Chest
Ethics in Cardiopulmonary MedicinePatients’ Perspectives on Physician Skill in End-of-Life Care: Differences Between Patients With COPD, Cancer, and AIDS
Section snippets
Study Design
In this qualitative study, we used focus groups to determine the perspectives of terminally ill patients, family members, and health-care professionals concerning physicians’ skills in providing end-of-life care. Focus groups are a qualitative study method that capitalizes on group dynamics to obtain information that may not be available through individual interviews or quantitative methods.1516 Results from this study have been previously published describing a conceptual framework of
Results
Table 1shows the number of patients in each disease category and the demographic characteristics of the focus group participants. Table 2shows the proportion of coded passages that fell within each domain for the different types of patients, and the rankings for the frequency with which each domain was identified. As Table 2 demonstrates, there were considerable similarities across disease groups in the frequency with which comments for each domain were identified. For all three disease groups,
Discussion
We previously used focus groups to develop an understanding of the domains and specific components of physicians’ skills in providing quality end-of-life care.11 In the current study, we compared and contrasted the perspectives of patients with COPD, ICU (often on a ventilator), AIDS, and cancer with the goal of providing physicians with insights to improve quality of end-of-life care for these patients. There were remarkable similarities in the overall domains across the three groups.11 For
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2022, Journal of Pain and Symptom ManagementCitation Excerpt :The paper concluded by noting that while the domains and model were novel and compelling, an evaluation of their usefulness was required. Data from this cohort was subsequently analyzed by patients’ disease process, with the predominant finding of substantial similarities in domains and components of physicians’ skills in providing good end-of-life care.15 However, some disease-specific differences existed such as COPD patients’ need for better education about their condition, AIDS patients’ worry about access to pain relief when many physicians has biases about addiction, and cancer patients’ concern with maintaining hope.
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2021, Journal of Pain and Symptom ManagementCitation Excerpt :Additionally, interviews were conducted with two palliative care-trained physicians at two healthcare systems outside of UW Medicine, and one patient family member, to provide additional perspective on improvements to the guides. Patients were not targeted given that the emphasis was on improving clinician-facing guides, and patients and caregivers had been included in previous qualitative studies and pilot work used to inform the development of the guides.4,13–18 During interviews, stakeholders were encouraged to share language that they typically use to conduct goals-of-care discussions with patients.
Support was provided by the Open Society Institute Project on Death in America.