Communication and decision making at end-of-life- physician emotional experiences: qualitative studies systematicreview

Latham, John S ORCID: 0000-0003-2687-8922, Butchard, Sarah and Mason, Stephen R ORCID: 0000-0002-4020-6869 (2022) Communication and decision making at end-of-life- physician emotional experiences: qualitative studies systematicreview. BMJ SUPPORTIVE & PALLIATIVE CARE. bmjspcare-2021-003446-.

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Abstract

<h4>Objective</h4>To explore the emotional experience of physicians in acute settings when encountering end-of-life conversations and decision making.<h4>Method</h4>Thematic synthesis of qualitative studies. Medline, PsychInfo, PubMed, BNI and CIAHL were searched from 1985 to 2021 for studies published in English. Data extraction was informed by a framework created for assessing methodological quality by Polanin, Pigott, Espelage and Grotpeter (2019) and adapted by Draper <i>et al.</i> (2019).<h4>Results</h4>Of 8429 papers identified, 17 were selected for review. Two themes containing 10 subthemes described the emotional and psychological factors impacting the experience of end-of-life care, namely: a tension between desire and ability to communicate end-of-life news, and a conflict of hiding versus revealing self across several practical and emotional contexts.<h4>Conclusion</h4>Medical training is only a small factor in how well a person copes with end-of-life care and may sometimes feed negative appraisals . Lack of support from senior colleagues, fear of criticism and a sense of perceived failure were linked to lower self-efficacy in end-of-life care. Beyond learning practical skills, physicians benefit from understanding the psychological factors impacting their experience and in building self-efficacy, and observing senior colleagues effectively process strong and difficult emotions.<h4>Practical implications</h4>Promoting personal reflection and sharing of the experiences encountered in end-of-life care, especially modelled from senior colleagues, may contribute to improvements in competence and reduce the impact of heroism, feelings of failure and avoidance in practice.

Item Type:	Article
Uncontrolled Keywords:	Bereavement, Communication, End of life care, Hospital care, Psychological care, Transitional care
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	21 Sep 2022 14:22
Last Modified:	25 Jan 2024 12:58
DOI:	10.1136/bmjspcare-2021-003446
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3154334