'It needs experience and courage': Awareness towards end of life communication practices in oncologists: A mixed methods study

Eur J Cancer Care (Engl). 2022 Nov;31(6):e13737. doi: 10.1111/ecc.13737. Epub 2022 Oct 18.

Abstract

Objective: End of life communication (EOLC) is generally regarded as a challenging aspect of the medical profession, with high influences of culture, the physician's experience and awareness. The aim of the current study was to assess the awareness of Austrian oncologists towards EOLC practices in their daily clinical routine and to identify limiting and supporting factors of these conversations.

Methods: Overall, 45 oncologists participated in the assessment in this cross-sectional, mixed-method design using semi-structured interviews and questionnaire.

Results: Themes that occurred during the interviews included the initiation of EOLC, EOLC in practice, strategies for EOLC, limiting and supporting factors and consequences of EOLC. There were several variations in the EOLC approach, that is, the use of time frames, timing, initiation and the amount of details given to the patient.

Conclusion: Oncologists agreed that EOLC is important in their daily clinical routine and for their patients. Nevertheless, there seems to be an underlying variation in approaches chosen by Austrian oncologists. This variation might be reduced by asking patients about their information preferences in advance and by routine implementation of communication guidelines, nomograms and prognostic calculators to reduce uncertainty.

Keywords: attitude; cancer; end of life communication; oncology; physician patient communication.

MeSH terms

  • Attitude of Health Personnel
  • Communication
  • Courage*
  • Cross-Sectional Studies
  • Death
  • Humans
  • Oncologists*
  • Terminal Care* / methods