Simon, Alfred

[["dc.bibliographiccitation.artnumber","161"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Neurology"],["dc.bibliographiccitation.volume","22"],["dc.contributor.author","Salzmann, Laura"],["dc.contributor.author","Alt-Epping, Bernd"],["dc.contributor.author","Simon, Alfred"],["dc.date.accessioned","2022-06-01T09:39:41Z"],["dc.date.available","2022-06-01T09:39:41Z"],["dc.date.issued","2022"],["dc.date.updated","2022-07-29T12:07:18Z"],["dc.description.abstract","Background Palliative sedation has become widely accepted as a method to alleviate refractory symptoms in terminally ill patients. Controversies regarding this topic especially concern the use of palliative sedation for psychological symptoms, the use in patients who are not imminently dying and the simultaneous withdrawal of life-sustaining measures. Amyotrophic lateral sclerosis (ALS) is characterized by symptoms including muscle weakness, dysphagia, dysarthria, muscle spasms and progressive respiratory insufficiency. Due to these characteristic symptoms, palliative sedation might be considered to be necessary to alleviate refractory suffering in ALS patients. However, palliative sedation in ALS is only rarely discussed in current medical literature and guidelines. Methods A questionnaire survey was conducted among neurologists and palliative care practitioners in Germany. The participants were asked to evaluate the use of palliative sedation in different situations. Results Two hundred and ninety-six completed questionnaires were analyzed. The results suggest high levels of support for the use of palliative sedation in ALS patients. 42% of the participants stated that they had already used palliative sedation in the treatment of ALS patients. Acceptance of palliative sedation was higher in case of physical symptoms than in case of psychological symptoms. Refusal of artificial nutrition did not lead to a lower acceptance of palliative sedation. Doctors with specialist training in palliative care had already used palliative sedation in ALS patients more often and they were more likely to accept palliative sedation in different situations than the participants without a background in palliative care. Conclusion Our survey showed that palliative sedation in ALS is widely accepted by the attending doctors. In case of psychological symptoms, palliative sedation is looked at with more concern than in case of physical symptoms. The refusal of artificial nutrition does not result in a decreased acceptance of palliative sedation. Doctors with specialist training in palliative care are more likely to approve of palliative sedation in ALS."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2022"],["dc.identifier.citation","BMC Neurology. 2022 Apr 30;22(1):161"],["dc.identifier.doi","10.1186/s12883-022-02681-7"],["dc.identifier.pii","2681"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/108536"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-572"],["dc.relation.eissn","1471-2377"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject","Palliative sedation"],["dc.subject","Amyotrophic lateral sclerosis (ALS)"],["dc.subject","Palliative care"],["dc.title","Palliative sedation in amyotrophic lateral sclerosis: results of a nationwide survey among neurologists and palliative care practitioners in Germany"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","10"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Palliative Care"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Bausewein, C."],["dc.contributor.author","Hodiamont, F."],["dc.contributor.author","Berges, N."],["dc.contributor.author","Ullrich, A."],["dc.contributor.author","Gerlach, C."],["dc.contributor.author","Oechsle, K."],["dc.contributor.author","Pauli, B."],["dc.contributor.author","Weber, J."],["dc.contributor.author","Stiel, S."],["dc.contributor.author","Schneider, N."],["dc.contributor.author","Krumm, N."],["dc.contributor.author","Rolke, R."],["dc.contributor.author","Gebel, C."],["dc.contributor.author","Jansky, M."],["dc.contributor.author","Nauck, F."],["dc.contributor.author","Wedding, U."],["dc.contributor.author","van Oorschot, B."],["dc.contributor.author","Roch, C."],["dc.contributor.author","Werner, L."],["dc.contributor.author","Fischer, M."],["dc.contributor.author","Schallenburger, M."],["dc.contributor.author","Reuters, M. C."],["dc.contributor.author","Schwartz, J."],["dc.contributor.author","Neukirchen, M."],["dc.contributor.author","Gülay, A."],["dc.contributor.author","Maus, K."],["dc.contributor.author","Jaspers, B."],["dc.contributor.author","Radbruch, L."],["dc.contributor.author","Heckel, M."],["dc.contributor.author","Klinger, I."],["dc.contributor.author","Ostgathe, C."],["dc.contributor.author","Kriesen, U."],["dc.contributor.author","Junghanß, C."],["dc.contributor.author","Lehmann, E."],["dc.contributor.author","Gesell, D."],["dc.contributor.author","Gauder, S."],["dc.contributor.author","Boehlke, C."],["dc.contributor.author","Becker, G."],["dc.contributor.author","Pralong, A."],["dc.contributor.author","Strupp, J."],["dc.contributor.author","Leisse, C."],["dc.contributor.author","Schloesser, K."],["dc.contributor.author","Voltz, R."],["dc.contributor.author","Jung, N."],["dc.contributor.author","Simon, S. T."],["dc.contributor.authorgroup","for the PallPan Study Group"],["dc.date.accessioned","2022-02-01T10:31:31Z"],["dc.date.accessioned","2022-08-18T12:34:18Z"],["dc.date.available","2022-02-01T10:31:31Z"],["dc.date.available","2022-08-18T12:34:18Z"],["dc.date.issued","2022-01-13"],["dc.date.updated","2022-07-29T12:07:05Z"],["dc.description.abstract","Abstract\r\n \r\n Background\r\n In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON).