Doctors reactions to memorable patients deaths’

Between 5-17.5% of doctors reported sadness of moderate to severe intensity following the death of a memorable patient. Fatigue, problems in sleeping, changes in appetite, anger and relief were particularly reported. There were no significant associations between the intensity of the responses and gender, seniority or specialty, except that female doctors were more likely to have cried.

Doctors who attended 12 lunchtime seminars and teaching sessions in a hospital between 1 May and 1 August 2005 were invited to participate in a study. They had to fill in a questionnaire on their own. Questionnaire responses were anonymised as far as possible.
194 of 239 invited doctors participated, 7 did not complete the questionnaire.

Coping strategies of doctors
83.5 respondents revealed that “talking with others” was their preferred method.

Other popular forms of coping were:
1. having time alone (64.4%)
2. socializing (36.2%)
3. exercise (26.6%)
4. seeking religious guidance (21.8%)

In general support for doctors is provided in equal measure by other doctors, nurses and others: friends, family, loved ones.

What is a memorable patient death?

A patient death that had occurred within the previous few months which the doctor recollected for any particular reason. This has it’s limitations. Doctors good describe their responses to a specific incident, rather than describe their general or typical responses.

Other limitations of this study were:
1. modestly sized convenient sample of doctors
2. adaptation of the questionnaire
3. recall bias as a result of the delay between the memorable death and the questionnaire

Additional important finding
Over half of doctors recognized the need for improved training in dealing with patient death.

Article discussed:
“Memorable patients deaths'”: reactions of hospital doctors and their need for support
Moores, TS, Castle, KL, Shaw, KL, Stockton, MR, Bennett, MI.
Medical Education 2007;41: 942-946.