Relationships between personal attitudes about death and communication with terminally ill patients: How oncology clinicians grapple with mortality

PATIENT EDUCATION AND COUNSELING

卷:99

Article

Rodenbach, Rachel A.¹  Rodenbach, Kyle E.¹  Tejani, Mohamedtaki A.²  Epstein, Ronald M.³ 

[1] Univ Rochester, Sch Med & Dent, 601 Elmwood Ave, Rochester, NY 14642 USA

[2] Univ Rochester, Med Ctr, Dept Med, Hematol Oncol, 601 Elmwood Ave, Rochester, NY 14642 USA

[3] Univ Rochester, Med Ctr, Dept Family Med, 1381 South Ave, Rochester, NY 14620 USA

关键词: Physician-patient communication;    End of life care;    Oncology;    Death and dying;    Qualitative;   

DOI  :  10.1016/j.pec.2015.10.010

来源: Elsevier

【 摘 要 】

Objective: Clinician discomfort with death may affect care of patients but has not been well-studied. This study explores oncology clinicians' attitudes surrounding their own death and how these attitudes both affect and are affected by their care of dying patients and their communication with them. Methods: Qualitative interviews with physicians (n = 25), nurse practitioners (n = 7), and physician assistants (n = 1) in medical or hematologic oncology clinical practices about communication styles, care of terminally ill patients, and personal perspectives about mortality. Results: Clinicians described three communication styles used with patients about death and dying: direct, indirect, or selectively direct. Most reported an acceptance of their mortality that was conditional, meaning that that they could not fully know how they would respond if actually terminally ill. For many clinicians, caring for dying patients affected their outlook on life and death, and their own perspectives on life and death affected their approach to caring for dying patients. Conclusion: An awareness of personal mortality may help clinicians to discuss death more openly with patients and to provide better care. Practice implications: Efforts to promote self-awareness and communication training are key to facilitating clear communication with and compassionate care of terminally ill patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free