title: How do surgeons experience and cope with the death and dying of their patients? A qualitative study in the context of life-limiting illnesses.
abstract: BACKGROUND
  The present qualitative study explores surgeons' experiences and coping mechanisms with the death of their patients in the context of life-limiting illnesses.
  
  
  METHODS
  Nine Australian surgeons participated in in-depth interviews. Thematic analysis of the interview transcriptions allowed for identification of themes and subthemes. Methodological trustworthiness and rigor were preserved at all stages of the research process.
  
  
  RESULTS
  The essence of surgical practice, comprising participants' descriptions of their identity as surgeons, influenced their experiences and coping mechanisms when dealing with death and dying. The following subthemes were identified: distancing from patients, wanting to fix problems, doing in terms of operating on a patient, prominence of the surgeon's personal ability, and high personal responsibility for patient outcomes. Giving hope and having a mixed surgical practice were some of the coping mechanisms described by participants.
  
  
  CONCLUSIONS
  Death and dying are a part of surgical practice, and surgeons face challenges as they care for dying patients. Although participants stated that they felt less affected by dealing with patients dying of life-limiting illnesses than by unexpected deaths, their descriptions of their encounters, reactions, and behaviors, as well as their use of language, suggest that these deaths have a lasting impact. Potential areas for improvement of surgical practice and approaches to teaching about death and dying in surgery are addressed. Furthermore, the results of this study suggest the need to expand research in this area.
authors: Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, SA 5005, Australia. sofia.zambranoramos@adelaide.edu.au
authors: Sofia C
authors: SC
authors: Zambrano
authors: Anna
authors: A
authors: Chur-Hansen
authors: Gregory B
authors: GB
authors: Crawford
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003107:Colorectal Surgery; D005762:Gastroenterology; D013502:General Surgery; D006176:Gynecology; D006801:Humans; D007407:Interviews as Topic; D010819:Physician's Role; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D012944:Social Support; D013021:South Australia; D013043:Specialties, Surgical; D013795:Thanatology