Bereavement practices of gynecologic oncologists: Physician and care team practices compared to caregiver needs.

Abstract

12021 Background: Gynecologic cancers account for over 34,000 deaths in the United States annually. Family-centered care is beneficial to the family unit and patient throughout the illness course. Research is lacking regarding how physicians should approach family members or other caregivers after a patient dies. We aimed to assess how gynecologic oncologists are currently practicing and compare that to family members’ needs during the bereavement period. Methods: We devised a set of paired surveys that were distributed to the Society for Gynecologic Oncology and to patient families. Families were recruited using social media, publicizing in local organizations, and advertising in University of Connecticut campus-wide emails. Likert-scale style questions with responses ranging from “1” to “10” were used to assess opinions on aspects of bereavement care and reported as means. Differences in means were assessed using ANOVA and T-tests and considered to be statistically significant if the P-value was < 0.05. Results: We received completed surveys from 129 physicians and 17 caregivers from different families. 48% of physicians reported contacting patient families, and, similarly, 47% of family members reported receiving contact from physicians. Physicians had a mean 6.21/10 confidence level (where 10 is maximum confidence) in providing bereavement care, while families reported 5.76/10 confidence in their physician’s ability to provide bereavement support ( P = 0.493). Factors that influenced physicians confidence in providing bereavement support were undergoing formal training in bereavement (6.84/10 vs 5.14/10 for physicians who had not been trained, P < 0.001) and being in practice for more than 11 years (5.65/10 for ≤10 years in practice, 7.05 for ≥11 years, P = 0.001). Physicians who contacted patients personally had a higher confidence level (6.98/10) in providing bereavement support compared with those who did not contact families (5.51/10, P < 0.001). Family members were nearly unanimous in reporting a desire for physicians to contact them personally (16/17), and stated that a phone call (56%) or a sympathy card (38%) were their preferred methods of contact. Conclusions: Our study suggests that although families appreciate contact from physicians after their loss, physicians do not have a high level of confidence in providing this support. Physicians who undergo bereavement training and who reached out after patients had died have higher confidence levels in interacting with family members. Based on these results, formal bereavement training should be incorporated into gynecologic oncology fellowships in order to increase the comfort levels and likelihood of gynecologic oncologists reaching out to families after a patient has died.