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Kim K, Churilov L, Tan CO, Phan T, Geertsema J, Krieser R, Mehra R, Stewart PA, Rachbuch C, Huang A, Weinberg L. Anaesthetists' attitudes towards attending the funerals of their patients: A cross-sectional study among Australian and New Zealand anaesthetists. PLoS One 2020; 15:e0239996. [PMID: 33151958 PMCID: PMC7643987 DOI: 10.1371/journal.pone.0239996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022] Open
Abstract
A patient’s death can pose significant stress on the family and the treating anaesthetist. Anaesthetists’ attitudes about the benefits of and barriers to attending a patient’s funeral are unknown. Therefore, we performed a prospective, cross-sectional study to ascertain the frequency of anaesthetists’ attendance at a patient’s funeral and their perceptions about the benefits and barriers. The primary aim was to investigate the attitudes of anaesthetists towards attending the funeral of a patient. The secondary aims were to examine the perceived benefits of and barriers to attending the funeral and to explore the rate of bonds being formed between anaesthetists, patients and families. Of the 424 anaesthetists who completed the survey (response rate 21.2%), 25 (5.9%) had attended a patient’s funeral. Of the participants, 364 (85.9%) rarely formed special bonds with patients or their families; 233 (55%) believed that forming a special bond would increase the likelihood of their attendance. Showing respect to patients or their families was the most commonly perceived benefit of attending a funeral. Participants found expression of personal grief and caring for the patient at the end-of-life and beyond beneficial to themselves and the family. Fear of their attendance being misinterpreted or perceived as not warranted by the family as well as time restraints were barriers for their attendance. Most anaesthetists had never attended a patient’s funeral. Few anaesthetists form close relationships with patients or their families. Respect, expression of grief and caring beyond life were perceived benefits of attendance. Families misinterpreting the purpose of attendance or not expecting their attendance and time restraints were commonly perceived barriers. Trial registration:ACTRN 12618000503224.
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Affiliation(s)
- Kwangtaek Kim
- Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - Leonid Churilov
- Department of Medicine (Austin Health) & Melbourne Brain Centre at Royal Melbourne Hospital, Melbourne Medical School, Victoria, Australia
| | - Chong Oon Tan
- Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - Tuong Phan
- Department of Anaesthesia, St Vincent’s Hospital, Fitzroy, Victoria, Australia
| | - Jake Geertsema
- Department of Anaesthesia, The Northern Hospital, Epping, Victoria, Australia
| | - Roni Krieser
- Department of Anaesthesia, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rishi Mehra
- Department of Anaesthesia, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Paul Anthony Stewart
- Department of Anaesthesia, Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - Clive Rachbuch
- Department of Anaesthesia, Box Hill Hospital, Box Hill, Victoria, Australia
| | - Andrew Huang
- Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - Laurence Weinberg
- Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, Austin Health, The University of Melbourne, Victoria, Australia
- * E-mail:
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Kim K, Churilov L, Huang A, Weinberg L. Bereavement practices employed by hospitals and medical practitioners toward attending funeral of patients: A systematic review. Medicine (Baltimore) 2019; 98:e16692. [PMID: 31490361 PMCID: PMC6739025 DOI: 10.1097/md.0000000000016692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To ascertain bereavement practices offered by hospitals and medical practitioners (MPs), factors that influence the likelihood of MPs' involvement in funeral attendance, the benefits and barriers to attendance to a patient's funeral as perceived by MPs and the rate of attendance to patients' funeral by MPs. DESIGN MEDLINE (Ovid), Embase, PubMed, and Google Scholar were searched with a systematic search structure for randomized controlled trials, comparative observational studies, case series, cross-sectional studies, editorials, and letters. The search was limited to English only. The study was registered with Prospero (Registration Number: CRD42018095368). RESULTS A total of 381 articles were identified with 46 articles meeting the inclusion criteria. Of the 46, 16 were editorials and 12 were letters. Eighteen were cross-sectional studies conducted in the United States, Canada, Australia, Israel, and Ireland. Year of publication ranged from 1990 to 2017. Of these, 12 were quantitative, 3 were qualitative, and 3 were mixed-method studies. Two of the cross-sectional studies involved family members of deceased patients while others involved MPs. Bereavement practices offered by hospitals included memorial services, letters, and services provided by bereavement coordinators. Bereavement practices employed by MPs included answering or making phone calls, attending family meetings, and sending condolence letters. MPs' attendance at a patient's funeral was influenced by MPs' gender, age years of experience the medical specialty. Perceived benefits of MPs' attendance at a patient's funeral included providing support to the family, extending the professional relationship, illustrating respect to the patient and the family, resolving guilt and personal growth. Barriers to the attendance included a lack of time, blurring of professional boundaries, personal discomfort with death, emotional arousal, and discouragement by colleagues. General practice had an attendance rate of 71%. Attendance rates for palliative care, oncology, and psychiatrists ranged from 63% to 81%, 7.1% to 67%, and 15% to 67%, respectively. Intensivists had an attendance rate of 22%. CONCLUSION Several bereavement practices are provided by hospitals and MPs. Funeral attendance is an uncommon bereavement practice. MPs' attitudes toward attending a patient's funeral are understudied in many specialties. Patient factors that influence MPs' participation in bereavement practices are poorly understood.
