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General practitioners' experiences of the psychological aspects in the care of a dying patient

Published online by Cambridge University Press:  23 May 2008

Brian Kelly ,
Francis T Varghese ,
Paul Burnett ,
Jane Turner ,
Marguerite Robertson ,
Patricia Kelly ,
Geoffrey Mitchell  and
Pat Treston
Brian Kelly*
Affiliation:
Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia
Francis T Varghese
Affiliation:
Discipline of Psychiatry, Southern Clinical School, University of Queensland Medical School, Brisbane, QLD, Australia
Paul Burnett
Affiliation:
Charles Sturt University, Wagga Wagga, NSW, Australia
Jane Turner
Affiliation:
Discipline of Psychiatry, Southern Clinical School, University of Queensland Medical School, Brisbane, QLD, Australia
Marguerite Robertson
Affiliation:
Discipline of Psychiatry, Southern Clinical School, University of Queensland Medical School, Brisbane, QLD, Australia
Patricia Kelly
Affiliation:
Discipline of Psychiatry, Southern Clinical School, University of Queensland Medical School, Brisbane, QLD, Australia
Geoffrey Mitchell
Affiliation:
Discipline of General Practice, University of Queensland Medical School, Brisbane, QLD, Australia
Pat Treston
Affiliation:
Mt. Olivet Hospital and Home Care Services, Brisbane, QLD, Australia
*
Address correspondence and reprint requests to: Brian Kelly, Centre for Rural and Remote Mental Health, University of Newcastle, Bloomfield Hospital, Forest Rd Orange, NSW, 2800, Australia. E-mail: Brian.Kelly@newcastle.edu.au
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Abstract

Objective:

General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients.

Method:

Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews.

Results:

The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient).

Significance of results:

The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.

Keywords

General practitionerDoctor–patient relationshipQualitativePsycho-social
Type
Original Articles
Information
Palliative & Supportive Care , Volume 6 , Issue 2 , June 2008 , pp. 125 - 131
Copyright
Copyright © Cambridge University Press 2008

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