Patients' perspectives on physician skill in end-of-life care: differences between patients with COPD, cancer, and AIDS

Title

Patients' perspectives on physician skill in end-of-life care: differences between patients with COPD, cancer, and AIDS

Creator

Curtis JR; Wenrich MD; Carline JD; Shannon SE; Ambrozy DM; Ramsey PG

Publisher

Chest

Date

2002

Subject

Female; Male; Aged; Attitude to Death; Focus Groups; Medical; Non-U.S. Gov't; Pulmonary Disease; Human; Neoplasms/psychology; Truth Disclosure; Support; Middle Age; Ethics; Physician-Patient Relations; Terminal Care/psychology; Clinical Competence; Acquired Immunodeficiency Syndrome/psychology; Chronic Obstructive/psychology

Description

OBJECTIVES: Patients' views of physician skill in providing end-of-life care may vary across different diseases, and understanding these differences will help physicians improve the quality of care they provide for patients at the end of life. The objective of this study was to examine the perspectives of patients with COPD, cancer, or AIDS regarding important aspects of physician skill in providing end-of-life care. DESIGN: Qualitative study using focus groups and content analysis based on grounded theory. SETTING: Outpatients from multiple medical settings in Seattle, WA. PATIENTS: Eleven focus groups of 79 patients with three diseases: COPD (n = 24), AIDS (n = 36), or cancer (n = 19). RESULTS: We identified, from the perspectives of patients, the important physician skills for high-quality end-of-life care. Remarkable similarities were found in the perspectives of patients with COPD, AIDS, and cancer, including the importance of emotional support, communication, and accessibility and continuity. However, each disease group identified a unique theme that was qualitatively more important to that group. For patients with COPD, the domain concerning physicians' ability to provide patient education stood out as qualitatively and quantitatively more important. Patients with COPD desired patient education in five content areas: diagnosis and disease process, treatment, prognosis, what dying might be like, and advance care planning. For patients with AIDS, the unique theme was pain control; for patients with cancer, the unique theme was maintaining hope despite a terminal diagnosis. CONCLUSIONS: Patients with COPD, AIDS, and cancer demonstrated many similarities in their perspectives on important areas of physician skill in providing end-of-life care, but patients with each disease identified a specific area of end-of-life care that was uniquely important to them. Physicians and educators should target patients with COPD for efforts to improve patient education about their disease and about end-of-life care, especially in the areas defined above. Physicians caring for patients with advanced AIDS should discuss pain control at the end of life, and physicians caring for patients with cancer should be aware of many patients' desires to maintain hope. Physician understanding of these differences will provide insights that allow improvement in the quality of care.
2002

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

356-62

Issue

1

Volume

122

Citation

Curtis JR; Wenrich MD; Carline JD; Shannon SE; Ambrozy DM; Ramsey PG, “Patients' perspectives on physician skill in end-of-life care: differences between patients with COPD, cancer, and AIDS,” Pediatric Palliative Care Library, accessed June 30, 2022, https://pedpalascnetlibrary.omeka.net/items/show/12590.

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