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Physicians' knowledge and practice on death certification in the North West Bank, Palestine: across sectional study
Jamal A S Qaddumi1, Zaher Nazzal2, Allam Yacoub3
1Faculty of Medicine and Health Sciences, An-Najah National University, PO box 7, Nablus, Palestine. jamal9877@najah.edu.
Insights
Physicians demonstrate poor knowledge and practice in completing death notification forms (DNF), impacting mortality data accuracy. Training and improved DNF guidelines are recommended to enhance death certification.
Area of Science:
- Public Health
- Medical Documentation
- Epidemiology
Background:
- Accurate mortality data is crucial for public health practices.
- Physicians' inaccurate completion of death notification forms (DNF) is a global concern.
- This study assesses physician knowledge and practice regarding DNF completion.
Purpose of the Study:
- To evaluate physicians' knowledge and practical skills in completing death notification forms.
- To identify factors contributing to inaccuracies in death certification.
- To provide recommendations for improving the quality of death notification forms.
Main Methods:
- A self-administered questionnaire was distributed to 200 physicians in Palestine.
- A case scenario was included to assess the completion of the cause of death section.
- Chi-square tests were used to analyze the association between physician characteristics and responses.
Main Results:
- Only 40.6% of physicians correctly completed the cause of death section.
- Correct identification of immediate and underlying causes of death was 48.7% and 71.3%, respectively.
- 17.3% reported the mechanism of death without the underlying cause; 14.7% incorrectly reported the sequence of events.
Conclusions:
- Physicians' knowledge and practice in completing DNFs are insufficient, compromising mortality data accuracy.
- Complex cases, DNF design issues, and lack of training contribute to errors.
- Recommendations include regular training workshops and developing a DNF completion manual.
Background:
Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this study is to assess the physicians' knowledge and practice on completing the DNF.
Methods:
A self-administered questionnaire was distributed to 200 physicians in governmental and non-governmental hospitals in the North West-Bank in Palestine. Furthermore, a case scenario was included in the questionnaire and physicians were asked to fill the cause of death section. The percentage of errors committed while completing the cause of death section were computed. A Chi square test was used to assess the association between physicians' characteristics and their responses.
Results:
Only 40.6% of the participants completed the cause of death section correctly. The immediate and underlying causes of death were correctly identified by 48.7% and 71.3% of physicians, respectively. Almost one-fifth (17.3%) of physicians wrote the mechanism of death without reporting the underlying cause of death and 14.7% of them reported the sequence of events leading to death incorrectly.
Conclusions:
Physicians' knowledge and practice on completing the DNF is poor and insufficient, which may seriously affect the accuracy of mortality data. Complicated cases, problems in the current design of the DNFs and lack of training were the most common factors contributing to inaccuracy in death certification. We recommend offering periodical training workshops on completing the DNF to all physicians, and developing a manual on completing the DNFs with clear instructions and guidelines.