Comparing resident physicians', post-graduate interns' and medical intern's knowledge, perceptions, beliefs & attitudes towards death and dying at the Vicente Sotto Memorial Medical Center, 2001

OBJECTIVE: This study aims to determine the difference in the beliefs, attitudes, knowledge about death and dying, as well as the perception of physicians responsibility towards the dying patient among the medical interns, post-graduate interns (PGI), and resident physicians of Vicente Sotto Memorial Medical Center (VSMMC). METHODOLOGY: A total of 45 respondents were randomly selected, with each group residents, PGIs and interns- having 15 respondents each. This survey used a 4 part self-administered questionnaire, which was given and collected on the same day. Analysis of variance (F value) was used in determining if there was a statistically significant difference among the 3 groups. RESULTS: Majority (91.1%) of the respondents believed in life after death while 8.9 percent did not believe in life after death. Majority (80%) of the respondents had a positive attitude towards death, while 20 percent had a negative attitude toward death. About a third (64.4%) of the respondents were able to give the correct sequence of the stages of death and dying as described by Kubler-Ross. On the 10-item quiz identifying each stage of death and dying the mean scores were as follows: residents = 8.13, PGIs = 8.33, and medical interns = 7.6. Majority of the respondents either strongly agreed or agreed with the statements identifying the responsibilities of the physician to a dying patient, but one statement about the doctors role in giving hope to a dying patient caused some uncertainty among the interns. Analysis of variance showed that the respondents beliefs in life after death, attitudes toward death, and knowledge about the stages of death and dying did not differ significantly.                                                                                                                               CONCLUSION: The VSMMC residents, PGIs, and medical interns believe in life after death, have a positive attitude towards death, have an adequate knowledge on the stages of Death and Dying as well as have a generally good grasp of the physicians responsibilities to the dying patient.

Clinical case conference "Breaking the invisible chain"

DP is a young woman who while working as a nursing aide in U.A.E. was repeatedly raped by Jose, a man she considered as her "second father." Because of the dismal condition of the accommodation provided by her employer she was forced to live with Jose and his family. DP endured the abuse and never told Joses wife because she was bound by her sense of "utang na loob." She waited until her contract expired before she went home to Tagbilaran. Upon her return to the Philippines she was haunted by the horrible experiences in U.A.E. She developed symptoms of PTSD (post-traumatic stress disorder). She only sought psychiatric treatment after repeated prodding of her boyfriend. She was also subjected to cognitive-behavioral therapy to relieve PTSD symptoms. After four months of combined pharmacotherapy and cognitive behavioral therapy her PTSD symptoms resolved.