Patients' perspectives on physician skill in end-of-life care

Differences between patients with COPD, Cancer, and AIDS

J. Randall Curtis, Marjorie D. Wenrich, Jan D. Carline, Sarah Shannon, Donna M. Ambrozy, Paul G. Ramsey

Research output: Contribution to journalArticle

170 Citations (Scopus)

Abstract

Objectives: Patients' views of physician skill in providing end-of-life care may vary across different diseases, and understanding these differences will help physicians improve the quality of care they provide for patients at the end of life. The objective of this study was to examine the perspectives of patients with COPD, cancer, or AIDS regarding important aspects of physician skill in providing end-of-life care. Design: Qualitative study using focus groups and content analysis based on grounded theory. Setting: Outpatients from multiple medical settings in Seattle, WA. Patients: Eleven focus groups of 79 patients with three diseases: COPD (n = 24), AIDS (n = 36), or cancer (n = 19). Results: We identified, from the perspectives of patients, the important physician skills for high-quality end-of-life care. Remarkable similarities were found in the perspectives of patients with COPD, AIDS, and cancer, including the importance of emotional support, communication, and accessibility and continuity. However, each disease group identified a unique theme that was qualitatively more important to that group. For patients with COPD, the domain concerning physicians' ability to provide patient education stood out as qualitatively and quantitatively more important. Patients with COPD desired patient education in five content areas: diagnosis and disease process, treatment, prognosis, what dying might be like, and advance care planning. For patients with AIDS, the unique theme was pain control; for patients with cancer, the unique theme was maintaining hope despite a terminal diagnosis. Conclusions: Patients with COPD, AIDS, and cancer demonstrated many similarities in their perspectives on important areas of physician skill in providing end-of-life care, but patients with each disease identified a specific area of end-of-life care that was uniquely important to them. Physicians and educators should target patients with COPD for efforts to improve patient education about their disease and about end-of-life care, especially in the areas defined above. Physicians caring for patients with advanced AIDS should discuss pain control at the end of life, and physicians caring for patients with cancer should be aware of many patients' desires to maintain hope. Physician understanding of these differences will provide insights that allow improvement in the quality of care.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalChest
Volume122
Issue number1
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Terminal Care
Chronic Obstructive Pulmonary Disease
Acquired Immunodeficiency Syndrome
Physicians
Neoplasms
Hope
Patient Education
Quality of Health Care
Focus Groups
Advance Care Planning
Pain
Aptitude

Keywords

  • AIDS
  • Cancer
  • COPD
  • End-of-life care
  • HIV
  • Palliative care
  • Patient education
  • Physician competence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Curtis, J. R., Wenrich, M. D., Carline, J. D., Shannon, S., Ambrozy, D. M., & Ramsey, P. G. (2002). Patients' perspectives on physician skill in end-of-life care: Differences between patients with COPD, Cancer, and AIDS. Chest, 122(1), 356-362. https://doi.org/10.1378/chest.122.1.356

Patients' perspectives on physician skill in end-of-life care : Differences between patients with COPD, Cancer, and AIDS. / Curtis, J. Randall; Wenrich, Marjorie D.; Carline, Jan D.; Shannon, Sarah; Ambrozy, Donna M.; Ramsey, Paul G.

In: Chest, Vol. 122, No. 1, 2002, p. 356-362.

Research output: Contribution to journalArticle

Curtis, JR, Wenrich, MD, Carline, JD, Shannon, S, Ambrozy, DM & Ramsey, PG 2002, 'Patients' perspectives on physician skill in end-of-life care: Differences between patients with COPD, Cancer, and AIDS', Chest, vol. 122, no. 1, pp. 356-362. https://doi.org/10.1378/chest.122.1.356
Curtis, J. Randall ; Wenrich, Marjorie D. ; Carline, Jan D. ; Shannon, Sarah ; Ambrozy, Donna M. ; Ramsey, Paul G. / Patients' perspectives on physician skill in end-of-life care : Differences between patients with COPD, Cancer, and AIDS. In: Chest. 2002 ; Vol. 122, No. 1. pp. 356-362.
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