Self-Protective Altruism

Relationship between physicians' death anxiety and medical communication and decision-making: A systematic review

OBJECTIVE

To examine the relationship between physicians' death anxiety and medical communication and decision-making. It was hypothesized that physicians' death anxiety may lead to the avoidance of end-of-life conversations and a preference for life-prolonging treatments.

METHODS

PubMed and PsycInfo were systematically searched for empirical studies on the relation between physicians' death anxiety and medical communication and decision-making.

RESULTS

This review included five quantitative and two qualitative studies (N = 7). Over 38 relations between death anxiety and communication were investigated, five were in line with and one contradicted our hypothesis. Physicians' death anxiety seemes to make end-of-life communication more difficult. Over 40 relations between death anxiety and decision-making were investigated, three were in line with and two contradicted the hypothesis. Death anxiety seemes related to physicians' guilt or doubt after a patient's death.

CONCLUSIONS

There was insufficient evidence to confirm that death anxiety is related to more avoidant communication or decision-making. However, death anxiety does seem to make end-of-life communication and decision-making more difficult for physicians.

PRACTICE IMPLICATIONS

Education focused on death and dying and physicians' emotions in medical practice may improve the perceived ease with which physicians care for patients at the end of life.

Self-compassion as a buffer against concrete but not abstract threat

Terror management theory posits that validation of self-esteem is a major defense mechanism in keeping mortal concerns at bay. Yet, self-esteem often leads to devaluation of others. Self-compassion (SC) is an alternative, more inclusive construct than self-esteem. We explored among 125 university students whether SC serves as a defense mechanism from abstract and concrete threats responses, utilizing a dot-probe task and mortality salience priming. Although SC was not associated with avoidance of abstract threats, it was associated with avoidance of concrete threats. These findings underscore the potential role of SC in coping with trauma and in shielding from developing post-traumatic symptoms.

Parental regret regarding children's vaccines-The correlation between anticipated regret, altruism, coping strategies and attitudes toward vaccines

BACKGROUND

Parental hesitancy for recommended childhood vaccines is a growing public health concern influenced by various factors. This study aimed to explore regret regarding parental decisions to vaccinate their children via possible correlations between anticipated regret, altruism, coping strategies, and parents' attitudes toward the vaccination of their children.

METHODS

The study was conducted during 2014 in Israel. Data were collected via snowballing methodology (i.e., Internet forums, Facebook and e- mails). 314 parents of children ages 0-6 years participated in the study. Questionnaires were distributed and completed on-line including attitudes toward vaccines, altruism, coping strategies, regret and anticipated regret.

RESULTS

Pearson analysis revealed a moderate negative association between attitudes toward vaccinations and regret. In addition, weak but significant positive associations emerged between anticipated regret and regret as well as between gender and regret. Performing hierarchical regression analysis revealed contribution of 35.9 % to the explained variance of regret suggesting that coping strategy of instrumental support, attitudes toward vaccinations and anticipated regret are linked significantly to regret.

CONCLUSION

Parental attitudes toward vaccines and anticipated regret have a salient role when deciding whether or not to vaccinate children and contribute to the prediction of regret regarding vaccination. In order to increase parental consent to vaccination of their children, it is important to minimize possible regret through the strength of the recommendation and/or knowledge base about risk/benefit (perceived, heuristic) of vaccines that might influence parental attitudes and lessen their anticipated regret.

TRIAL REGISTRATION

N/A. This is not a clinical trial and thus does not require registration. Ethics approval was received from Ariel University School of Social Work Ethics committee (18/02/14). This was an attitude survey. The Ariel University School of Social Work Ethics committee approved performance of this attitude survey (18/02/14).