Perceptions of bereavement care in consultant geriatricians and advanced trainees in geriatric medicine (original) (raw)
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Family practice, 2002
Non-response is an important potential source of bias in survey research. With evidence of falling response rates from GPs, it is of increasing importance when undertaking postal questionnaire surveys of GPs to seek to maximize response rates and evaluate the potential for non-response bias. Our aim was to investigate the effectiveness of follow-up procedures when undertaking a postal questionnaire study of GPs, the use of publicly available data in assessing non-response bias and the development of regression models predicting responder behaviour. A postal questionnaire study was carried out of a random sample of 600 GPs in Wales concerning their training and knowledge in palliative care. A cumulative response rate graph permitted optimal timing of follow-up mailings: a final response rate of 67.6% was achieved. Differences were found between responders and non-responders on several parameters and between sample and population on some parameters: some of these may bias the sample d...
Use of the Consultation Letter Rating Scale among Geriatric Medicine Postgraduate Trainees
Journal of the American Geriatrics Society, 2019
OBJECTIVESThe implementation of competency‐based evaluations increases the emphasis on in‐training assessment. The Consultation Letter Rating Scale (CLRS), published by the Royal College of Physicians and Surgeons of Canada, is a tool that assesses written‐communication competencies. This multisite project evaluated the tool's validity, reliability, feasibility, and acceptability for use in postgraduate geriatric medicine training.METHODSGeriatric medicine trainees provided consultation letters from the 2017‐2018 academic year. Geriatricians reviewed a standardized module and completed the tool for all the deidentified letters. The reviewers recorded the time used to complete the tool for each letter and completed a survey on content validity. Trainees completed a survey on the tool's usefulness. Responses were reviewed independently by two authors for thematic content. The unweighted and the weighted κ were used to measure interrater reliability.RESULTSA total of 10 of 11 (...
REFLECTIONS IN FAMILY MEDICINE Patient Reflections: Saying Good-Bye to a Retiring Family Doctor
2015
Purpose: The purpose of this study was to describe the doctor–patient relationship as expressed in written comments to a retiring family physician. Methods: All 200 of the written notes and e-mails to a single family physician retiring after 42 years in practice were examined using content analysis for general themes and meaning. No phone or per-sonal verbal responses were included. Results: Seven themes emerged with regards to what patients appreciated in their family physician relationship. These included “being there, ” caring, medical expertise, personal characteristics, multiple roles/anything goes, family, and continuity. Conclusion: Analyzing comments from actual patients at the end of a long-term relationship with an individual physician confirms beliefs of what patients consider important based on theoretical models, surveys, and interviews. (J Am Board Fam Med 2008;21:461–465.) A positive doctor–patient relationship can have an improved health impact1 and the lack of one c...
Where do general practitioners find patients with possible palliative care needs?
BJGP Open, 2020
Background: For general practitioners (GPs) to implement early palliative care, the first step is to identify patients with palliative care needs, e.g. with a no-response to the Surprise Question (SQ) (not surprised if a patient would die within a year). Aim: To describe setting-specific screening results of patients eligible for early palliative care in family practices, here defined as patients aged 45 years with a GPs’ no-answer to the SQ. Design and setting: Secondary analysis. Cross-sectional descriptive study in family practices in 5 Belgian areas. Methods: GPs were recruited by targeted sampling. As a first part of an implementation research project, participating GPs provided demographic information about themselves and also provided a response to the SQ for all patients who came to the practice in ten consecutive office days. A summary table describing the gender, age, location of contact (surgery, patient’s home, or nursing home) of the patients was provided by each GP. Re...
The oldest old and GP end-of-life care in the Dutch community: a nationwide study
2010
Background: Provision of adequate care for the oldest old is increasingly crucial, given the current ageing trends. This study explores differences in end-of-life care of the oldest (≥85 years) versus the younger (65-84 years) old; testing the hypothesis that age could be an independent correlate of receiving specialised palliative care services (SPCS), having palliative-centred treatment and dying in a preferred place. Methods: general practitioners (GPs) participating in the nation-wide representative network in the Netherlands were asked to fill in patient, illness and care characteristics of all registered patients ≥65 years, who died non-suddenly in their practices between 2005 and2008, using standardised forms. Associations with the palliative care variables were tested using multiple logistic regression. Results: nine hundred and ninety patients were registered. Among the oldest old, there were more women than men, more patients with heart failure than cancer, less hospital and home deaths and more residential care home deaths compared with the younger old. Of the oldest old, fewer received SPCS and more preferred to die in a residential care home than the younger old. Age was independently associated with palliative care provided: compared with the younger group, the oldest old received SPCS less often (OR = 0.7) and were treated with a palliative-centred goal more often (OR = 2.4); but age was not related to dying in a preferred place, i.e. independent of other characteristics. Conclusion: this study shows age to be independently associated with receiving SPCS in the Dutch community. Although the GPs do recognise the 'palliative phase' in the oldest old, involvement of specialist teams is somewhat less.