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Patient deaths and medical residents: an Asian perspective
  1. Teresa Tan1,
  2. Pei Lin Koh1,2,
  3. Marcia Levetown3,
  4. Lisa Wong1,
  5. Joanne Lee4,
  6. Woon Chai Yong4 and
  7. Eng Soo Yap4,5
  1. 1Khoo Teck Puat—National University Children’s Medical Institute, National University Health System, Singapore
  2. 2Paediatrics, National University Singapore Yong Loo Lin School of Medicine, Singapore
  3. 3Houston, Texas, USA
  4. 4Department of Haematology-Oncology, National University Cancer Institute, National University Health System, Singapore
  5. 5Department of Laboratory Medicine, National University Hospital, Singapore
  1. Correspondence to Dr Eng Soo Yap, Department of Haematology- Oncology, National University Cancer Institute, National University Health System, Singapore; eng_soo_yap{at}nuhs.edu.sg

Abstract

Objectives Death is a significant event that affects healthcare providers emotionally. We aimed to determine internal medicine (IM) and paediatric (PD) residents’ responses and the impact on the residents following patient deaths, and to compare any differences between IM and PD residents. We also aimed to determine whether sufficient resources and measures were in place to support residents through their grief process.

Methods This is a single-centre, cross-sectional study involving residents from IM and PD programmes from an academic tertiary hospital in Singapore. The residents completed a questionnaire regarding their responses and emotions after experiencing patient deaths.

Results A total of 122 residents (85 IM and 37 PD, equally distributed between year 1 to year 4 of residency training) participated, with 100% response rate. Only half (57%) felt they would be comfortable treating a dying patient and 66.4% reported feeling sad following their patient’s death. Most (79.5%) were not aware of support resources that were available and 82% agreed that formal bereavement training should be included in the residency curriculum. PD residents had more negative symptoms than IM residents, with poor concentration (PD 35.1% vs IM 16.5%, p=0.02) and lethargy (PD 35.1% vs IM 9.4%, p<0.01) being the most common.

Conclusion In our Asian context, residents are negatively affected by patient deaths, especially the PD residents. There is a need to incorporate relevant bereavement training for all residents.

  • bereavement
  • education and training
  • family management
  • paediatrics

https://doi.org/10.1136/bmjspcare-2020-002239

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    Footnotes

    • Contributors TT contributed in the analysis, interpretation of data and drafted the manuscript. PLK contributed in the conception of the work, interpretation of data and substantively revised the manuscript. ML contributed in the interpretation of data and substantively revised the manuscript. LW contributed in the acquisition, analysis, interpretation of data and substantively revised the manuscript. JL contributed in the acquisition, analysis, interpretation of data and substantively revised the manuscript. WCY contributed in the conception of the work, interpretation of data and substantively revised the manuscript. ESY contributed in the conception and design of the work, analysis, interpretation of data and substantively revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the institutional ethics review board, National Healthcare Group—Domain Specific Review Board (Ref. No. 2013/01050).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon request