TY - JOUR
T1 - Community physicians describe management issues for patients expected to live less than twelve months
AU - Goodlin, Sarah J.
AU - Jette, Anne M.
AU - Lynn, Joanne
AU - Wasson, John H.
PY - 1998
Y1 - 1998
N2 - We examine management issues experienced by community physicians providing care to patients they expect to die within a year. In a case series, 61 physicians in northern New England enrolled 182 consecutive dying patients. Important management issues for these patients were recorded at enrollment and eight months later. The patients' average age was 74 years; most had cancer (48%) or cardiovascular disease (38%). Almost two-thirds of the patients died within eight months of enrollment. Major management issues for the physicians in care of these patients were deficits in basic self-care, emotional support, pain control, and nutrition. Pain control and family need for support were reported most frequently. Although demand for physician time was seldom a major management issue, when it occurred it correlated with patients' emotional needs or their desire to extend life (p<0.01). Two barriers to optimum care commonly cited by physicians were (a) the differences in treatment expectations between family members, patients, and physicians and (b) the incurable, progressive nature of the patients' diseases. Efforts to improve care for patients who have limited life expectancy should further explore the perceptions of community physicians.
AB - We examine management issues experienced by community physicians providing care to patients they expect to die within a year. In a case series, 61 physicians in northern New England enrolled 182 consecutive dying patients. Important management issues for these patients were recorded at enrollment and eight months later. The patients' average age was 74 years; most had cancer (48%) or cardiovascular disease (38%). Almost two-thirds of the patients died within eight months of enrollment. Major management issues for the physicians in care of these patients were deficits in basic self-care, emotional support, pain control, and nutrition. Pain control and family need for support were reported most frequently. Although demand for physician time was seldom a major management issue, when it occurred it correlated with patients' emotional needs or their desire to extend life (p<0.01). Two barriers to optimum care commonly cited by physicians were (a) the differences in treatment expectations between family members, patients, and physicians and (b) the incurable, progressive nature of the patients' diseases. Efforts to improve care for patients who have limited life expectancy should further explore the perceptions of community physicians.
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U2 - 10.1177/082585979801400106
DO - 10.1177/082585979801400106
M3 - Article
C2 - 9575711
AN - SCOPUS:0032017869
SN - 0825-8597
VL - 14
SP - 30
EP - 35
JO - Journal of palliative care
JF - Journal of palliative care
IS - 1
ER -