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Affiliation(s)
| | - Leonid Churilov
- Department of Medicine (Austin Health), Melbourne Medical School, The University of Melbourne, Heidelberg, Australia
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Zambrano SC, Chur-Hansen A, Crawford GB. Beyond Right or Wrong: Attitudes and Practices of Physicians, Nurses, Psychologists, and Social Workers Regarding Attendance at Patient Funerals. J Palliat Med 2019; 22:400-407. [DOI: 10.1089/jpm.2018.0234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sofia C. Zambrano
- Universitäres Zentrum für Palliative Care, Inselspital, Bern University Hospital, Bern, Switzerland
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Gregory B. Crawford
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia
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Makarem M, Mohammed S, Swami N, Pope A, Kevork N, Krzyzanowska M, Rodin G, Hannon B, Zimmermann C. Experiences and Expectations of Bereavement Contact among Caregivers of Patients with Advanced Cancer. J Palliat Med 2018; 21:1137-1144. [DOI: 10.1089/jpm.2017.0530] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Maisam Makarem
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Shan Mohammed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Nadia Swami
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Ashley Pope
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Nanor Kevork
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Monika Krzyzanowska
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Breffni Hannon
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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Phillips JL, Lobb E, Mohacsi P, Heneka N, Currow D. Identifying systems barriers that may prevent bereavement service access to bereaved carers: A report from an Australian specialist palliative care service. Collegian 2018. [DOI: 10.1016/j.colegn.2017.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zambrano SC, Chur-Hansen A, Crawford GB. Attending patient funerals: Practices and attitudes of Australian medical practitioners. DEATH STUDIES 2017; 41:78-86. [PMID: 27611349 DOI: 10.1080/07481187.2016.1214631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The appropriateness of attending a patient's funeral is a medical dilemma. This article focuses on 437 doctors who participated in an online survey. Seventy-one percent of general practitioners, 67% of oncologists, 67% of psychiatrists, 63% of palliative medicine specialists, 52% of surgeons, and 22% of intensive care specialists had attended patient funerals. Significant differences in demographics and between specialties were identified in terms of barriers and benefits associated with attendance. Although attendance is a personal decision, there is a need for open discussions in medical education and professional development concerning death and the role of doctors after a patient dies.
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Affiliation(s)
- Sofía C Zambrano
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Anna Chur-Hansen
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Gregory B Crawford
- b School of Medicine , The University of Adelaide , Adelaide , Australia
- c Northern Adelaide Palliative Service , Northern Adelaide Local Health Network, Adelaide , Australia
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Hayward JS, Makinde O, Vasudev NS. Letters of condolence: assessing attitudes and variability in practice amongst oncologists and palliative care doctors in Yorkshire. Ecancermedicalscience 2016; 10:642. [PMID: 27347006 PMCID: PMC4898960 DOI: 10.3332/ecancer.2016.642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Indexed: 11/17/2022] Open
Abstract
Background Following a patient’s death, some doctors routinely write a letter of condolence to the bereaved family. Practice appears to vary widely but this is poorly documented, particularly in the UK setting. We wished to explore the attitudes of oncologists and palliative care consultants towards writing letters of condolence to patient’s families. Methods A sample of oncology and palliative care consultants from across Yorkshire were invited via email to complete an anonymous online survey. The survey aimed to identify current practice regarding condolence letter writing and respondents attitudes towards this. Results A total of 47 (72%) recipients completed the survey, comprised of clinical oncologists (45%), medical oncologists (42%), and palliative care consultants (13%). The majority (87%) reported sending condolence letters, but amongst this group, only 49% indicated they do this ‘often’ or ‘always’. When asked whether they would use a standard template letter, should it be made available, 77% of participants responded negatively. Many later commented that a template with room for flexibility would be better received. The majority (72%) were also not in favour of the introduction of policies to try to unify practices. Conclusions Practices and attitudes towards condolence letter writing are variable. The participants in this study felt strongly about when and how they wished to express condolences. A single unifying policy seems unlikely to be appropriate or feasible.
