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Korean Physicians' Perspectives on Prognostication in Palliative Care: A Qualitative Study

Authors
 Eon Sook Lee  ;  Sang-Yeon Suh  ;  Thomas W LeBlanc  ;  Sang Hwa Himchack  ;  Sanghee Shiny Lee  ;  Yoonjoo Kim  ;  Hong-Yup Ahn 
Citation
 AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE, Vol.36(6) : 500-506, 2019-06 
Journal Title
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE
ISSN
 1049-9091 
Issue Date
2019-06
MeSH
Adult ; Communication ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Neoplasms / therapy* ; Palliative Care / organization & administration* ; Physician-Patient Relations ; Physicians / psychology* ; Prognosis ; Qualitative Research ; Republic of Korea ; Time Factors
Keywords
prognosis ; cancer ; palliative care ; qualitative research ; physician ; end-of-life care
Abstract
Background: Prognostication is an essential component of palliative care for patients with advanced cancer but also poses challenges. Little is known about physicians' perspectives on prognostication and prognostic tools used in palliative care practice in Eastern countries. Objectives: To explore Korean physicians' perspectives and experiences with prognostication in their palliative care practices. Methods: Semi-structured interviews were conducted in Korea in 11 palliative care physicians. A constant comparative and grounded theory approach was used to derive themes from interview transcripts. Results: Participants on average had 6.4 (SD = 4.5, range 0.5-15) years of hospice and palliative care experience. We identified 4 main themes about prognostication: (1) the importance of prognostication (to help patients and their families prepare for death, to determine the appropriate time of transition to hospice care, to facilitate appropriate decision making, and to facilitate communication with patients and their families); (2) difficulties of prognostication (discomfort estimating the exact date of death); (3) basis of prognostication (clinical prediction of survival as well as prognostic scores); and (4) areas for further research (need for a simpler scoring system or parameters to predict survival with greater certainty). Conclusion: Palliative care physicians in Korea reported similar perceptions about the role and challenges inherent in prognostication compared to clinicians in Western cultures. However, they emphasize the need to predict final days to keep families with dying patients, reflecting family-centered aspects of Asian culture. They reported frustrations with inaccurate prognostication schemas and called for the development of simpler, more accurate predictors as a focus of future research.
Full Text
https://journals.sagepub.com/doi/10.1177/1049909118824542
DOI
10.1177/1049909118824542
Appears in Collections:
3. College of Nursing (간호대학) > Others (기타) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189254
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