Experiences, challenges and perspectives for ensuring end-of-life patient care: A national online survey with general practitioners in Germany

• Published in: PloS one Vol. 16; no. 7; p. e0254056
• Main Authors: Tielker, Jannik M, Weber, Jan P, Simon, Steffen T, Bausewein, Claudia, Stiel, Stephanie, Schneider, Nils
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 27.07.2021; Public Library of Science (PLoS)
• Subjects: Beliefs, opinions and attitudes; Cooperation; Coronaviruses; COVID-19; End of life; Ethics; Evaluation; Focus groups; Funding; Health care; Medical care; Medical schools; Medicine; Medicine and Health Sciences; Nurses; Nursing; Nursing homes; Palliative care; Pandemics; Patients; People and places; Physicians (General practice); Polls & surveys; Population; Quality management; Quality of life; Questionnaires; Research and Analysis Methods; Severe acute respiratory syndrome coronavirus 2; Sociodemographics; Software; Surveys; Terminal care; Verbal communication; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0254056

The SARS-CoV-2 (COVID-19) pandemic is posing major challenges for health care systems. In Germany, one such challenge has been that adequate palliative care for the severely ill and dying (with and without COVID-19), as well as their loved ones, has not been available at all times and in all settings., the pandemic has underlined the significance of the contribution of general practitioners (GPs) to the care of severely ill and dying patients. To describe GPs' experiences, challenges and perspectives with respect to end-of-life care during the first peak of the pandemic (spring 2020) in Germany. In November and December 2020, a link to an Unipark online survey was sent to GPs registered on nationwide distribution lists. In total, 410 GPs responded; 61.5% indicated that the quality of their patients' end-of-life care was maintained throughout the pandemic, 36.8% reported a decrease in quality compared to pre-pandemic times. Of the GPs who made home visits to severely ill and dying patients, 61.4% reported a stable number of visits, 28.5% reported fewer visits. 62.7% of the GPs reported increased telephone contact and reduced personal contact with patients; 36.1% offered video consultations in lieu of face-to-face contact. The GPs reported that relatives were restricted (48.5%) or prohibited from visiting (33.4%) patients in nursing homes. They observed a fear of loneliness among patients in nursing homes (91.9%), private homes (87.3%) and hospitals (86.1%). The present work provides insights into the pandemic management of GPs and supports the development of a national strategy for palliative care during a pandemic.