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Affiliation(s)
| | | | - Naveen S Vasudev
- Leeds Institute of Cancer and Pathology, University of Leeds, LS9 7TF, UK; St James's Institute of Oncology, Leeds, LS9 7TF, UK
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Yu J, Bang KS. Pediatric Nurses’ Perception and Knowledge about Pediatric Hospice Palliative Care. ACTA ACUST UNITED AC 2015. [DOI: 10.14475/kjhpc.2015.18.3.235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Juyoun Yu
- Doctoral Student, College of Nursing, Seoul National University, Seoul, Korea
| | - Kyung-Sook Bang
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
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Barbero Gutiérrez J, Alameda Angulo A, Díaz Sayas L, Jiménez Ávalos MC, García Llana H. Las cartas de condolencia: marco conceptual y protocolo. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.medipa.2012.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Granek L, Mazzotta P, Tozer R, Krzyzanowska MK. Oncologists' protocol and coping strategies in dealing with patient loss. DEATH STUDIES 2013; 37:937-952. [PMID: 24517522 DOI: 10.1080/07481187.2012.692461] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To identify what protocol and coping strategies oncologists turn to cope with patient loss, the authors interviewed 20 oncologists at 3 hospitals. Using the grounded theory method, findings revealed that their protocol may include meeting with families, participating in bereavement rituals, making a phone call, or sending a condolence card. Coping strategies included social support, activity-oriented coping, turning to faith, compartmentalization, and withdrawing from patients and families. The authors conclude by offering implications from this research on how to address oncologists' grief over patient loss in institutional settings in order to improve bereavement care for families and enhance oncologists' quality of life.
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Affiliation(s)
- Leeat Granek
- Department of Public Health, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Paolo Mazzotta
- Palliative Care Consult Team, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Richard Tozer
- Medical Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - Monika K Krzyzanowska
- Department of Medical Oncology & Hematology, Princess Margaret Hospital, Toronto, Ontario, Canada
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Walsh T, Breslin G, Curry P, Foreman M, McCormack M. A whole-hospital approach? Some staff views of a hospital bereavement care service. DEATH STUDIES 2013; 37:552-568. [PMID: 24520927 DOI: 10.1080/07481187.2012.673532] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A qualitative study was conducted to address staff's views of bereavement care in a large hospital setting. Two focus-groups and 1 interview were attended by 21 self-selected staff. The qualitative analysis yielded the following: (a) a staff training program within a structured bereavement care service may give staff a sense of confidence and pride in this aspect of their work; (b) a whole-hospital approach to bereavement care may offer an alternative model to individual clinical services; (c) the question is raised as to whether the presence of a bereavement co-ordinator helps contain staff anxiety and other painful emotions generated by contact with the dying and bereaved; and (d) the potential role of ancillary staff in bereavement care warrants more study.
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Affiliation(s)
- Trish Walsh
- School of Social Work and Social Policy, Trinity College, Dublin, Ireland.
| | | | - Philip Curry
- School of Social Work and Social Policy, Trinity College, Dublin, Ireland
| | - Maeve Foreman
- School of Social Work and Social Policy, Trinity College, Dublin, Ireland
| | - Martin McCormack
- Social Work Department, Beaumont Hospital, Whitehall, Dublin, Ireland
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Muta R, Sanjo M, Miyashita M, Wakabayashi R, Ando E, Morita T, Tsuneto S, Shima Y. What Bereavement Follow-Up Does Family Members Request in Japanese Palliative Care Units? Am J Hosp Palliat Care 2013; 31:485-94. [DOI: 10.1177/1049909113488239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: There is no standardized method by which bereavement care is offered by hospice/palliative care units (PCUs) in Japan. Aim: To evaluate bereavement services provided by hospice/PCUs and clarify demands for bereavement care. Design: Qualitative design based on semistructured interviews and content analysis. Setting/participants: Forty-four bereaved family members of patients with cancer who died in 9 PCUs in 4 regions. Results: Memorial services were positively evaluated for the following variables: reunion and interaction with staff; the service’s relaxed atmosphere; staff attentiveness; suitable location; suitable timing; program content; and interaction with other bereaved families. Memorial cards were positively evaluated regarding the level of concern shown by the staff and the personalized card. Respondents indicated their desire for a care system, a bereaved family care program, and information services.
