Table 2. Current respiratory health professional participation in palliative and end-of-life care.
| Respiratory Therapists (n = 87) | Other Respiratory Professionals (n = 36) | Overall n = 123 | p | |
|---|---|---|---|---|
| Frequency of deaths/month from respiratory disease on respondent caseload | ||||
| 0 | 6 (6.9) | 2 (5.6 | 8 (6.5 | NA |
| ≤5 | 50 (57.5) | 22 (61.1 | 72 (58.5 | NA |
| >5 | 16 (18.4) | 3 (8.3 | 19 (15.4 | NA |
| Unsure | 15 (17.2) | 9 (25.0 | 24 (19.5 | NA |
| Frequency of providing end-of-life care to respiratory patients | ||||
| Once a month or more | 24 (27.6) | 6 (16.7 | 30 (24.4 | NA |
| Several times a year | 29 (33.3) | 11 (30.6 | 40 (32.5 | NA |
| Once a year | 13 (14.9) | 3 (8.3 | 16 (13.0 | NA |
| Never | 21 (24.1) | 16 (44.0 | 37 (30.1 | NA |
| Frequency of having end-of-life discussions with respiratory patients | ||||
| Always/often | 17 (19.5) | 9 (25.0) | 26 (21.1) | 0.75 |
| Sometimes | 36 (41.4) | 15 (41.7) | 51 (41.5) | 0.75 |
| Rarely/never/not in my scope of practice | 34 (27.6) | 12 (33.3) | 46 (37.4) | 0.75 |
| Proportion of respiratory patients with Advance Care Plan (estimated) | ||||
| <25% | 35 (40.2) | 16 (44.4) | 51 (41.5) | NA |
| 26%–50% | 11 (12.6) | 5 (13.9) | 16 (13.0) | NA |
| ≥50% | 17 (19.5) | 4 (11.1) | 21 (17.1) | NA |
| Unsure | 24 (27.6) | 11 (30.6) | 35 (28.5) | NA |
| Level of comfort discussing Advance Care Plans | ||||
| Comfortable | 56 (64.4) | 24 (66.7) | 80 (65.0) | NA |
| Neutral | 12 (13.8) | 3 (8.3) | 15 (12.2) | NA |
| Uncomfortable | 19 (21.8) | 9 (25.0) | 28 (22.8) | NA |
| Discuss MAiD with patients | ||||
| Yes | 7 (8.0) | 7 (19.4) | 14 (11.4) | 0.70 |
| No | 80 (92.0) | 29 (80.6) | 109 (88.6) | 0.70 |
| Important patient and family barriers to end-of-life discussions | ||||
| Patient difficulty accepting prognosis | 75 (86.2) | 34 (94.4) | 109 (88.6) | 0.23 |
| Patient difficulty accepting limitations and complications | 78 (89.7) | 30 (83.3) | 108 (87.8) | 0.40 |
| Family member difficulty accepting prognosis | 78 (89.7) | 34 (94.4) | 112 (91.9) | 0.49 |
| Patient lack of capacity | 78 (89.7) | 35 (97.2) | 113 (91.9) | 0.16 |
| Lack of agreement amongst family members regarding palliative care | 77 (88.5) | 35 (97.2) | 112 (91.1) | 0.10 |
| Language barrier | 67 (77.0) | 31 (86.1) | 98 (79.7) | 0.25 |
| No advance care plan | 48 (55.2) | 26 (72.2) | 74 (60.2) | 0.08 |
| Important provider barriers to end-of-life discussions | ||||
| Uncertainty about prognosis | 65 (74.7) | 29 (80.6) | 94 (76.4) | 0.49 |
| Lack of training to have discussion | 68 (78.2) | 23 (63.9) | 91 (74.0) | 0.10 |
| Desire to maintain hope | 34 (39.1) | 22 (61.1) | 56 (45.5) | NA |
| Not part of my role/scope of practice | 25 (28.7) | 14 (38.9) | 39 (31.7) | 0.48 |
| Lack of time | 60 (68.2) | 28 (77.8) | 88 (71.5) | 0.32 |
| Disagreement among team members | 51 (58.6) | 24 (66.7) | 75 (61.0) | 0.41 |
| Own belief system | 17 (19.5) | 10 (27.8) | 27 (22.0) | 0.32 |
Note: NA, not available as cell counts of <5 precluded statistical analyses. MAiD, medical assistance in dying.