Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers' experiences.

End-of-life Hastened death Health professionals Relatives Systematic mixed-methods review Voluntarily stopping eating and drinking (VSED)

Journal

Health policy (Amsterdam, Netherlands)
ISSN: 1872-6054
Titre abrégé: Health Policy
Pays: Ireland
ID NLM: 8409431

Informations de publication

Date de publication:
30 Sep 2024
Historique:
received: 04 06 2023
revised: 03 07 2024
accepted: 23 09 2024
medline: 9 10 2024
pubmed: 9 10 2024
entrez: 8 10 2024
Statut: aheadofprint

Résumé

Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED. In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743). We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low. Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.

Sections du résumé

BACKGROUND BACKGROUND
Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED.
METHODS METHODS
In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743).
FINDINGS RESULTS
We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low.
INTERPRETATION CONCLUSIONS
Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.

Identifiants

DOI: 10.1016/j.healthpol.2024.105174 PMID: 39378716
pubmed: 39378716
pii: S0168-8510(24)00184-2
doi: 10.1016/j.healthpol.2024.105174
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

105174

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

Auteurs

Christina Mensger (C)

Institute of Public Health, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: christina.mensger@posteo.de.

Yang Jiao (Y)

Institute of Public Health, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: yang.jiao@posteo.de.

Maximiliane Jansky (M)

Department of Palliative Medicine, University Medical Center Göttingen, Georg-August University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany. Electronic address: maximiliane.jansky@med.uni-goettingen.de.

Christian Banse (C)

Department of Palliative Medicine, University Medical Center Göttingen, Georg-August University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany. Electronic address: christian.banse@med.uni-goettingen.de.

Friedemann Nauck (F)

Department of Palliative Medicine, University Medical Center Göttingen, Georg-August University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany. Electronic address: Friedemann.Nauck@med.uni-goettingen.de.

Monika Nothacker (M)

Institute for Medical Knowledge Management, c/o Philipps University Marburg, Association of the Scientific Medical Societies (AWMF-IMWi), Birkenstr. 67, 10559 Berlin, Germany. Electronic address: nothacker@awmf.org.

Henrikje Stanze (H)

Department of Palliative Medicine, University Medical Center Göttingen, Georg-August University of Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany; Centre for Nursing Research and Counselling, School of Social Science, Hochschule Bremen - City University of Applied Sciences, Am Brill 2-4, 28195 Bremen, Germany. Electronic address: Henrikje.Stanze@hs-bremen.de.

Classifications MeSH