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Affiliation(s)
- Rieko Muta
- Department of Adult Nursing, Faculty of Nursing, Bunri University of Hospitality, Saitama, Japan
| | - Makiko Sanjo
- Department of Adult Health Nursing, Faculty of Nursing, Toho University, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Rieko Wakabayashi
- Formerly of Department of Adult Nursing, University of Toyama, Toyama, Japan
| | - Etsuko Ando
- Department of Adult and Elderly Health Care Nursing, Faculty of Nursing, Kobe City College of Nursing, Hyogo, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Satoru Tsuneto
- Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan
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Kusano AS, Kenworthy-Heinige T, Thomas CR. Survey of bereavement practices of cancer care and palliative care physicians in the Pacific Northwest United States. J Oncol Pract 2012; 8:275-81. [PMID: 23277763 DOI: 10.1200/jop.2011.000512] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2012] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Physicians caring for patients with cancer frequently encounter individuals who will die as a result of their disease. The primary aim of this study was to examine the frequency and nature of bereavement practices among cancer care and palliative care physicians in the Pacific Northwest United States. Secondary aims included identification of factors and barriers associated with bereavement follow-up. METHODS An institutional review board (IRB) -approved, anonymous online survey of cancer specialists and palliative care physicians in Alaska, Washington, Oregon, Idaho, Montana, and Wyoming was performed in fall 2010. Potential participants were identified through membership in national professional organizations. Summary statistics and logistic regression methods were used to examine frequency and predictors of bereavement practices. RESULTS A total of 194 (22.7%) of 856 physicians participated in the online survey, with 164 (19.1%) meeting study inclusion criteria. Overall, 70% of respondents reported always or usually making a telephone call to families, sending a condolence letter, or attending a funeral service after a patient's death. The most common perceived barriers to bereavement follow-up were lack of time and uncertainty of which family member to contact. Sixty-nine percent of respondents did not feel that they had received adequate training on bereavement follow-up during postgraduate training. CONCLUSION Although a significant portion of respondents engaged in some form of bereavement follow-up, the majority felt inadequately trained in these activities. Efforts to identify available resources and address bereavement activities in postgraduate training may contribute to improved multidisciplinary treatment of patients with cancer and their families.
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Affiliation(s)
- Aaron S Kusano
- University of Washington School of Medicine, Seattle, WA 98195, USA.
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Corn BW, Shabtai E, Merimsky O, Inbar M, Rosenbaum E, Meirovitz A, Wexler ID. Do oncologists engage in bereavement practices? A survey of the Israeli Society of Clinical Oncology and Radiation Therapy (ISCORT). Oncologist 2010; 15:317-26. [PMID: 20228130 DOI: 10.1634/theoncologist.2009-0257] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We sought to determine the level of involvement of oncologists in bereavement rituals after a patient dies. SUBJECTS AND METHODS Members of the Israeli Society for Clinical Oncology and Radiation Therapy (ISCORT) were surveyed. The survey instrument consisted of questions regarding participation in bereavement rituals for patients in general and those with whom the oncologist had a special bond. Oncologists were queried as to the reasons for nonparticipation in bereavement rituals. RESULTS Nearly 70% of the ISCORT membership (126 of 182) completed the survey tool. Respondents included radiation, surgical, and medical oncologists. In general, oncologists rarely participated in bereavement rituals that involved direct contact with families such as funerals and visitations. Twenty-eight percent of physicians at least occasionally participated in rituals involving direct contact whereas 45% had indirect contact (e.g., letter of condolence) with the family on an occasional basis. There was significantly greater involvement in bereavement rituals when oncologists developed a special bond with the patient. In a stepwise linear regression model, the only factor significantly associated with greater participation in bereavement rituals was self-perceived spirituality in those claiming not to be religious. The major reasons offered for nonparticipation were time constraints, need to maintain appropriate boundaries between physicians and patients, and fear of burnout. CONCLUSION Although many oncologists participate at least occasionally in some sort of bereavement ritual, a significant proportion of oncologists are not involved in these practices at all.
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