"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.

In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for...

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Autores principales:	Kerstin Kremeike, Thomas Dojan, Carolin Rosendahl, Saskia Jünger, Vanessa Romotzky, Kathleen Boström, Gerrit Frerich, Raymond Voltz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6ebf3f757724495981c869db88c83829
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spelling	oai:doaj.org-article:6ebf3f757724495981c869db88c838292021-12-02T20:06:09Z"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.1932-620310.1371/journal.pone.0257382https://doaj.org/article/6ebf3f757724495981c869db88c838292021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257382https://doaj.org/toc/1932-6203In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: "outer framework", "extended care system" and "health-professional-patient-relationship". Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations-especially the proactive approach-are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.Kerstin KremeikeThomas DojanCarolin RosendahlSaskia JüngerVanessa RomotzkyKathleen BoströmGerrit FrerichRaymond VoltzPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257382 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kerstin Kremeike Thomas Dojan Carolin Rosendahl Saskia Jünger Vanessa Romotzky Kathleen Boström Gerrit Frerich Raymond Voltz "Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
description	In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: "outer framework", "extended care system" and "health-professional-patient-relationship". Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations-especially the proactive approach-are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.
format	article
author	Kerstin Kremeike Thomas Dojan Carolin Rosendahl Saskia Jünger Vanessa Romotzky Kathleen Boström Gerrit Frerich Raymond Voltz
author_facet	Kerstin Kremeike Thomas Dojan Carolin Rosendahl Saskia Jünger Vanessa Romotzky Kathleen Boström Gerrit Frerich Raymond Voltz
author_sort	Kerstin Kremeike
title	"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
title_short	"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
title_full	"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
title_fullStr	"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
title_full_unstemmed	"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
title_sort	"withstanding ambivalence is of particular importance"-controversies among experts on dealing with desire to die in palliative care.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/6ebf3f757724495981c869db88c83829
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"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.

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