Most Oncologists Contact Bereaved Family and Caregivers

 

The majority of recently surveyed cancer care physicians initiate communication with the bereaved family and caregivers of their patients who have died. However, over two-thirds feel they did not receive adequate bereavement training during their residency or fellowship, according to a study presented at the 53rd Annual Meeting of the American Society for Radiation Oncology (ASTRO).

“In particular with cancer, there has been a movement to encourage physician involvement throughout the course of disease, including after a patient’s passing,” said Aaron S. Kusano, MD, a radiation oncology resident at the University of Washington School of Medicine in Seattle. “The empathy in physicians dedicated to cancer care doesn’t translate into an inherent ability to lead difficult conversations or comfortably express grief.”

The primary goals of the prospective study included:

• Examining the frequency and characteristics of bereavement practices among oncologists and palliative care physicians in the northwest United States
• Identifying issues and obstacles associated with bereavement follow-up
• Determining any differences in bereavement practices among medical specialties

An anonymous online pilot survey in the fall of 2010 involving 162 attending radiation oncologists, medical oncologists, surgical oncologists, and palliative care physicians directly involved with patient care found that 70% of those surveyed routinely initiated at least 1 bereavement activity. By far, the most common form of follow-up involved sending a condolence letter. Making a telephone call to bereaved family members and attending a funeral service following a patient’s death were two other prevalent physician-initiated activities.

Results indicated that, for those physicians who did not initiate bereavement follow-up, 90% would routinely be accessible for phone calls from a patient’s family.

Several factors made a physician more apt to perform follow-up care. These included:

• Being a medical oncologist (compared to radiation oncologist and palliative care physician)
• Having palliative care program access
• Sensing the responsibility to write a condolence letter

On the other hand, survey results showed these commonly perceived barriers add difficulty to bereavement follow-up:

• Lack of time for correspondence
• An uncertainty regarding which family member to contact
• Feeling uncomfortable about what to say
• A deficiency in bereavement support resources

“This study highlights the needs to more clearly define the physicians’ role in bereavement activities and address bereavement activities in provider’s post-graduate training as we work to improve the multidisciplinary treatment of cancer patients and their families,” Kusano said.

Source: ASTRO.