Physician Behavior toward Death Pronouncement in Palliative Care Units

Background: There are few studies on bereaved caregivers' perceptions of physician behavior toward death pronouncement. Although previous research indicates that most caregivers are satisfied with physician behavior toward death pronouncement at home hospices, bereaved caregivers' perceptions of death pronouncement in palliative care units (PCUs) have not been investigated. Objective: The aim was to examine bereaved caregivers' perceptions of physician behavior toward death pronouncement in PCUs. Design and Methods: This was a cross-sectional questionnaire survey of bereaved caregivers who had lost a family member in a PCU. Measures were based on a previous study to assess bereaved caregivers' evaluations of physician behavior toward death pronouncement. Results: Of 861 questionnaires sent to bereaved caregivers, 480 responses were analyzed. Overall, 86% of bereaved caregivers were satisfied with physician behavior toward death pronouncement. Logistic regression analysis revealed three predictors of caregiver satisfaction: "Polite behavior" (odds ratio [OR]: 0.12; 95% confidence intervals [CI]: 0.03-0.46; p < 0.01), "Physician introduced himself/herself to family" (OR: 0.3; 95% CI: 0.1-0.8; p = 0.02), and "Physician confirmed death automatically or routinely" (OR: 11.6; 95% CI: 4.7-28.4; p < 0.01). Caregivers whose family member's death was confirmed by the primarily responsible physician were significantly more satisfied than those whose family member's death was confirmed by an unfamiliar physician. Conclusions: Most caregivers who lost family members in PCUs were satisfied by the physicians' behavior toward death pronouncement. Politeness was one of the most important factors associated with caregiver satisfaction.