"Guidebook on Doctors' Behaviors for Death Diagnosis Created by Community Healthcare Providers" Changed Residents' Mind for Death Diagnosis

J Palliat Care. 2020 Aug 25;825859720951698. doi: 10.1177/0825859720951698. Online ahead of print.

Abstract

Background: Education regarding death diagnosis is not often included in the medical education.

Objective: To investigate the change minds at the time of death diagnosis among residents after lectures based on our guidebook.

Design: Uncontrolled, open-label, multi-center trial.

Subjects: A total of 131 doctors undergoing their initial training were enrolled this study.

Measurements: Questionnaires were administered to volunteers before and after the lecture by the clinical training instructor presented information regarding doctors' behaviors at the death diagnosis based on our guidebook at each hospital.

Results: The subjects had an average age of 27.1 years and comprised 76 men (58.0%) and 54 women (41.2%). A total of 83 subjects (63.4%) had learned how to diagnose death as medical students, and 52 subjects (39.7%) had experienced death diagnosis scenes as medical students. Among those who had difficulties related to death diagnoses, the highest number (88.4%) indicated that "I do not know what to say to the family after a death diagnosis". Self-evaluation significantly increased after the lecture for many items concerning explanations to and considerations of the family: the effect size for "Give words of comfort and encouragement to family" increased significantly after the lecture to 0.9.

Conclusions: Few of the residents felt that they had received education regarding death diagnoses; they reported difficulties with diagnosing death and responding to patients' families. After the lecture using our guidebook, residents' mind changed significantly for death diagnosis, suggesting that the guidebook at the time of death diagnosis may be useful.

Keywords: death diagnosis; doctors’ behaviors; education.