Patient altruism at the end of life: A scoping review

Article Article scientifique Revue de la littérature Patient altruism at the end of life: A scoping review eng 2024-04-12 2024-04-12 author Sterie Anca-Cristina 0000-0003-1607-5229 author Borasio Gian Domenico author Deml Michael 0000-0003-2224-8173 798236 author Gamondi Claudia 0000-0002-1537-9055 author Jox Ralf J. 0000-0002-3040-4714 author Larkin Philip 0000-0001-8424-3920 author Trombert Alexia 0000-0002-4833-5219 880455 author Rubli Truchard Eve 0000-0003-3666-563X author Bernard Mathieu 0000-0003-2823-8806 1-13 10.1017/S1478951524000361 38605652 1478-9515 https://www.cambridge.org/core/product/identifier/S1478951524000361/type/journal_article Objectives: The concept of altruism is evidenced in various disciplines but remains understudied in end-of-life (EOL) contexts. Patients at the EOL are often seen as passive recipients of care, whereas the altruism of professionals and families receives more research and clinical attention. Our aim was to summarize the state of the scientific literature concerning the concept of patient altruism in EOL contexts. Methods: In May 2023, we searched 11 databases for scientific literature on patient altruism in EOL contexts in consultation with a health information specialist. The scoping review is reported using the PRISMA checklist for scoping reviews. We used a data charting form to deductively extract data from the selected articles and then mapped data into 4 themes related to our research questions: how authors describe and employ the concept of patient altruism; expressions of patient altruism; consequences of patients’ altruistic acts; and possible interventions fostering patient altruism. Results: Excluding duplicates, 2893 articles were retrieved; 33 were included in the final review. Altruism was generally considered as an act or intention oriented toward the benefit of a specific (known) or non-specific (generic) recipient. Patients expressed altruism through care and support, decisions to withhold treatment or actively hasten death, and engagement in advance care planning. Consequences of altruism were categorized in patient-centered (contribution to meaning in life and quality of life), non-patient-centered (leaving a positive impact and saving money), and negative consequences (generating feelings of guilt, exposing individuals with low self-esteem). Interventions to encourage altruism comprised specific interventions, providing opportunities to plan for future care, and recognizing and respecting the patients’ altruistic motivations. Significance of results: We identified heterogeneous and limited research conceptualization of patient altruism and its operationalization in palliative care settings. A deeper conceptual, empirical, and theoretical exploration of patient altruism in EOL is necessary. Altruism End of life Palliative care Patients Scoping review Dewey 300 10 Faculté des sciences de la société T false Palliative & supportive care 9c91da21-ea27-4397-9d63-c257c984d7b2 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 288809 application/pdf CC BY-4.0 50498f2d54ac3ed4391e719a6c877eb370c200327fc86026ff26c996136ec22b openAccess Faculté des sciences de la société

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Patient altruism at the end of life: A scoping review	Palliative & supportive care			2024	148	242

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Trombert, Alexia