Perceptions of Futility in Interventional Radiology: A Multipractice Systematic Qualitative Analysis.
Cardiovasc Intervent Radiol
; 44(1): 127-133, 2021 Jan.
Article
in En
| MEDLINE
| ID: mdl-33078233
ABSTRACT
PURPOSE:
To characterize perceptions of palliative versus futile care in interventional radiology (IR) as a roadmap for quality improvement.METHODS:
Interventional radiologists (IRs) and referring physicians were recruited for anonymous interviews and/or focus groups to discuss their perceptions and experiences related to palliative verse futile care in IR. Sessions were recorded, transcribed, and systematically analyzed using dedicated software, content analysis, and grounded theory. Data collection and analysis continued simultaneously until additional interviews stopped revealing new themes 24 IRs (21 males, 3 females, 1-39 years of experience) and 7 referring physicians (3 males, 4 females, 6-14 years of experience) were analyzed.RESULTS:
Many IRs (75%) perceived futility as an important issue. Years of experience (r = 0.60, p = 0.03) and being in academics (r = 0.62, p = 0.04) correlated with greater perceived importance. Perceptions of futility and whether a potentially inappropriate procedure was performed involved a balance between four sets of factors (patient, clinician, procedural, and cultural). These assessments tended to be qualitative in nature and are challenged by a lack of data, education, and consistent workflows. Referring clinicians were unaware of this issue and assumed IR had guidelines for differentiating between palliation and futility.CONCLUSION:
This study characterized the complexity and qualitative nature of assessments of palliative verses futile care in IR while highlighting potential means of improving current practices. This is important given the number of critically ill patients referred to IR and costs of potentially inappropriate interventions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Perception
/
Referral and Consultation
/
Radiology, Interventional
/
Medical Futility
/
Radiologists
Type of study:
Guideline
/
Qualitative_research
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Cardiovasc Intervent Radiol
Year:
2021
Document type:
Article
Affiliation country:
United States