\r\n \r\n \r\n Methods\r\n Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified.\r\n \r\n \r\n Discussion\r\n For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting."],["dc.identifier.citation","BMC Palliative Care. 2022 Jan 13;21(1):10"],["dc.identifier.doi","10.1186/s12904-021-00898-w"],["dc.identifier.pii","898"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/98881"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112928"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-517"],["dc.publisher","BioMed Central"],["dc.relation.eissn","1472-684X"],["dc.rights.holder","The Author(s)"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.subject","Palliative care"],["dc.subject","End of life care"],["dc.subject","SARS-CoV-2"],["dc.subject","Pandemic"],["dc.subject","Pandemic preparedness"],["dc.title","National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","167"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Palliative Care"],["dc.bibliographiccitation.volume","21"],["dc.contributor.author","Koenig, Julia F. L."],["dc.contributor.author","Asendorf, Thomas"],["dc.contributor.author","Simon, Alfred"],["dc.contributor.author","Bleckmann, Annalen"],["dc.contributor.author","Truemper, Lorenz"],["dc.contributor.author","Wulf, Gerald"],["dc.contributor.author","Overbeck, Tobias R."],["dc.date.accessioned","2022-10-04T05:34:29Z"],["dc.date.available","2022-10-04T05:34:29Z"],["dc.date.issued","2022-09-28"],["dc.date.updated","2022-10-02T03:12:18Z"],["dc.description.abstract","Abstract\r\n \r\n Background\r\n The advance directive represents patients’ health care choices and fosters patients’ autonomy. Nevertheless, understanding patients’ wishes based on the information provided in advance directives remains a challenge for health care providers. Based on the ethical premises of positive obligation to autonomy, an advanced directive that is disease-centred and details potential problems and complications of the disease should help health care providers correctly understand patients’ wishes. To test this hypothesis, a pilot-study was conducted to investigate whether physicians could make the correct end-of-life decision for their patients when patients used a disease-centred advance directive compared to a common advance directive. \r\n \r\n \r\n Material and methods\r\n A randomised, controlled, prospective pilot study was designed that included patients with non-small cell lung cancer (NSCLC) stage VI from the Department of Haematology and Medical Oncology, University Medical Centre, Goettingen. Patients were randomised into intervention and control groups. The control group received a common advance directive, and the intervention group received a disease-centred advance directive. Both groups filled out their advance directives and returned them. Subsequently, patients were asked to complete nine medical scenarios with different treatment decisions. For each scenario the patients had to decide whether they wanted to receive treatment on a 5-point Likert scale. Four physicians were given the same scenarios and asked to decide on the treatment according to the patients’ wishes as stated in their advance directives. The answers by patients and physicians were then compared to establish whether physicians had made the correct assumptions.\r\n \r\n \r\n Results\r\n Recruitment was stopped prior to reaching anticipated sample target. 15 patients with stage IV NSCLC completed the study, 9 patients were randomised into the control group and 6 patients in the intervention group. A total of 135 decisions were evaluated. The concordance between physicians’ and patients’ answers, was 0.83 (95%-CI 0.71–0.91) in the intervention group, compared to 0.60 (95%-CI 0.48–0.70) in the control group, and the difference between the two groups was statistically significant (p = 0.005).\r\n \r\n \r\n Conclusion\r\n This pilot study shows that disease-centred advance directives help physicians understand their NSCLC patients’ wishes more precisely and make treatment choices according to these wishes.\r\n \r\n \r\n Trial registration\r\n The study is registered at the German Clinical Trial Register (no. DRKS00017580, registration date 27/08/2019)."],["dc.identifier.citation","BMC Palliative Care. 2022 Sep 28;21(1):167"],["dc.identifier.doi","10.1186/s12904-022-01057-5"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/114312"],["dc.language.iso","en"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.subject","Advance directive"],["dc.subject","Palliative care"],["dc.subject","End-of-life decision making"],["dc.subject","Prospective pilot study"],["dc.title","“SpezPat”- common advance directives versus disease-centred advance directives: a randomised controlled pilot study on the impact on physicians’ understanding of non-small cell lung cancer patients’ end-of-life decisions"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]