title: Discussing end-of-life care issues with terminally ill patients and their relatives: comparisons among physicians, nurses and psychologists.
abstract: OBJECTIVE
  The aim of this study was to analyse the end-of-life topics most frequently discussed by Italian physicians, nurses and psychologists with terminally ill patients and their relatives. Findings were compared with the levels of communication reported by physicians in other countries involved in the EURELD research project, in Europe and elsewhere.
  
  
  METHODS
  An ad hoc questionnaire was prepared to measure levels of communication and administered to 716 professionals (181 physicians, 454 nurses and 81 psychologists) employed in geriatric hospital wards, hospices and nursing homes, or registered with professional associations in the Veneto and Trentino Alto-Adige regions of north-east Italy. Statistical analyses (frequency analysis, multivariate logistic regression) were conducted on data from questionnaires returned by standard mail or email.
  
  
  RESULTS
  Communication levels vary for the various end-of-life issues which physicians, nurses and psychologists are required to discuss and the individuals with whom they deal. Italian physicians are more communicative with relatives than with patients, whereas psychologists tend to discuss these problems more with patients than with members of their families. Nurses behave in much the same way with both patients and relatives. By comparison with their colleagues elsewhere in Europe, Italian physicians reveal more evident differences in their willingness to discuss end-of-life issues, depending on whether they are communicating with patients or relatives. Having received bio-ethical training helps physicians communicate with their patients.
  
  
  CONCLUSIONS
  Communicating is a fundamental part of providing care for terminally ill patients and support for their families. The patient care process involves several kinds of professionals, who are all increasingly called upon to be prepared to discuss the end of a patient's life, and to develop a therapeutic relationship which includes communicating without evading any of the aspects (and problems) relating to this crucial final stage of an individual's life.
authors.affiliation: Geriatrics Division, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Iasevoli
authors.forename: Valter
authors.initials: V
authors.lastname: Giantin
authors.forename: Alberto
authors.initials: A
authors.lastname: Voci
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Valentini
authors.forename: Anna
authors.initials: A
authors.lastname: Zurlo
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Paola
authors.initials: P
authors.lastname: Siviero
authors.forename: Graziella
authors.initials: G
authors.lastname: Orrù
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.forename: Renzo
authors.initials: R
authors.lastname: Pegoraro
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003142:Communication; D005190:Family / Q000523:psychology*; D006801:Humans; D007558:Italy; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011584:Psychology; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*