Communication with Families in the Last Days of a Patient’s Life and Optimal Delivery of a Death Pronouncement

Okamoto, Soichiro; Uneno, Yu; Mori, Masanori; Yamaguchi, Takashi; Nakajima, Nobuhisa

doi:10.5772/intechopen.84730

Cited by 2 publications

(4 citation statements)

References 68 publications

(85 reference statements)

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Section: Usefulness Discussionmentioning

confidence: 99%

“…There is a paucity of literature on teaching DWLE with most focusing on DP [11]. Additionally, although many schools deliver education around end-of-life care, there is less published about delivering death news [11]. Physician-patient-family communication and physician behavior during a DP is an important component of DWLE.…”

Section: Usefulness Discussionmentioning

confidence: 99%

“…Physician-patient-family communication and physician behavior during a DP is an important component of DWLE. This communication leaves a lasting impression on families, which has the potential to either positively or negatively impact the family during the bereavement process [11][12][13].…”

Section: Usefulness Discussionmentioning

confidence: 99%

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Death Pronouncement: Preparing Incoming Residents for Duties When Life Ends

Kaloti¹,

Nabaty²,

Mohamed³

et al. 2022

Cureus

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IntroductionUndergraduate Medical Education (UME) prepares future residents for many aspects of medical practice, but it is rarely all-inclusive. Death pronouncement (DP), a highly important aspect of clinical training for residents, seems to be inadequately addressed and taught in undergraduate institutions. Studies have indicated that most first-year residents received minimal DP training and felt unprepared for this duty. Despite being a challenging situation, a formal teaching course is not universally taught, with most institutions merely delivering point-of-care DP instruction to medical trainees provided by supervising faculty, senior residents, and nurses. Our primary objective was to provide formal education in Duties When Life Ends (DWLE), with the goal of enhancing familiarity, knowledge, and confidence in addressing the circumstances surrounding death for graduating medical students transitioning to residency. MethodsAs a part of a Transition to Residency (TTR) course for students entering nonsurgical specialties, we developed a curriculum to provide formal education to fourth-year medical students in DWLE that included a two-hour didactic session delivered virtually, followed by an in-person simulation session. The didactic session covered the history, processes of DP, death physical examination, identification of medical examiner (ME) case, education on how to deliver death news to family, information about autopsies and organ donation, distinction between the cause and mechanism of death, and documentation of death notes and certificates, as well as provider self-reflection and appropriate coping mechanisms for patient death.In the 45-minute simulation, students were divided into small groups and given a case summary. During the first half, they performed a physical examination and a verbal pronouncement on cadavers, followed by an interactive small group session where students reviewed the case and worked to identify the cause of death, determine if the death was a medical examiner's case, deliver death news to the family, and complete a death progress note and certificate. Pre-and post-session questionnaires were administered, assessing three components: process familiarity, knowledge, and confidence. Finally, participants assessed course usefulness and had a free response opportunity for comments and feedback. ResultsOverall, 198 students participated in all sessions, with 182 completing both pre-and post-session questionnaires. Pre-survey revealed that 70% of participants reported witnessing DP previously, with only 20% being familiar with the process of DP and 6% with documentation. Following the intervention, a comparison of the pre-and post-course questionnaires assessing process familiarity, knowledge, and confidence using a five-point Likert scale demonstrated statistically significant improvement in the mean scores in all three domains, with reported course usefulness of 96%. ConclusionA DWLE curriculum, as a part of the TTR course, was effective in improving self-reported familiarity, kn...

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Section: Usefulness Discussionmentioning

confidence: 99%

Section: Usefulness Discussionmentioning

confidence: 99%

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Death Pronouncement: Preparing Incoming Residents for Duties When Life Ends

Kaloti¹,

Nabaty²,

Mohamed³

et al. 2022

Cureus

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show abstract

“…Family communication includes daily conversations, conflict resolution, decision-making, and emotional expression that the place between family members. It has been shown that family communication relating to death will affect family members’ emotional responses and long-term mental health ( 44 ). If family communication is smooth, open, and positive, parents are more likely to establish a sense of trust and understanding with their children.…”

Section: Theoretical Basis and Research Hypothesismentioning

confidence: 99%

Research on factors influencing Chinese parents’ support for death education: a cross-sectional survey

Chen,

Xiao,

Huang

et al. 2024

Front. Public Health

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ObjectiveThis study aims to explore the factors influencing Chinese parents’ attitudes toward death education. Given the current lack of such education in China, this research is particularly significant. Death education is vital for shaping the values of young people and alleviating mental health issues, such as depression and suicidal tendencies. By identifying these influencing factors, this study seeks to provide guidance for policymakers and educators in promoting the development and widespread adoption of death education.MethodsTo do so, a national cross-sectional quota sample of 12,435 Chinese parents was used. Borrowing from social-ecological theory, the researchers carried out multiple stepwise regression analyses to examine the individual, family, and social-level factors that shape the supportive attitudes of Chinese parents toward death education.ResultsThe findings revealed that at the individual level, parent (β = 0.04, p < 0.001), education level (β = 0.07, p < 0.001), and religious belief (β = −0.02, p < 0.05) were significant predictors of Chinese parents’ support for death education. Meanwhile, at the family and social level, average monthly household income (β = 0.07, p < 0.001), family health (β = 0.03, p < 0.05), family communication (β = 0.02, p < 0.05), social support (β = 0.15, p < 0.001), neighborhood relations (β = 0.11, p < 0.001), and social network size (β = 0.05, p < 0.001) were significant predictors of Chinese parents’ supportive attitudes toward death education.ConclusionBased on these findings, it is suggested that the relevant development, planning, publicity, and public welfare groups and government departments should promote death education, provide more social support, and encourage neighborhood harmony. As higher education and average monthly household income were found to significantly impact the support, the government should improve access to higher education and actively work to increase residents’ income to facilitate the development of death education.

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Communication with Families in the Last Days of a Patient’s Life and Optimal Delivery of a Death Pronouncement

Cited by 2 publications

References 68 publications

Death Pronouncement: Preparing Incoming Residents for Duties When Life Ends

Death Pronouncement: Preparing Incoming Residents for Duties When Life Ends

Research on factors influencing Chinese parents’ support for death education: a cross-sectional survey

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