Table 2.
Results of survey about perspectives of and approach to end-of-life discussion among emergency physicians
| Survey components | Survey results (n=63), n (%) |
|---|---|
| Comfort level | 1 - very uncomfortable, 5 - very comfortable |
| General | 3.84 (0.94) |
| Terminal illness | 4.37 (0.77) |
| Sudden death | 3.44 (1.16) |
| Chronic disease with end-organ failure | 4.14 (1.00) |
| Frailty | 4.13 (0.91) |
| De-escalation of care | 3.75 (1.06) |
| Barriers to EOL discussion | 1 - least important; 5 - most important |
| Communication with family/clinicians | 4.38 (0.68) |
| Lack of understanding of palliative care/EOL pathways | 3.90 (0.93) |
| Lack of rapport | 3.84 (1.05) |
| ED design/space/time constraints | 3.71 (1.11) |
| ED support system | 3.54 (1.00) |
| Uncertainty/lack of collaboration | 3.48 (0.98) |
| Uncertain quality of EOL care | 3.40 (1.03) |
| Limited education/training | 3.33 (1.16) |
| Patient age | 3.33 (1.23) |
| Patient background | 3.14 (1.22) |
| Conflict resolution methods | |
| Defer to other colleagues (e.g., ICU) | 38 (60.3) |
| Involve more family members | 10 (15.9) |
| Attempt again | 8 (12.7) |
| Escalate to more senior members | 7 (11.1) |
| Continue ED management without further discussion | 4 (6.3) |
| Concur with patient/family decision | 2 (3.2) |
| Combination of >1 method | 13 (20.6) |
| Deferment of discussion | |
| Yes | 9 (14.3) |
| No | 25 (38.7) |
| Maybe | 29 (46.0) |
| Personally affected by EOL discussion | |
| Yes | 19 (30.2) |
| No | 35 (55.6) |
| Maybe | 9 (14.3) |
| Debriefing | |
| Yes | 7 (11.1) |
| No | 25 (39.7) |
| Sometimes | 31 (49.2) |
| COVID-19 affecting EOL discussions | |
| Yes | 5 (7.9) |
| No | 58 (92.1) |
Data represented as count (%) or mean (SD) for categorical and continuous data, respectively. EOL: End-of-life, ED: Emergency department, ICU: Intensive care unit, SD: Standard deviation