Bereavement Practices of Physicians in Oncology and Palliative Care | Hematology | JAMA Internal Medicine | JAMA Network
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Original Investigation
May 25, 2009

Bereavement Practices of Physicians in Oncology and Palliative Care

Author Affiliations

Author Affiliations: Departments of Medical Oncology & Hematology (Drs Chau, Zimmermann, and Krzyzanowska) and Public Health Sciences (Dr Taback), University of Toronto, Toronto, Ontario, Canada; Departments Psychosocial Oncology and Palliative Care (Dr Zimmermann), Biostatistics (Mr Ma), and Medical Oncology & Hematology (Dr Krzyzanowska), Princess Margaret Hospital, Toronto.

Arch Intern Med. 2009;169(10):963-971. doi:10.1001/archinternmed.2009.118

Background  Cancer physicians frequently interact with dying patients, but little is known about these physicians' practices. The purpose of this study was to evaluate the frequency and nature of bereavement practices among medical oncologists (MOs), radiation oncologists (ROs), and palliative care specialists (PCs); and to identify factors associated with bereavement follow-up.

Methods  Survey of all Canadian MOs, ROs, and PCs via their respective national organizations using an anonymous electronic and postal mail survey.

Results  A total of 535 of 756 eligible physicians completed the survey (71%). Overall, 33.3% (95% confidence interval [CI], 29.3%-37.4%) of respondents indicated that they usually or always make a telephone call, send a condolence card, or attend a funeral following a patient's death; 30.5% (95% CI, 26.5%-34.4%) reported performing at least 1 of these practices sometimes; and 36.2% (95% CI, 32.1%-40.3%) reported performing at least 1 of these practices rarely or never. Among the specific practices, respondents were more likely to call a family at least sometimes than to send a condolence card or attend funeral services. Palliative care specialists reported the highest rates of bereavement follow-up. In multivariate regression analysis, female sex, working in an academic setting, palliative care specialty, lack of formal palliative care program, endorsement of the statement that physicians had a responsibility to send a condolence card, and high number of patient deaths were associated with more frequent bereavement follow-up.

Conclusions  Few cancer physicians provide bereavement follow-up routinely. This suggests that consensus is lacking among cancer physicians regarding their role in bereavement care.