Perspectives of community dwelling octogenarians about the use of life-sustaining technologies for their future care
Bibliographic record
Abstract
To better inform advance care planning initiatives, we conducted a qualitative study of community dwelling people aged 80 or more to enrich our understanding of their perspectives about the use of life-sustaining technologies in relation to their future care. In a semi-structured interview, 14 participants were asked what kind of health care they would want if they became seriously ill, so ill that they might die. We specifically probed their preferences for life-sustaining technologies and circumstances in which they had shared these preferences. Transcripts and field notes were analysed to categorise data in themes and subthemes. Participants represented octogenarians with variable levels of decision preparedness and included people who preferred a range of involvement in decision-making from passive to active consumers. Three overarching themes included: (1) their faith in others to do the right thing, (2) their focus on managing certainties, and (3) the role that perception of prolonging agony or alleviating suffering played in their preference for life-sustaining technologies. Few participants had considered that decisions would need to be made about life-sustaining technologies during the dying process and therefore had never considered the need to discuss their preferences to facilitate decisions in future. A key barrier to engaging some octogenarians may be their perception that there was no decision to be made since “they'll take care of me”. Insights gained from this study highlight the sort of “active engagement” strategies needed to improve advance care planning and end of life decision making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.004 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".