Facing Death in Clinical Practice: A View from Physicians in Mexico

Álvarez-del-Río, Asunción; Marván, Ma. Luisa; Santillán-Doherty, Patricio; Delgadillo, Silvia; Oñate‐Ocaña, Luis F.

doi:10.1016/j.arcmed.2013.05.005

Cited by 8 publications

(11 citation statements)

References 19 publications

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“…What nurses with more professional experience do indeed possess is better communication with dying patients. 18 Analyzing the responses provided by nurses and those given by physicians in the previous study, 9 there were significant differences between what physicians reported that they do and what nurses said that physicians do. According to nurses, physicians do not tell their patients the truth to the extent that they say they do.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, we investigated nurses' perceptions with respect to physicians' actions dealing with terminally ill patients, which allowed us to compare nurses' responses with those provided by physicians in a previous study. 9 Of the nurses invited to respond to the questionnaire, only 3% declined to participate. This high response frequency indicates an interest that may be explained by the fact that the subject of death is a concern in the nurses' daily work.…”

Section: Discussionmentioning

confidence: 99%

“…9 It is an 18-item, 5-point Likert scale whose scores range from 1 (strongly disagree) to 5 (strongly agree) and is divided into two parts: a) twelve items explore the nurses' views about their practice of caring for terminally ill patients, and b) six items about nurses' perceptions with respect to physicians' behaviors in dealing with terminally ill patients, four of these similar to those of the PVD, in that the sole difference is that the wording of the PVD is in the first person and the wording of the NVD is in third person, because it refers to physicians. As in the case of the PVD, NVD content validity was assessed using the Lawshe formula (asking 18 judges), and the discriminative capacity of each item was calculated using the extreme groups method.…”

Section: Instrumentmentioning

confidence: 99%

“…8 In a recent study that explored the views of Mexican physicians about death in their clinical practices, end-oflife was found to be an important topic for them. 9 Though the majority of these physicians valued the need to communicate uncertain outcomes when standard treatments begin to fail, the data obtained appeared to reflect what they thought the correct thing to do was, rather than what they actually did, which remained unknown.…”

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confidence: 99%

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Facing death in the clinical practice: a view from nurses in Mexico

Marván

Oñate‐Ocaña²,

Santillán-Doherty

et al. 2017

Salud Publica Mex

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Objective. To explore the views of nurses on death in their practice, and their perception about physicians' actions dealing with terminally ill patients. Materials and methods. Two hundred ninety-five nurses with experience caring for terminally ill patients responded to a questionnaire developed for this study. Results. The majority of participants considered that terminally ill patients should know about their prognosis. Although nearly all nurses said that when a patient brings up the subject and they talk with the patient about death, several of the nurses find it difficult to establish a relationship with these patients. Concerning nurses' perception about physicians' actions, they considered that physicians avoid the subject of death with their patients more than the physicians acknowledge. Conclusions. More education and training of physicians and nurses on end-of-life issues is needed to improve communication with dying patients and to provide them with better care.Keywords: nurses; death; nurse-patient relationship; physicianpatient relationship ResumenObjetivo. Explorar las opiniones de enfermeras y enfermeros sobre el tema de la muerte en su práctica clínica, así como su percepción sobre las acciones de los médicos que tratan pacientes en fase terminal. Material y métodos. Doscientas noventa y cinco enfermeras y enfermeros con experiencia en enfermos terminales respondieron un cuestionario que fue desarrollado para este estudio. Resultados. La mayoría de los participantes consideraron que los enfermos terminales deben conocer su pronóstico. Aunque casi todos dijeron que cuando los pacientes abordan el tema de la muerte hablan con ellos al respecto, varios encuentran difícil establecer una relación con ellos. En cuanto a su percepción sobre los médi-cos, el personal de enfermería considera que éstos evitan el tema de la muerte con sus pacientes más de lo que reconocen. Conclusiones. Es necesario brindar capacitación a médicos y personal de enfermería sobre temas relacionados con el fin de la vida para mejorar su comunicación con los pacientes terminales y brindarles una mejor atención.Palabras clave: enfermeras; muerte; relación enfermerapaciente; relación médico-paciente

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Instrumentmentioning

confidence: 99%

mentioning

confidence: 99%

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Facing death in the clinical practice: a view from nurses in Mexico

Marván

Oñate‐Ocaña²,

Santillán-Doherty

et al. 2017

Salud Publica Mex

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“…Lazcano et al [17] suggest that an incomplete and vague communication pattern prevails between physicians and patients, resulting from the physician’s paternalistic attitude that tends to disregard patient autonomy. Another study [18], explored the attitude of Mexican physicians towards death in their practice, and found that only a minority of participants had received some form of training in the management of terminally ill patients (28%), but regardless, they still assumed their care (73%). Personal experience and years of practice had taught them how to face death, but still, most considered it would be wise and necessary to attend seminars or workshops on the subject (77%).…”

Section: Introductionmentioning

confidence: 99%

Experience of oncology residents with death: a qualitative study in Mexico

et al. 2019

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BackgroundPhysicians play a fundamental role in the care of patients at the end of life that includes knowing how to accompany patients, alleviate their suffering and inform them about their situation. However, in reality, doctors are part of this society that is reticent to face death and lack the proper education to manage it in their clinical practice. The objective of this study was to explore the residents’ concepts of death and related aspects, their reactions and actions in situations pertaining to death in their practice, and their perceptions about existing and necessary training conditions.MethodsA qualitative approach was used to examine these points in depth based on interviews conducted with seven oncology residents.ResultsParticipants do not have a clear concept of death and, although it is seen as a common phenomenon, they consider it an enemy to beat. The situations to which respondents react more frequently with frustration and sadness after the death of patients were when they felt emotionally involved, if they identify with the patient, in cases of pediatric patients and with patients who refuse treatment. To deal with death, participants raise barriers and attempt to become insensitive. Although residents in this study recognize the importance of training to learn how to better deal with death, it seems they are not fully invested in reaching more of it.ConclusionsParticipants face death in a daily basis without the necessary training, which appears to impact them more than they are willing to accept. They do not achieve their goals managing situations regarding death as well as they assume they do. Despite recognizing the need of more training and support for better coping with death, they prefer to continue to learn from their experience.Trial registrationNot applicable.

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