PHYSICIANS AND DEATH - COMMENTS AND BEHAVIOR OF 605 DOCTORS IN THE NORTHEAST OF ITALY

The aim of this study was to determine the influence of socio-demograp hic and professional factors on physicians' attitudes to the terminall y ill. Between May 1992 and May 1993, a survey was conducted in the pr ovince of Pordenone (north-east, Italy) in order to analyse a number o f specific issues, such as emotional involvement, the need for aggress ive treatments and the communication of diagnosis and prognosis. After obtaining a list of board-certified physicians from the Medical Assoc iation office in Pordenone, a modification of the cancer questionnaire of Haley and Blanchard (QSPT) was mailed to 916 doctors. Of these, 60 5 (60%; 487 male, 118 female; mean age 41+/-11 SD) returned the comple ted questionnaire. Within the group of responders, we identified three main subgroups, according to their type of activity: general practiti oners (175, 29%), hospital doctors (235, 39%) and other doctors (195, 32%). In age, sex and activity, the only significant difference betwee n responders and non-responders was age (mean age 41 and 43 years resp ectively), Most of the responders (77%) stated that they were able to deal with the terminally ill patient and his/her needs; 44%, however, admitted that patients' anxiety is sometimes unbearable. For the vast majority of the doctors polled (91%), providing a comfortable environm ent for an incurable patient was more important than pursuing aggressi ve treatment, but only 44% were convinced of the uselessness of aggres sive care. To the question on whether to disclose information about im minent death to allow patients to prepare spiritually, 37% answered '' No'', 38% ''Yes'', and 25% were uncertain. Almost all responders (95%) , however, believed in the beneficial effect of hope on the terminally ill, Our results suggest that doctors' professional and, most of all, sociodemographic and cultural factors determine the relationship with the patient on both the emotional and the clinical decision-making le vels.