Differences in the Roles of Doctors and Nurses in End-of-life care at Home According to Underlying Disease

Abstract

This is a qualitative study involving physicians and nurses experienced in providing home end-of-life care. The methodology employed in this study consisted of a self-administered questionnaire distributed to 16 home physicians. The questionnaire aimed to investigate the distinctions and attributes associated with the end-of-life care process, as well as the roles they assume in this context. Additionally, semi-structured interviews were conducted with 5 home physicians, 3 visiting nurses, and 1 professional nurse. The analysis was carried out using a modified Grounded Theory Approach (M-GTA), with the overarching theme of “Enabling End-of-Life Care at Home” and a focus on the individuals involved in providing end-of-life care at home, including physicians and nurses. The results revealed that 25% of the home physicians found end-of-life care to be challenging. All participants indicated that the end-of-life care process differs between cancer and non-cancer patients. The distinct characteristics of the end-of-life care process were summarized in 16 categories. Notably, the ability to predict prognosis was associated with “cancer,” and the learning of the end-of-life care process from a practitioner was highlighted by M-GTA. The perception that “prognosis can be predicted” was commonly held among physicians but less prevalent among nurses. This difference in perception was identified as one of the factors contributing to the difficulties experienced by nurses in end-of-life care.