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Physicians' emotional responses to patients' deaths increase with care length, says Pitt

PITTSBURGH, Aug. 1 The longer a doctor spends caring for a patient, the more vulnerable that doctor is to feelings of loss when that patient dies but doctors often suffer these emotions in silence. These findings from a study by University of Pittsburgh researchers are published in this week's issue of The British Medical Journal, a theme issue entitled "What is a Good Death?"

Previous studies have shown that physicians, particularly those who are younger and less experienced, often feel sadness and even guilt over the death of a patient. The University of Pittsburgh researchers, working with investigators from Harvard Medical School, expanded on that information by looking at training level as well as other variables related to physician response, and how these physicians deal with emotions that arise over the death of a patient.

"Physicians form bonds with their patients, and when a patient dies, the physician is going to have some emotions surface," said investigator and senior author Robert M. Arnold, M.D., the Leo H. Criep Chair in Patient Care, professor of medicine and chief of the Section of Palliative Care and Medical Ethics, University of Pittsburgh School of Medicine. "Today's medical education system does not address this important issue. I worry that this may be partly responsible for the high rate of burnout among physicians."

Researchers surveyed 188 interns, residents and primary attending physicians who were caring for 68 patients at the time of death at two U.S. teaching hospitals. They examined how training level, sex, marital status and duration of care predicted outcomes such as doctors' experiences, emotional reactions and use of coping resources.

As is usually the case in a teaching hospital, most physicians (82 percent) had not known the patient before the final hospital admission. At the time of death, 36 percent knew the patient for three days or less, and 36 knew the patient for four to seven days. Only 2
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Contact: Kathryn Duda
412-624-2607
University of Pittsburgh Medical Center
1-Aug-2003


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