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Korean Physicians' Perspectives on Prognostication in Palliative Care: A Qualitative Study
Eon Sook Lee1, Sang-Yeon Suh2,3, Thomas W LeBlanc4
11 Department of Family Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
The American Journal of Hospice & Palliative Care
|January 29, 2019
Summary
Korean palliative care physicians find prognostication vital but challenging. They desire simpler, more accurate tools to aid families in end-of-life care decisions and preparation.
Area of Science:
- Palliative Care Medicine
- Oncology
- Medical Prognosis
Background:
- Prognostication is crucial in advanced cancer palliative care but presents challenges.
- Physician perspectives on prognostication tools in Eastern palliative care are under-researched.
Purpose of the Study:
- To investigate Korean physicians' views and experiences with prognostication in palliative care.
- To understand the nuances of prognostic practices in a Korean cultural context.
Main Methods:
- Semi-structured interviews with 11 palliative care physicians in Korea.
- Grounded theory and constant comparative analysis of interview transcripts.
Main Results:
- Physicians highlighted prognostication's importance for patient/family preparation and care transitions.
- Challenges include discomfort with precise death date estimation and reliance on clinical judgment alongside scores.
- Identified need for simpler, more accurate prognostic tools and parameters.
Conclusions:
- Korean physicians share Western counterparts' views on prognostication's role and challenges.
- Cultural emphasis on family presence necessitates accurate prediction of final days.
- Urgent need for improved, simpler prognostic tools identified for future research.