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Gynecol Oncol. 2012 Mar;124(3):471-3. doi: 10.1016/j.ygyno.2011.09.029. Epub 2011 Oct 20.

A survey of gynecologic oncologists regarding the end-of-life discussion: a pilot study.

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1
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA.

Abstract

OBJECTIVES:

To identify the practices and attitudes of gynecologic oncologists regarding the end-of-life discussion.

METHODS:

A pilot survey was sent to 1105 members of the Society of Gynecologic Oncologists (SGO). The survey consisted of 20 questions and was sent via the website Survey Monkey.

RESULTS:

Response rate was 12.8%. Sixty percent of respondents were male, most ranged between 30 and 60 years of age and more than half performed 5-10 major surgeries per week. More than half of respondents (53.9%) deferred the End of Life discussion until the patient had sustained a major change in functional and/or medical status. Thirty percent initiated it at the first recurrence or progression of disease. Forty three percent of respondents characterized the discussion as an on-going process. Patients' age, social support, health insurance, and co-morbidities had no influence on the discussion, and neither did the tumor's site of origin or grade. More respondents initiated the discussion in advanced stage cancer (57%) and after salvage chemotherapy institution (54%). Forty four percent of respondents reported that "understanding and acceptance" was the initial response by patient when counseled about withdrawal of care. This increased to 86% when the issue was revisited. Confusion or reluctance to discuss the subject were initially reported to be 12% and 19%, respectively, but decreased to 2% and 3%, respectively, when withdrawal of care was subsequently addressed with the patient.

CONCLUSIONS:

This pilot survey sheds a light on attitudes and practices about the end-of-life discussion that deserve to be further studied.

PMID:
22014628
DOI:
10.1016/j.ygyno.2011.09.029
[Indexed for MEDLINE]

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