ABSTRACT
The purpose of this study was to determine the impact of physician sitting versus standing on the patient's preference of physician communication style, and perception of compassion and consult duration. Sixty-nine patients were randomized to watch one of two videos in which the physician was standing and then sitting (video A) or sitting and then standing (video B) during an inpatient consultation. Both video sequences lasted 9.5 minutes. Thirty-five patients (51%) blindly preferred the sitting physician, 16 (23%) preferred the standing, and 18 (26%) had no preference. Patients perceived that their preferred physician was more compassionate and spent more time with the patient when compared with the other physician. There was a strong period effect favoring the second sequence within the video. The patients blinded choice of preference (P = 0.003), perception of compassion (P = 0.0016), and other attributes favored the second sequence seen in the video. The significant period effect suggests that patients prefer the second option presented, notwithstanding a stated preference for a sitting posture (55/68, 81%). Physicians should ask patients for their preference regarding physician sitting or standing as a way to enhance communication.
Subject(s)
Inpatients/psychology , Medical Oncology , Patient Satisfaction , Physician-Patient Relations , Physicians , Posture , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Empathy , Female , Humans , Male , Middle Aged , Perception , Time FactorsSubject(s)
Attitude to Death , Communication , Neoplasms/psychology , Parent-Child Relations , Adolescent , Child , Child, Preschool , Denial, Psychological , Female , Humans , Male , Neoplasms/diagnosis , Neoplasms/therapy , Patient Care Team/standards , Stress, Psychological , Terminal Care , Truth DisclosureABSTRACT
OBJECTIVE: We reviewed our experience with 28 consecutive children referred for assessment and intervention. These were the children of patients with terminal cancer referred to the Palliative Care and Symptom Control Service. In all cases the dying parent was a biological parent. METHODS: Eleven parameters were assessed in each of 29 children and their incidence was calculated. The children and their parents were seen in a semistructured interview, together as well as separately. The parameters were: seeking reassurance (82), becoming a caretaker (79), inability to separate from parent (79), anger about feeling abandoned (68), despair (57), guilt (54), discipline problems, aggressive behavior (46), denial (39), blame of others (21), and fear for the child's own health (18). RESULTS: Our results suggest that children with dying parents manifest significant distress as well as a greater understanding of their parent's illness than is usually suspected. SIGNIFICANCE OF RESULTS: Timely intervention by a child psychiatrist or other mental health professional with proven competence in working with children can help children to better cope with the death and dying of their parent and ameliorate the process of bereavement following the parent's death. Because of our small sample, we cannot generalize about all of the findings. Further research is required to characterize the level of distress in the children and the long-term impact in their overall adjustment to life.
