Dataset Information

What matters when doctors die: A qualitative study of family perspectives.

ABSTRACT:

Background

The challenges of supporting the end-of-life preferences of patients and their families have often been attributed to poor understanding of the patient's condition. Understanding how physicians, as patients, communicate their end-of-life care preferences to their families may inform shared decision making at end of life.

Objectives

The purpose of this study was to understand what matters to families of physicians when decision making with and for a physician who is approaching the end of life.

Design

Cross-sectional qualitative design.

Participants

We conducted interviews with family members of deceased physicians.

Approach

We analyzed the data using the constant comparison method to identify themes.

Key results

Family members (N = 26) rarely were unclear about the treatment preferences of physicians who died. Three overarching themes emerged about what matters most to physicians' families: (1) honoring preferences for the context of end-of-life care; (2) supporting the patient's control and dignity in care; and, (3) developing a shared understanding of preferences. Families struggled to make decisions and provide the care needed by the physicians at the end of life, often encountering significant challenges from the healthcare system.

Conclusions

Even when disease and prognosis are well understood as in this group of physicians, families still experienced difficulties in end-of-life decision making. These findings highlight the need to specifically address preferences for caregiver, care setting and symptom management in shared end-of-life decision making conversations with patients and families.

SUBMITTER: Abshire MA

PROVIDER: S-EPMC7310709 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

What matters when doctors die: A qualitative study of family perspectives.

Abshire Martha A MA Nolan Marie T MT Dy Sydney M SM Gallo Joseph J JJ

PloS one 20200623 6

<h4>Background</h4>The challenges of supporting the end-of-life preferences of patients and their families have often been attributed to poor understanding of the patient's condition. Understanding how physicians, as patients, communicate their end-of-life care preferences to their families may inform shared decision making at end of life.<h4>Objectives</h4>The purpose of this study was to understand what matters to families of physicians when decision making with and for a physician who is appr ...[more]

PMID: 32574209

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Project description:BACKGROUND:Professionalism is amongst the major dimensions determining the competence of medical doctors. Poor professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan. METHODS:A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40?years, who had studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchical levels, from house officer to consultant specialist, in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. RESULTS:The data analysis revealed that rigidity of opinions, unacceptability of contrasting perspectives, false pride, and perceived superiority over other professions and patients were major components of poor medical professionalism. Most of the young doctors believed that there is no need to include professionalism and humanity course modules in the medical curriculum, because topics related to social sciences are deemed irrelevant to medicine and judged to be common sense. The doctors recognised good professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues and paramedics. Other factors contributing to poor medical professionalism included the use of social media applications during duty hours, ridiculing patients, substance use such as smoking cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays, lack of cooperation from paramedical staff, and inadequate role models. CONCLUSIONS:Poor medical professionalism among young doctors needs to be addressed by policymakers. There is a need to revisit the medical curriculum to strengthen professionalism. It is essential to develop the qualities of tolerance, teachability, and acceptance in doctors in order to facilitate interprofessional collaborations and avoid medical errors.

Project description:?BACKGROUND: Many countries have insufficient numbers of family doctors, and more females than males leave the workforce at a younger age or have difficulty sustaining careers. Understanding the differing attitudes, pressures, and perceptions between genders toward their medical occupation is important to minimise workforce attrition. ?AIM: To explore factors influencing the resilience of female family doctors during lifecycle transitions. ?DESIGN & SETTING: International qualitative study with female family doctors from all world regions. ?METHOD: Twenty semi-structured online Skype interviews, followed by three focus groups to develop recommendations. Data were transcribed and analysed using applied framework analysis. ?RESULTS: Interview participants described a complex interface between competing demands, expectations of their gender, and internalised expectations of themselves. Systemic barriers, such as lack of flexible working, excessive workload, and the cumulative impacts of unrealistic expectations impaired the ability to fully contribute in the workplace. At the individual level, resilience related to: the ability to make choices; previous experiences that had encouraged self-confidence; effective engagement to obtain support; and the ability to handle negative experiences. External support, such as strong personal networks, and an adaptive work setting and organisation or system maximised interviewees' professional contributions. ?CONCLUSION: On an international scale, female family doctors experience similar pressures from competing demands during lifecycle transitions; some of which relate to expectations of the female's 'role' in society, particularly around the additional personal pressures of caring commitments. Such situations could be predicted, planned for, and mitigated with explicit support mechanisms and availability of workplace choices. Healthcare organisations and systems around the world should recognise this need and implement recommendations to help reduce workforce losses. These findings are likely to be of interest to all health professional staff of any gender.

Dataset Information

What matters when doctors die: A qualitative study of family perspectives.

Background

Objectives

Design

Participants

Approach

Key results

Conclusions

Publications

What matters when doctors die: A qualitative study of family perspectives.

Similar Datasets

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