Which Physicians' Behaviors on Death Pronouncement Affect Family-Perceived Physician Compassion? A Randomized, Scripted, Video-Vignette Study

Abstract

To convey compassion on death pronouncement, we recommend that physicians initiate prompt examination, explain that the physician has received a sign-out, perform examination respectfully, ascertain the time of death with a wristwatch, and reassure the families that the patient did not experience pain.

Communication with Families in the Last Days of a Patient’s Life and Optimal Delivery of a Death Pronouncement

“…Confirmation by the primary responsible physician was significantly preferred than that by an unfamiliar physician [65]. Based on these findings of optimal behaviors, Mori et al performed a unique study applying a randomized, scripted, video-vignette study design [5]. In this randomized, videovignette study, volunteer participants viewed two videos of death pronouncements by an on-call physician with or without compassion-enhanced behaviors [5].…”

“…Based on these findings of optimal behaviors, Mori et al performed a unique study applying a randomized, scripted, video-vignette study design [5]. In this randomized, videovignette study, volunteer participants viewed two videos of death pronouncements by an on-call physician with or without compassion-enhanced behaviors [5]. This behavior included five components: "waiting until the families calm themselves down, explaining that the physician has received a sign-out containing information of the patient's condition, performing the examination respectfully, ascertaining the time of death with a wristwatch (vs. a smartphone), and reassuring the families that the patient did not experience pain."…”

“…Participants who viewed the compassion-enhanced behaviors video assigned significantly higher scores for physician compassion and trust in the physician and lower scores for anger, sadness, fear, and disgust. This study proposed recommendations that physicians should initiate a prompt examination, explain that they have received a sign-out, perform the examination respectfully, ascertain the time of death with a wristwatch, and reassure the families that the patient did not experience pain [5].…”

“…Sharing these bedside clinical signs with families can allow them to understand the patients' condition, estimate prognosis, and prepare for the impending event. Moreover, a recent unique research study regarding the death pronouncement (e.g., a video-vignette study design) revealed effective and respectful ways to deliver this pronouncement [5].…”

Development of a List of Competencies and Entrustable Professional Activities for Resident Physicians During Death Pronouncement: A Modified Delphi Study

“…This is because the death of a loved one is a critically serious life event for the family members and relatives of the deceased [4,5]. Appropriate death pronouncement practice itself can potentially be a type of bereavement care for family members [6,7].…”