Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

Title

Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.

Creator

Bruera E; Neumann CM; Mazzocato C; Stiefel F; Sala R

Publisher

Palliative Medicine

Date

2000

Subject

Female; Humans; Male; Canada; Prognosis; Prospective Studies; Patient-Centered Care; Resuscitation Orders; Cross-Cultural Comparison; Europe; DNAR; Truth Disclosure; Palliative Care/px [Psychology]; Family/px [Psychology]; Physician-Patient Relations; Terminally Ill/px [Psychology]; Attitude of Health Personnel; Neoplasms/px [Psychology]; South America

Description

The subject of communication between palliative care physicians and their patients regarding their diagnosis and prognosis has not been extensively researched. The purpose of this survey was to compare the attitudes and beliefs of palliative care specialists regarding communication with the terminally ill in Europe, South America, and Canada. A sample of palliative care physicians from South America (Argentina and Brazil), French-speaking Europe, and Canada were identified, and posted a questionnaire. Physicians who stated that they practised palliative care at least 30% of their time were considered evaluable as palliative care specialists. Of a total of 272 questionnaires, 228 were returned (84%); and 182/228 (81%) respondents were considered to be palliative care specialists. Palliative care physicians in all three regions believed that cancer patients should be informed of their diagnosis and the terminal nature of their illness. Physicians reported that at least 60% of their patients knew their diagnosis and the terminal stage of their illness in 52% and 24% of cases in South America, and 69% and 38% of cases in Europe, respectively. All physicians agreed that 'do not resuscitate' orders should be present, and should be discussed with the patient in all cases. While 93% of Canadian physicians stated that at least 60% of their patients wanted to know about the terminal stage of their illness, only 18% of South American, and 26% of European physicians said this (P < 0.001). Similar results were found when the physicians were asked the percentage of families who want patients to know the terminal stage of their illness. However, almost all of the physicians agreed that if they had terminal cancer they would like to know. There was a significant association between patient based decision-making and female sex (P = 0.007), older age (P = 0.04), and physicians from Canada and South America (P < 0.001). Finally, in their daily decision making, South American physicians were significantly more likely to support beneficence and justice as compared with autonomy. Canadian physicians were more likely to support autonomy as compared with beneficence. In summary, our findings suggest that there are major regional differences in the attitudes and beliefs of physicians regarding communication at the end of life. More research is badly needed on the attitudes and beliefs of patients, families, and health care professionals in different regions of the world.
2000

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

287-98

Issue

4

Volume

14

Citation

Bruera E; Neumann CM; Mazzocato C; Stiefel F; Sala R, “Attitudes and beliefs of palliative care physicians regarding communication with terminally ill cancer patients.,” Pediatric Palliative Care Library, accessed July 31, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11820.

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