyun Y Shim Jae Yong JY

Han'guk Hosup'isu Wanhwa Uiryo Hakhoe chi = The Korean journal of hospice and palliative care 20200901 3

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in pati ...[more]

PMID: 37497368

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Project description:BackgroundPractice variation in recurrent pregnancy loss (RPL) care is common. International guidelines vary in their recommendations for the management of RPL couples, which could lead to an increase of cross border reproductive care. Currently, the Dutch RPL guideline is being adapted from the European Society for Human Reproduction and Embryology (ESHRE) guideline. We aim to identify discrepancies between RPL guidelines and RPL practice. These discrepancies could be considered in the development of a new guideline and implementation strategies to promote adherence to new recommendations.MethodsA nationwide survey on the management of RPL patients was conducted across all 107 hospital-based obstetrics and gynaecology practices in the Netherlands. The survey was sent via the Dutch Society for Obstetricians and Gynaecologists to all affiliated clinicians. The questionnaire consisted of 36 questions divided in four sections: clinician's demographics, RPL definition, investigations and therapy. The data were compared to the recommendations given by the Dutch national guideline and the most recent guideline of the ESHRE.ResultsAll hospital-based practices (100%; n = 107) filled in the online questionnaire. The majority of respondents defined RPL similarly, as two or more pregnancy losses (87.4%), not obligatory consecutive (93.1%). More than half of respondents routinely perform thrombophilia screening ( 58%), although not advised by the ESHRE, while thyroid function (57%), thyroid auto-immunity (27%) and β2-glycoprotein antibodies (42%) in the context of antiphospholipid syndrome (APS) are recommended but investigated less often. Regarding parental karyotyping, 20% of respondents stated they always perform parental karyotyping, without prior risk assessment. because of RPL. Treatment for hereditary thrombophilia was frequently (43.8% (n = 137)) prescribed although not recommended. And finally, a considerable part (12-16%) of respondents prescribe medication in case of unexplained RPL.ConclusionWhile many clinicians perform investigations recommended by the ESHRE, there is a considerable variation of RPL practice in the Netherlands. We identified discrepancies between RPL guidelines and RPL practice, providing possibilities to focus on multifaceted implementation strategies, such as educational intervention, local consensus processes and auditing and feedback. This will improve the quality of care provided to RPL patients and may diminish the necessity felt by patients to turn to multiple opinions or cross border reproductive care.

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Dataset Information

Clinical Practice Guideline for Care in the Last Days of Life.

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Clinical Practice Guideline for Care in the Last Days of Life.

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