title: Doctors' emotional reactions to recent death of a patient: cross sectional study of hospital doctors.
abstract: OBJECTIVE
  To describe doctors' emotional reactions to the recent death of an "average" patient and to explore the effects of level of training on doctors' reactions.
  
  
  METHODS
  Cross sectional study using quantitative and qualitative data.
  
  
  METHODS
  Two academic teaching hospitals in the United States.
  
  
  METHODS
  188 doctors (attending physicians (equivalent to UK consultants), residents (equivalent to UK senior house officers), and interns (equivalent to UK junior house officers)) who cared for 68 patients who died in the hospital.
  
  
  METHODS
  Doctors' experiences in providing care, their emotional reactions to the patient's death, and their use of coping and social resources to manage their emotions.
  
  
  RESULTS
  Most doctors (139/188, 74%) reported satisfying experiences in caring for a dying patient. Doctors reported moderate levels of emotional impact (mean 4.7 (SD 2.4) on a 0-10 scale) from the death. Women and those doctors who had cared for the patient for a longer time experienced stronger emotional reactions. Level of training was not related to emotional reactions, but interns reported needing significantly more emotional support than attending physicians. Although most junior doctors discussed the patient's death with an attending physician, less than a quarter of interns and residents found senior teaching staff (attending physicians) to be the most helpful source of support.
  
  
  CONCLUSIONS
  Doctors who spend a longer time caring for their patients get to know them better but this also makes them more vulnerable to feelings of loss when these patients die. Medical teams may benefit from debriefing within the department to give junior doctors an opportunity to share emotional responses and reflect on the patient's death.
authors.affiliation: Department of Behavioural Medicine and Oncology, University of Pittsburgh Cancer Institute, 5150 Centre Ave #445, Pittsburgh, PA 15232, USA. ellenr@pitt.edu
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Redinbaugh
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sullivan
authors.forename: Susan D
authors.initials: SD
authors.lastname: Block
authors.forename: Nina M
authors.initials: NM
authors.lastname: Gadmer
authors.forename: Matthew
authors.initials: M
authors.lastname: Lakoma
authors.forename: Ann M
authors.initials: AM
authors.lastname: Mitchell
authors.forename: Deborah
authors.initials: D
authors.lastname: Seltzer
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wolford
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
mesh_terms: D000223:Adaptation, Psychological; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D012944:Social Support; D013727:Terminal Care; D014481:United States