Announcing a patient’s death is a highly sensitive occasion that can leave a lasting imprint on how families cope with their loss; nevertheless, the exact ways physicians should adjust their approach during this moment are still not well defined. To determine if missing specific actions by the physician correlated with families’ feeling that the death pronouncement process needed to be improved for patients with advanced cancer receiving care in palliative care units (PCUs). This research was a secondary examination of data from a large-scale, multicenter questionnaire study conducted in 2018. The original survey gathered responses from family members who had lost a loved one to cancer in PCUs. We applied univariate analysis to assess the demand for better physician conduct at the time of death pronouncement. Bivariate analysis was then used to examine associations among the desire for improvement, the physician involved (primary responsible physician, team member, or other physician), and nine distinct behaviors.
422 questionnaires (64.2%) were returned. After reviewing 356 of these replies, we found that 32.5% of respondents believed the death pronouncement required improvement. Omitting certain key actions during the pronouncement — above all, failing to describe the cause of death to the family clearly (odds ratio: 11.89, P < 0.001) — was strongly linked to this perceived need. Clear differences emerged depending on which type of physician performed the pronouncement (primary responsible physician vs. a member of the same team vs. another physician [15.1% vs. 42.6% vs. 45.7%, P < 0.001]). A notable positive association was identified between omitting certain physician behaviors during death pronouncement and the sense that improvement was necessary. The two most frequent shortcomings were not giving a direct explanation of the cause of death to family members and not speaking to the patient before beginning the physical check.
