Table 4.
Determinants of oncologist-reported burden when communicating discontinuation of anticancer treatment
| Univariate analyses |
Multivariate analyses |
||||
|---|---|---|---|---|---|
| Low level (n = 206) | High level (n = 190) | P value | Odds ratio (95% CI) | P value | |
| Feeling that breaking bad news will deprive the patient of hope | 3.1 ± 0.9 | 3.8 ± 0.8 | <0.01 | 1.8 (1.4–2.5) | <0.01 |
| Concern that the oncologist may be blamed by the patient's family | 2.1 ± 0.8 | 2.8 ± 1.1 | <0.01 | 1.5 (1.2–1.9) | <0.01 |
| Concern that the patient may lose self-control | 2.8 ± 0.8 | 3.4 ± 0.9 | <0.01 | 1.4 (1.1–1.9) | <0.01 |
| Insufficient time to break bad news | 3.3 ± 1.0 | 3.8 ± 0.9 | <0.01 | 1.2 (0.99–1.6) | 0.049 |
| Possibility that the time for breaking bad news is interrupted by other tasks | 3.1 ± 1.0 | 3.5 ± 1.1 | <0.01 | ||
| Opposition from family members to breaking bad news to the patient | 2.7 ± 1.0 | 3.2 ± 1.1 | <0.01 | ||
| Evidence from a certain group does not always apply to every patient | 2.6 ± 0.9 | 3.0 ± 1.1 | <0.01 | ||
| The oncologist is unable to answer philosophical questions regarding death and the value of life | 2.5 ± 0.8 | 3.0 ± 1.0 | <0.01 | ||
| Feeling a sense of guilt because oncologists cannot provide effective anticancer treatment | 2.1 ± 0.9 | 2.7 ± 1.1 | <0.01 | ||
| Concern that the oncologist may be criticized by the patient | 2.1 ± 0.8 | 2.7 ± 1.0 | <0.01 | ||
| Scientific evidence is not always predictable or reproducible | 2.3 ± 0.8 | 2.7 ± 1.0 | <0.01 | ||
| Opposition from patients to breaking bad news to their families | 2.2 ± 0.8 | 2.6 ± 1.2 | <0.01 | ||
| Fear of talking to patients whom the oncologist does not know very well | 2.2 ± 0.9 | 2.5 ± 1.1 | <0.01 | ||
| Lack of confidence in oncological skills | 2.2 ± 0.8 | 2.5 ± 0.9 | <0.01 | ||
| Uneasiness in changing roles from curing patients to caring for patients | 1.9 ± 0.8 | 2.3 ± 0.9 | <0.01 | ||
| Concern that an objective stance cannot be maintained if the oncologist becomes too intimate with the patient | 1.9 ± 0.7 | 2.2 ± 0.8 | <0.01 | ||
| Concern that the oncologist does not have the latest knowledge | 2.1 ± 0.8 | 2.2 ± 0.9 | 0.24 | ||
| Fear that the oncologist may become very emotionally involved, such as expressing anger or sadness | 1.9 ± 0.6 | 2.0 ± 0.8 | 0.24 | ||
| Concern that the oncologist cannot answer all knowledge-based questions posed by the patient | 2.0 ± 0.8 | 2.2 ± 0.9 | 0.34 | ||
| Fear of the oncologists' own illness and death | 1.9 ± 0.7 | 2.0 ± 1.0 | 0.78 | ||
Oncologists who rated their burden level as heavily burdened or burdened (high-level group) are compared as a single group against all others (low-level group). Multiple logistic regression analyses used the high-level burden group as the dependent variable. Each condition was rated on a scale of 1 (do not feel any burdened) to 5 (feel heavily burdened).