PHYSICIANS OF THE DYING: COPING WITH PERSONAL DEATH CONCERNS

Abstract

This study examined the beliefs that among physicians working with dying patients, denial of death concerns is a more frequent reaction than acknowledgment of those concerns, that physicians who deny their own death concerns are less able to help patients cope with these fears and are more uncomfortable in work with the dying.;Subjects were 58 oncologists/hematologists. Each was administered the Color-Word Interference Test to assess death concerns at below the level of awareness, a measure of consciously admitted attitudes, Statements of Dying Patients to assess empathy to fears of patients, and questions to ascertain the doctor's perceptions of his own sense of comfort in this work. When time permitted, physicians were asked why they had chosen this area, how it affected their personal lives, and how they coped with these effects.;Data were analyzed across groups and individually. Groups were based on high and low scores on the CWIT and the DAS. The largest group formed had high scores on the CWIT with low on the DAS, but Chi Square Analysis fell short of significance. Analysis of individual scores also indicated that denial cannot be considered the more likely reaction.;A two-way ANOVA comparing the four groups on responses to Dying Patient Statements revealed no significant effects initially, but preplanned comparisons revealed significant differences between high and low scorers on the DAS. Doctors who denied death concerns tended to be less empathic to the fears of dying patients. This was also found in multiple regression analysis.;No relationship was found between the doctors' "sense of comfort" and death concerns, at either level of awareness. However, "sense of comfort" was found to be a significant predictor of responses to Patient Statements.;A significant relationship between age and years of experience and the CWIT emerged. Doctors with low concerns at below the level of awareness were significantly older and more experienced.;Information obtained through discussions was reviewed. The overall impression conveyed was that these physicians are aware of their difficulties and of the need to develop more effective ways of coping with the work they have chosen.