Caring for Terminally Ill Patients: A Comparative Analysis of Physician Assistant and Medical Studentsʼ Attitudes

Abstract

In caring for the terminally ill, a PA student's fear of death and dying (or thanatophobia) may affect his or her ability to be an effective clinician and will certainly influence his or her role as a patient advocate and educator. In 1998, Merrill et al. showed a significant difference between medical and nursing students' level of thanatophobia.1 The purpose of this study was to assess the level and predictors of thanatophobia of PA students compared with those of medical students. In this study, PA students rated how much they agreed or disagreed with statements from an 80-item survey that included a previously published scale for thanatophobia. In addition to this scale, the survey included five other personal trait scales that may have been associated with their level of thanatophobia. The PA students' responses were compared with previously collected responses of medical students using students' t-test, regression analysis, and analysis of variance. It was found that senior PA students scored significantly lower than senior medical students in thanatophobia as well as in authoritarianism, Machiavellianism, and depressed mood. For both student groups, intolerance to clinical uncertainty was a predictor of thanatophobia. For the PA student group, depressed mood was also a significant predictor. Based on these data, PAs may be more comfortable than doctors in treating terminally ill persons. Hence, most PAs would be better suited to caring for terminally ill patients, especially in areas such as geriatrics, hospice, and primary care in general.