A new study by Dr. Leeat Granek of Ben Gurion University’s Faculty of Health Sciences suggests that many oncologists do not communicate well enough with patients about death and dying. The study reveals that there is little training available to guide doctors through this crucial part of their work.
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The study, which was published in The Journal of Oncology Practice, was co-authored and researched in three Canadian hospitals. The researchers interviewed medical oncologists about what they found difficult in their job and what they felt they did well. Those interviewed indicated that communicating with patients and patients’ families about death and dying is one of the most stressful and difficult parts of their work.
Keeping the patient well-informed
Granek and her co-researchers found that there are a number of factors that make the task so arduous. Large obstacles lie with physician problems: difficulty with treatment and palliation, personal discomfort with death, diffusion of responsibility among colleagues, and lack of experience among other concerns. Patient factors, such as reluctance to talk about the end of life, language barriers, and young ages of patients are also hindrances. Limiting institutional factors include stigma surrounding palliative care, lack of protocol about end-of-life issues, and lack of training for oncologists about how to address these issues.
Granek explained that the study led to some strategies of effective communication. She stressed that “being open and honest with patients; having ongoing, early conversations; communicating about the goals of treatment; and balancing hope and reality about the end of life” are valuable approaches to creating better environment for patients. Granek added that further research and intervention are necessary to aid oncologists in achieving productive conversation about end-of-life issues.
Dr. Leeat Granek co-authored the article and study with Monika K Krzyzanowska, MD, MPH; Richard Tozer, MD; and Paolo Mazzotta, MD; all Canadian locals.
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