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End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity

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Abstract

Objective

The authors examined psychiatric residents’ attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity.

Methods

The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey had a mix of qualitative and quantitative questions.

Results

Eighty-two of116 invited psychiatric residents participated for a response rate of 71%. With favorable attitudes, residents felt least prepared in existential, spiritual, cultural, and some psychological aspects of caring for dying patients. Trainees conceptualized dignity at the end of life in a way very similar to that of patients, including concerns of the mind, body, soul, relationships, and autonomy. Residents desired more longitudinal, contextualized training, particularly in the psychosocial, existential, and spiritual aspects of care.

Conclusion

This is the first study to examine the end-of-life educational experience of psychiatric residents. Despite conceptualizing quality care and the construct of dignity similarly to dying patients, psychiatric residents feel poorly prepared to deliver such care, particularly the nonphysical aspects of caring for the dying. These results will inform curriculum development in end-of-life care for psychiatric residents, a complex area now considered a core competency.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Glendon R. Tait M.D., M.Sc., FRCP(C).

Additional information

The authors would like to thank Drs. Susan Block and Amy Sullivan for their encouragement, feedback on the survey design, and permission to adapt a portion of their previously published survey. Tina Martimianakis was very helpful in assisting with the coding of the qualitative data. Finally, the authors thank Dr. Glen Regehr for his statistical expertise.

At the time of submission, the authors declared no competing interests.

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Tait, G.R., Hodges, B.D. End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity. Acad Psychiatry 33, 451–456 (2009). https://doi.org/10.1176/appi.ap.33.6.451

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  • DOI: https://doi.org/10.1176/appi.ap.33.6.451

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