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The impact of healthcare professionals' personality and religious beliefs on the decisions to forego life sustaining treatments: an observational, multicentre, cross-sectional study in Greek intensive care units.
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- Author(s): Ntantana A;Ntantana A; Matamis D; Matamis D; Savvidou S; Savvidou S; Marmanidou K; Marmanidou K; Giannakou M; Giannakou M; Gouva Μ; Gouva Μ; Nakos G; Nakos G; Koulouras V; Koulouras V
- Source:
BMJ open [BMJ Open] 2017 Jul 21; Vol. 7 (7), pp. e013916. Date of Electronic Publication: 2017 Jul 21.- Publication Type:
Journal Article; Multicenter Study; Observational Study- Language:
English - Source:
- Additional Information
- Source: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
- Publication Information: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
- Subject Terms: Attitude of Health Personnel* ; Decision Making* ; Life Support Care* ; Personality* ; Religion* ; Terminal Care* ; Treatment Refusal*; Adult ; Cross-Sectional Studies ; Family ; Female ; Greece ; Humans ; Intensive Care Units ; Male ; Medical Futility ; Middle Aged ; Neuroticism ; Nurses ; Physicians ; Surveys and Questionnaires ; Withholding Treatment ; Young Adult
- Abstract: Objectives: To assess the opinion of intensive care unit (ICU) personnel and the impact of their personality and religious beliefs on decisions to forego life-sustaining treatments (DFLSTs).
Setting: Cross-sectional, observational, national study in 18 multidisciplinary Greek ICUs, with >6 beds, between June and December 2015.
Participants: 149 doctors and 320 nurses who voluntarily and anonymously answered the End-of-Life (EoL) attitudes, Personality (EPQ) and Religion (SpREUK) questionnaires. Multivariate analysis was used to detect the impact of personality and religious beliefs on the DFLSTs.
Results: The participation rate was 65.7%. Significant differences in DFLSTs between doctors and nurses were identified. 71.4% of doctors and 59.8% of nurses stated that the family was not properly informed about DFLST and the main reason was the family's inability to understand medical details. 51% of doctors expressed fear of litigation and 47% of them declared that this concern influenced the information given to family and nursing staff. 7.5% of the nurses considered DFLSTs dangerous, criminal or illegal. Multivariate logistic regression identified that to be a nurse and to have a high neuroticism score were independent predictors for preferring the term 'passive euthanasia' over 'futile care' (OR 4.41, 95% CI 2.21 to 8.82, p<0.001, and OR 1.59, 95% CI 1.03 to 2.72, p<0.05, respectively). Furthermore, to be a nurse and to have a high-trust religious profile were related to unwillingness to withdraw mechanical ventilation. Fear of litigation and non-disclosure of the information to the family in case of DFLST were associated with a psychoticism personality trait (OR 2.45, 95% CI 1.25 to 4.80, p<0.05).
Conclusion: We demonstrate that fear of litigation is a major barrier to properly informing a patient's relatives and nursing staff. Furthermore, aspects of personality and religious beliefs influence the attitudes of ICU personnel when making decisions to forego life-sustaining treatments.
Competing Interests: Competing interests: None declared.
(© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.) - References: Am J Respir Crit Care Med. 2003 May 15;167(10):1310-5. (PMID: 12738597)
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Intensive Care Med. 2011 Oct;37(10):1696-705. (PMID: 21877211) - Contributed Indexing: Keywords: Decisions to foregolife sustaining treatment (DFLST); End-of-Life (EoL); personality; religiousness
- Publication Date: Date Created: 20170723 Date Completed: 20180427 Latest Revision: 20190202
- Publication Date: 20240628
- Accession Number: PMC5577864
- Accession Number: 10.1136/bmjopen-2016-013916
- Accession Number: 28733295
- Source:
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