System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 42343105 DOI: 10.1177/10966218261463311

Understanding Clinicians' Perspectives on End-of-Life Dreams and Visions: An International Survey.

J Palliat Med

Authors: Muhammad Hamza Habib, Laura Fontanesi, Zainab Yusufali Motiwala, Arzu Çöltekin, Sidharth Misra, Alasdair MacLullich, Rasita Vinay, Caroline Hertler, David Blum, Katrin Singler, Catarina Simões, Vincenza Frisardi, Virginia Boccardi, Giuseppe Bellelli, Meltem Koca, Christopher W Kerr, Christopher A Jones, Simon Peng-Keller, Mathias Schlögl

Affiliations

  • Department of Medicine, Rutgers Cancer Institute, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
  • Institute of Interactive Technologies (IIT), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Windisch, Switzerland.
  • Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
  • Department of General Surgery, University of Texas Southwestern, Dallas, Texas, USA.
  • Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, Scotland.
  • Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland.
  • Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland.
  • Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.
  • Department of Radiation Oncology, Competence Center Palliative Care, UniversitätsSpital Zurich, Zurich, Switzerland.
  • Department of Geriatrics, Klinikum Fürth, Fürth, Germany.
  • Escola Superior de Saúde de Santa Maria, Porto, Portugal. Hospital da Luz Arrábida, Porto, Portugal. Centro de Investigação Interdisciplinar em Saúde, Universidade Católica Portuguesa, Porto, Portugal.
  • Geriatric Department and Frailty Research Unit, Casa di Cura Villa Verde, Taranto, Italy. IRCCS-AOUBO, Bologna, Italy.
  • Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
  • School of Medicine and Surgery, Acute Geriatric Unit, IRCCS San Gerardo Hospital, Milano-Bicocca University, Milan, Italy.
  • Department of Geriatrics, Etlik City Hospital, Ankara, Türkiye.
  • Hospice & Palliative Care Buffalo, Cheektowaga, New York, USA.
  • Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
  • Professur für Spiritual Care, Universität Zürich, Zürich, Switzerland.
  • Department of Geriatrics, Clinic Barmelweid, Barmelweid, Switzerland.

Abstract

BACKGROUND

End-of-life dreams and visions (ELDVs) are vivid, often subjective experiences that occur during the dying process. Even though the patient and family experiences of ELDVs are well documented, there is limited knowledge regarding the perspectives, preparedness, and perceived needs of health care professionals. ELDVs also remain insufficiently addressed in clinical care.

OBJECTIVE

To describe how frequently clinicians encounter ELDVs, perceived preparedness/training, and approaches to clinician and family education and communication.

METHODS

We conducted a survey to explore health care professional's perspectives and experiences surrounding ELDVs. The Checklist for Reporting Results of internet E-Surveys was followed. Our survey included 30 items across 7 sections. Professionals that take care of patients with serious or terminal illness were eligible for the study. We utilized a structured multimodal dissemination to achieve maximum diversity in participants.

RESULTS

Briefly, 247 participants were eligible for analysis. Frequent encounters for ELDVs were reported by participants. Participants perceived positive effects on patients more frequently than negative effects (W = 446.0, p < 0.001, r = 0.64). Clinical challenges were rated differently across categories (χ 2 = 160.97, p < 0.001, Kendall's W = 0.13). The most commonly endorsed clinical challenges were lack of institutional protocols and lack of standardized diagnostic criteria, both rated significantly higher than all other challenges (Bonferroni-corrected Wilcoxon tests: All p < 0.001). Participants endorsed multidisciplinary involvement and formal policy implementation.

CONCLUSION

ELDVs are common, but clinicians feel underprepared to respond to them. There is a need for structured training and institutional protocols. Future studies should include patients and their families and analyze how their experiences are shaped by physician responses.

MeSH

Vision, Ocular, Terminal Care, Hospice Care, Palliative Care, Dreams