Family physicians' involvement with dying patients and their families. Attitudes, difficulties, and strategies
D. Steinmetz, M. Walsh, L. L. Gabel and P. T. Williams
Department of Family Medicine, College of Medicine, Ohio State University, Columbus.
OBJECTIVE: To determine family physicians' perceptions of the difficulty in
caring for dying patients and how prepared they are to provide such care
relative to strategies used with difficulties encountered, personal need
for support and development, and cooperation with other caregivers. DESIGN:
Exploratory. SETTING: Physicians' offices. SUBJECTS: Thirty-five randomly
selected family physicians (doctors of medicine and doctors of osteopathy)
representative of family physicians practicing in Franklin County, Ohio.
INTERVENTIONS: None. MAJOR OUTCOME MEASURES: A semistructured interview
guide corresponding to a three-dimensional theoretical model developed
prior to the study was used to determine family physicians' perceptions
regarding care of dying patients and their families. The three dimensions
include family physicians' involvement with dying patients and their
families, their personal needs and development, and their cooperation with
other caregivers. RESULTS: Participants agreed that the care of dying
patients and their families is an important and special component of
practicing family medicine. Generally seeing themselves as adequately
prepared, they still found such care difficult and desired more education
and training to increase comfort of their patients and of themselves. Their
perceptions regarding the care of dying patients and their families could
be categorized in terms of communication as part of the care process,
family issues, legal and ethical issues, coordination of care, physicians'
feelings, and physicians' influence and support. CONCLUSIONS: Family
physicians require formal training in death issues and need to find a way
to maximize learning through personal experiences. Discussion of cases in a
support group may be beneficial.
