The experience of providing end‐of‐life care at home: The emotional experiences of young family physicians

• Published in: Journal of general and family medicine Vol. 23; no. 6; pp. 376 - 383
• Main Authors: Son, Daisuke, Oishi, Ai, Taniguchi, Shin‐ichi
• Format: Journal Article
• Language: English
• Published: Tokyo John Wiley & Sons, Inc 01.11.2022; John Wiley and Sons Inc; Wiley
• Subjects: Burnout; Death & dying; emotional distress; end‐of‐life care; family physician; Family physicians; general practice; home care; Hospitals; Medical research; Medicine; Nurses; Nursing care; Original; Palliative care; Patients; Physicians; Primary care; Qualitative research; Spirituality; Training; United States > US; Japan
• ISSN: 2189-7948; 2189-6577; 2189-7948
• DOI: 10.1002/jgf2.571

Background End‐of‐life care is now a major issue in Japan as a result of the rapidly aging population; hence, the need for fostering family physicians to be engaged in end‐of‐life care at home is increasing. Studies in the United States and the United Kingdom have shown that physicians feel emotional and moral distress in end‐of‐life care, and that they develop detachment and dehumanizing attitudes toward patients as a coping mechanism. However, few studies have explored the emotional experiences that family physicians have during home‐based end‐of‐life care. The aim of this study is to explore the emotional experiences of young family physicians in such situations. Methods We conducted a qualitative analysis of interviews with family medicine residents or family physicians who had just completed their residency. The interviews were audio‐recorded and transcripts were prepared. The coded data were analyzed according to thematic analysis using NVivo 10 software. Results Study participants were 12 family physicians of PGY 5–11, with experienced end‐of‐life care cases of 3–20. Thirteen themes were extracted from the data, which were categorized into five domains: difficulties in end‐of‐life discussion, emotions of physicians, the role of physicians, communicating with the family, and positivity in end‐of‐life care. The physicians experienced various emotions and struggles within these domains, but they also felt something positive through providing care for the dying patients and their families. Conclusion Family physicians experience various emotional difficulties during end‐of‐life home care. However, positive emotions at the end of life were also experienced through their care. This is the first study that focused on the emotional aspects of young family physicians providing end‐of‐life care at home through qualitative research. This study revealed the differences in the end‐of‐life care environment between home and hospital; physicians felt end‐of‐life care at home more comfortable than hospital care when interacting with patients and family. Limitation of the study is that we studied only Japanese family physicians, and the data did not reach theoretical saturation due to the relatively small sample size.