Featured Research

from universities, journals, and other organizations

Many Terminally Ill Patients Feel Abandoned By Their Doctors

Date:
March 11, 2009
Source:
Fred Hutchinson Cancer Research Center
Summary:
Terminally ill patients and their family caregivers often feel abandoned by their doctors and feel a sense of "unfinished business" with them, according to a new study.

Terminally ill patients and their family caregivers often feel abandoned by their doctors and feel a sense of "unfinished business" with them, according to a new study by an oncologist at the Seattle Cancer Care Alliance.

The study results identified two themes: before death, abandonment worries related to loss of continuity of communication between patient and physician; and at the time death or after, the patient's family's feelings of abandonment from a lack of closure with the physician.

"Doctors often don't realize how important this issue is for patients and their families," said lead author Anthony Back, M.D., an expert on patient/physician communication. "Something as simple as a phone call can go a long way toward allaying abandonment concerns," he said.

The study found that physicians also reported a lack of closure when patients died, but they did not associate this with abandonment.

"At first glance, continuity and closure may seem mutually exclusive but these elements reflect different needs occurring at different times in the dying process," the authors write. "Early on, patients and family caregivers fear that their physicians, whose expertise and caring they have come to depend on, will become unavailable."

Near death or afterward, the patient's family may experience a lack of closure of their physician relationship. Physicians also report similar feelings. "Most physicians are not consciously aware of having abandoned their patients. Instead, they report a lack of closure or a feeling of unfinished business," Back said.

The paper contains many direct quotes from patient and physician participants who were asked to answer a series of questions about their perceptions and needs about continuity and closure.

For example, this is what one patient told the researchers about the impending loss of the relationship with the doctor: "I think that it's important that you still have that contact with them even though there isn't anything they can do to make you better."

Back and colleagues at the University of Washington School of Medicine lay out a simple plan for how physicians and nurses can achieve continuity and closure before and after a patient dies.

Before death, continuity can be achieved by assuring patients that they will be available to see them and by maintaining contact, often by phone, as death approaches. Closure can be addressed by anticipating and acknowledging the probable last visit with a patient. After a patient dies, the researchers recommend that physicians call the family caregiver as an act of closure.

For his own patients, Back said he schedules appointments to see patients after they enter hospice care or he calls them if they are too sick to come to the office. He also makes calls to say goodbye and talks to family members as well.

The authors say that this study is the first empirical research on the subject that provides a longitudinal, prospective view using ongoing interviews with doctors, nurses, patients and family caregivers that began at the time the patient had advanced disease and continued through death and into the beginning of bereavement.

"The significance of our study is that it provides empirical grounding for a central professional value of non-abandonment," said Back, also an affiliate member in the Clinical Research Division at Fred Hutchinson Cancer Research Center.

For the study, the authors recruited 31 Washington oncologists, pulmonologists and general internists. The doctors identified patients who were in the late stages of cancer or severe chronic obstructive pulmonary disease. Fifty-five patients participated in the study, as did 36 family members or friend caregivers. Twenty-five nurses also were recruited.

The National Institute of Nursing Research funded the research.


Story Source:

The above story is based on materials provided by Fred Hutchinson Cancer Research Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Back et al. Abandonment at the End of Life From Patient, Caregiver, Nurse, and Physician Perspectives: Loss of Continuity and Lack of Closure. Archives of Internal Medicine, 2009; 169 (5): 474 DOI: 10.1001/archinternmed.2008.583

Cite This Page:

Fred Hutchinson Cancer Research Center. "Many Terminally Ill Patients Feel Abandoned By Their Doctors." ScienceDaily. ScienceDaily, 11 March 2009. <www.sciencedaily.com/releases/2009/03/090309161953.htm>.
Fred Hutchinson Cancer Research Center. (2009, March 11). Many Terminally Ill Patients Feel Abandoned By Their Doctors. ScienceDaily. Retrieved September 1, 2014 from www.sciencedaily.com/releases/2009/03/090309161953.htm
Fred Hutchinson Cancer Research Center. "Many Terminally Ill Patients Feel Abandoned By Their Doctors." ScienceDaily. www.sciencedaily.com/releases/2009/03/090309161953.htm (accessed September 1, 2014).

Share This




More Health & Medicine News

Monday, September 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

We've Got Mites Living In Our Faces And So Do You

We've Got Mites Living In Our Faces And So Do You

Newsy (Aug. 30, 2014) A new study suggests 100 percent of adult humans (those over 18 years of age) have Demodex mites living in their faces. Video provided by Newsy
Powered by NewsLook.com
Liberia Continues Fight Against Ebola

Liberia Continues Fight Against Ebola

AFP (Aug. 30, 2014) Authorities in Liberia try to stem the spread of the Ebola epidemic by raising awareness and setting up sanitation units for people to wash their hands. Duration: 00:41 Video provided by AFP
Powered by NewsLook.com
California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

California Passes 'yes-Means-Yes' Campus Sexual Assault Bill

Reuters - US Online Video (Aug. 30, 2014) California lawmakers pass a bill requiring universities to adopt "affirmative consent" language in their definitions of consensual sex, part of a nationwide drive to curb sexual assault on campuses. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
New Drug Could Reduce Cardiovascular Deaths

New Drug Could Reduce Cardiovascular Deaths

Newsy (Aug. 30, 2014) The new drug from Novartis could reduce cardiovascular deaths by 20 percent compared to other similar drugs. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins