eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
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4/2022
vol. 14
 
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abstract:
Original paper

Communicating a negative prognosis by primary care physicians

Aleksander Michał Biesiada
1, 2
,
Aleksandra Ciałkowska-Rysz
3, 4
,
Agnieszka Mastalerz-Migas
5

  1. AD VITAM Przychodnia Zdrowia sp. z o.o., NZOZ „Siloe”, Skawina, Polska
  2. Wydawnictwo Interaktywne Medutools sp. z o.o., Kraków, Polska
  3. Klinika Medycyny Paliatywnej, Wydział Lekarski Uniwersytetu Medycznego w Łodzi, Łódź, Polska
  4. Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej, Centralny Szpital Weteranów, Łódź, Polska
  5. Katedra i Zakład Medycyny Rodzinnej, Uniwersytet Medyczny im. Piastów Śląskich, Wrocław, Polska
Medycyna Paliatywna 2022; 14(4): 189–196
Online publish date: 2023/05/02
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The right to information about one’s own health condition, including adverse prognosis, derives from the provisions of the Act on Patients’ Rights and Patients’ Ombudsman and the Code of Medical Ethics. Appropriate tools, such as the SPIKES protocol, can support doctors in communicating a poor prognosis. The aim of this study was to investigate how doctors working in primary care communicate information about an adverse prognosis to their patients and their relatives. 72.2% of the 744 surveyed primary care physicians claimed that they raised the issue of death or adverse prognosis with the patient when directly asked, while 63.3% provided the information themselves. However, 15.1% of doctors did this in the absence of the patient without the patient’s consent, and 40.2% of respondents indicated that they passed on information about a poor prognosis to the family with the patient’s “implicit consent”. In the study, in a selected group of primary health care (PHC) doctors who also specialised in palliative medicine, 100% of respondents declared that they had the autonomy to discuss a poor prognosis. To support GPs in exercising the patient’s right to information about their condition, it is important to use the tools and competences for communicating a poor prognosis and to use the developed relationship with the patient and their relatives to communicate a poor prognosis openly. Continuous training, including in psychological competence, with psychological support for PHC doctors and the implementation of appropriate working protocols can help.
keywords:

primary health care, communication, prognosis, palliative care, death

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