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Your search keyword '"Zwakman, M."' showing total 3 results
Start Over Author "Zwakman, M." Topic terminal care
3 results on '"Zwakman, M."'

1. Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness.

Author

Zwakman M, Jabbarian LJ, van Delden J, van der Heide A, Korfage IJ, Pollock K, Rietjens J, Seymour J, and Kars MC

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Qualitative Research, Advance Care Planning, Decision Making, Neoplasms therapy, Palliative Care psychology, Patient Preference psychology, Terminal Care psychology
Abstract

Background: Advance care planning is seen as an important strategy to improve end-of-life communication and the quality of life of patients and their relatives. However, the frequency of advance care planning conversations in practice remains low. In-depth understanding of patients' experiences with advance care planning might provide clues to optimise its value to patients and improve implementation., Aim: To synthesise and describe the research findings on the experiences with advance care planning of patients with a life-threatening or life-limiting illness., Design: A systematic literature review, using an iterative search strategy. A thematic synthesis was conducted and was supported by NVivo 11., Data Sources: The search was performed in MEDLINE, Embase, PsycINFO and CINAHL on 7 November 2016., Results: Of the 3555 articles found, 20 were included. We identified three themes in patients' experiences with advance care planning. 'Ambivalence' refers to patients simultaneously experiencing benefits from advance care planning as well as unpleasant feelings. 'Readiness' for advance care planning is a necessary prerequisite for taking up its benefits but can also be promoted by the process of advance care planning itself. 'Openness' refers to patients' need to feel comfortable in being open about their preferences for future care towards relevant others., Conclusion: Although participation in advance care planning can be accompanied by unpleasant feelings, many patients reported benefits of advance care planning as well. This suggests a need for advance care planning to be personalised in a form which is both feasible and relevant at moments suitable for the individual patient.

Published
2018
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2. Patient and family caregiver perspectives of Advance Care Planning: qualitative findings from the ACTION cluster randomised controlled trial of an adapted respecting choices intervention.

Author

Pollock, K., Bulli, F., Caswell, G., Kodba-Čeh, H., Lunder, U., Miccinesi, G., Seymour, J., Toccafondi, A., van Delden, J. J. M., Zwakman, M., Rietjens, J., van der Heide, A., and Kars, M.

Subjects
CAREGIVER attitudes, TERMINAL care, LIBERTY, BURDEN of care, PATIENTS' attitudes, ADVANCE directives (Medical care), TREATMENT effectiveness, QUALITATIVE research, RANDOMIZED controlled trials, RESPONSIBILITY, CANCER patients, DECISION making, RESEARCH funding, RESPECT
Abstract

Advance Care Planning (ACP) is widely regarded as a component of good end-of-life care. However, findings from a qualitative international study of patient and family caregiver attitudes and preferences regarding ACP highlight participants' ambivalence towards confronting the future and the factors underlying their motivation to accept or defer anticipatory planning. They show how ACP impacts on, and can be determined by, relationships between patients and their family caregivers. Although some patients may welcome the chance to engage in ACP a tendency towards either therapeutic optimism or fatalism can limit its perceived appeal or benefit. The focus on individual autonomy as an ethical principle underlying ACP does not resonate with real world settings. Many patients naturally orient to share responsibility and decision making within the network of significant others in which they are embedded, rather than exert unfettered freedom of 'choice'. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Missing not at random in end of life care studies

Author

Carreras G., Miccinesi G., Wilcock A., Preston N., Nieboer D., Deliens L., Groenvold M., Lunder U., van der Heide A., Baccini M., Korfage I. J., Rietjens J. A. C., Jabbarian L. J., Polinder S., van Delden H., Kars M., Zwakman M., Verkissen M. N., Eecloo K., Faes K., Pollock K., Seymour J., Caswell G., Bramley L., Payne S., Dunleavy L., Sowerby E., Bulli F., Ingravallo F., Toccafondi A., Gorini G., Cerv B., Simonic A., Mimic A., Kodba-Ceh H., Ozbic P., Arnfeldt C., Thit Johnsen A., Family Medicine and Chronic Care, End-of-life Care Research Group, Carreras G., Miccinesi G., Wilcock A., Preston N., Nieboer D., Deliens L., Groenvold M., Lunder U., van der Heide A., Baccini M., Korfage I.J., Rietjens J.A.C., Jabbarian L.J., Polinder S., van Delden H., Kars M., Zwakman M., Verkissen M.N., Eecloo K., Faes K., Pollock K., Seymour J., Caswell G., Bramley L., Payne S., Dunleavy L., Sowerby E., Bulli F., Ingravallo F., Toccafondi A., Gorini G., Cerv B., Simonic A., Mimic A., Kodba-Ceh H., Ozbic P., Arnfeldt C., Thit Johnsen A., and Public Health

Subjects
Advance care planning, Quality of life, Epidemiology, Missing data, MODELS, POWER, Health Informatics, Disease cluster, 01 natural sciences, law.invention, 010104 statistics & probability, 03 medical and health sciences, missing data, 0302 clinical medicine, Quality of life (healthcare), LUNG-CANCER, Randomized controlled trial, SDG 3 - Good Health and Well-being, law, QUALITY-OF-LIFE, Statistics, Medicine and Health Sciences, Humans, 030212 general & internal medicine, Imputation (statistics), 0101 mathematics, advance care planning, Quality Of Life, Terminal Care, lcsh:R5-920, Models, Statistical, RANDOM FOREST, MNAR, 3. Good health, Random forest, MICE, MAR, Action study, Oncology, Research Design, oncology, Psychology, lcsh:Medicine (General), Research Article
Abstract

Background Missing data are common in end-of-life care studies, but there is still relatively little exploration of which is the best method to deal with them, and, in particular, if the missing at random (MAR) assumption is valid or missing not at random (MNAR) mechanisms should be assumed. In this paper we investigated this issue through a sensitivity analysis within the ACTION study, a multicenter cluster randomized controlled trial testing advance care planning in patients with advanced lung or colorectal cancer. Methods Multiple imputation procedures under MAR and MNAR assumptions were implemented. Possible violation of the MAR assumption was addressed with reference to variables measuring quality of life and symptoms. The MNAR model assumed that patients with worse health were more likely to have missing questionnaires, making a distinction between single missing items, which were assumed to satisfy the MAR assumption, and missing values due to completely missing questionnaire for which a MNAR mechanism was hypothesized. We explored the sensitivity to possible departures from MAR on gender differences between key indicators and on simple correlations. Results Up to 39% of follow-up data were missing. Results under MAR reflected that missingness was related to poorer health status. Correlations between variables, although very small, changed according to the imputation method, as well as the differences in scores by gender, indicating a certain sensitivity of the results to the violation of the MAR assumption. Conclusions The findings confirmed the importance of undertaking this kind of analysis in end-of-life care studies.

Published
2021

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