Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan

Background: Junior physicians' perceived difficulty in end-of-life care of patients with cancer has not been structurally investigated; therefore, current challenges and solutions in this area remain unknown. Objectives: To identify some difficulties junior physicians face in delivering end-of-...

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Main Authors: Soichiro Okamoto, Yu Uneno, Natsuki Kawashima, Shunsuke Oyamada, Yusuke Hiratsuka, Keita Tagami, Manabu Muto, Tatsuya Morita
Format: Article
Language:English
Published: Mary Ann Liebert 2022-10-01
Series:Palliative Medicine Reports
Subjects:
Online Access:https://www.liebertpub.com/doi/full/10.1089/PMR.2022.0008
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author Soichiro Okamoto
Yu Uneno
Natsuki Kawashima
Shunsuke Oyamada
Yusuke Hiratsuka
Keita Tagami
Manabu Muto
Tatsuya Morita
author_facet Soichiro Okamoto
Yu Uneno
Natsuki Kawashima
Shunsuke Oyamada
Yusuke Hiratsuka
Keita Tagami
Manabu Muto
Tatsuya Morita
author_sort Soichiro Okamoto
collection DOAJ
description Background: Junior physicians' perceived difficulty in end-of-life care of patients with cancer has not been structurally investigated; therefore, current challenges and solutions in this area remain unknown. Objectives: To identify some difficulties junior physicians face in delivering end-of-life care for patients with cancer and to clarify the support required to reduce these difficulties. Design: A nationwide survey was conducted in over 300 institutions selected randomly from 1037 clinical training hospitals in Japan. Participants: From each of these institutions, two resident physicians of postgraduate year (PGY) 1 or 2, two clinical fellows of PGY 3?5, and an attending physician were requested to respond to the survey. Measurements: The survey investigated issues regarding end-of-life care using the palliative care difficulties scale with two additional domains (?discussion about end-of-life care? and ?death pronouncement?). Items related to potential solutions for alleviating the difficulties as well were investigated. Results: A total of 198 resident physicians, 134 clinical fellows, and 96 attending physicians responded to the survey (response rate: 33.0%, 22.3%, and 32.0%). The results revealed that junior physicians face difficulties within specific domains of end-of-life care. The most challenging domain comprised communication and end-of-life discussion with patients and family members, symptom alleviation, and death pronouncement. The most favored supportive measure for alleviating these difficulties was mentorship, rather than educational opportunities or resources regarding end-of-life care. Conclusion: The findings of this study reveal the need for further effort to enrich the mentorship and support systems for junior physicians delivering end-of-life care.
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spelling doaj.art-f96b78d8348b47fdb74213c2911381ad2024-01-26T05:01:31ZengMary Ann LiebertPalliative Medicine Reports2689-28202022-10-013125526310.1089/PMR.2022.0008Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in JapanSoichiro OkamotoYu UnenoNatsuki KawashimaShunsuke OyamadaYusuke HiratsukaKeita TagamiManabu MutoTatsuya MoritaBackground: Junior physicians' perceived difficulty in end-of-life care of patients with cancer has not been structurally investigated; therefore, current challenges and solutions in this area remain unknown. Objectives: To identify some difficulties junior physicians face in delivering end-of-life care for patients with cancer and to clarify the support required to reduce these difficulties. Design: A nationwide survey was conducted in over 300 institutions selected randomly from 1037 clinical training hospitals in Japan. Participants: From each of these institutions, two resident physicians of postgraduate year (PGY) 1 or 2, two clinical fellows of PGY 3?5, and an attending physician were requested to respond to the survey. Measurements: The survey investigated issues regarding end-of-life care using the palliative care difficulties scale with two additional domains (?discussion about end-of-life care? and ?death pronouncement?). Items related to potential solutions for alleviating the difficulties as well were investigated. Results: A total of 198 resident physicians, 134 clinical fellows, and 96 attending physicians responded to the survey (response rate: 33.0%, 22.3%, and 32.0%). The results revealed that junior physicians face difficulties within specific domains of end-of-life care. The most challenging domain comprised communication and end-of-life discussion with patients and family members, symptom alleviation, and death pronouncement. The most favored supportive measure for alleviating these difficulties was mentorship, rather than educational opportunities or resources regarding end-of-life care. Conclusion: The findings of this study reveal the need for further effort to enrich the mentorship and support systems for junior physicians delivering end-of-life care.https://www.liebertpub.com/doi/full/10.1089/PMR.2022.0008end-of-life caremedical educationpalliative carepalliative care difficulties scalephysician support
spellingShingle Soichiro Okamoto
Yu Uneno
Natsuki Kawashima
Shunsuke Oyamada
Yusuke Hiratsuka
Keita Tagami
Manabu Muto
Tatsuya Morita
Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
Palliative Medicine Reports
end-of-life care
medical education
palliative care
palliative care difficulties scale
physician support
title Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
title_full Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
title_fullStr Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
title_full_unstemmed Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
title_short Difficulties Facing Junior Physicians and Solutions Toward Delivering End-of-Life Care for Patients with Cancer: A Nationwide Survey in Japan
title_sort difficulties facing junior physicians and solutions toward delivering end of life care for patients with cancer a nationwide survey in japan
topic end-of-life care
medical education
palliative care
palliative care difficulties scale
physician support
url https://www.liebertpub.com/doi/full/10.1089/PMR.2022.0008
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