Clinicians Need More Time, Training to Provide Optimum End-of-Life Care

A new study is shedding light on the need for cancer centers to invest more in palliative care services, adequate rooms for dying patients, staff training in end-of-life care, and advanced care–planning standards.

Karin Jors, MA

A new study is shedding light on the need for cancer centers to invest more in palliative care services, adequate rooms for dying patients, staff training in end-of-life care, and advanced care—planning standards.

The study, published early online in Cancer, surveyed physicians and nurses in 16 hospitals affiliated with 10 cancer centers in Baden-Württemberg, Germany and found that half of those surveyed indicated that they rarely have time to care for dying patients.

“In our aging society, it is predicted that the number of hospital deaths will continue to rise in the coming years, and many of these deaths will be attributable to cancer. For this reason, it is particularly important that cancer centers strive to create a comfortable, dignified experience for dying patients and their families,” Karin Jors, MA, of the University Medical Center Freiburg and lead author of the study, said in a statement. “Above all, this requires that staff members are provided with the adequate resources to care for these patients.”

The 1131 survey respondents were asked questions regarding end-of-life care, including structural conditions such as rooms and staff, education/training, working environment, family/caregivers, medical treatment, communication with patients, and dignified death.

The survey showed that 57% of the 1131 responders believed that patients could die with dignity on their ward. However, half of those surveyed indicated that they rarely have enough time to care for dying patients, and 55% found the rooms available for dying patients unsatisfactory.

Moreover, only 19% of respondents felt that they had been well prepared to care for dying patients (and only 6% of physicians felt this way).

Palliative care staff, however, reported much better conditions for dying patients than staff from other wards: 95% of palliative care staff indicated that patients die with dignity on their wards, according to the study results.

Generally, physicians perceived the circumstances for dying patients much more positively than nurses, especially regarding communication and life-prolonging measures. While 72% of physicians reported that patients can usually die a dignified death on their ward, only 52% of nurses shared this opinion.

The investigators encourage the integration of palliative care into standard oncology care, beginning as early as diagnosis. They also note that physicians and nurses would benefit from increased education and training in end-of-life care.