title: Urologist attitudes toward end-of-life care.
abstract: OBJECTIVE
  To examine urology trainees' views about the quality and current practices of end-of-life care and to explore strategies for improving integration and quality of care.
  
  
  METHODS
  We conducted semi-structured interviews with 20 trainees from 4 institutions in different regions of the United States. Open-ended questions allowed participants to express themselves independently, and follow-up discussions explored their perception of current end-of-life practices, as well as avenues for future integration and improvement. We analyzed transcripts using a multistage, cutting-and-sorting technique in an inductive approach based on grounded theory analysis.
  
  
  RESULTS
  Clinicians agreed that their patients do not currently receive ideal care and were interested in joining a team geared towards improving care at the end of life. They expressed a preference for a multidisciplinary team, although the precise role each wanted to play within the team varied. Better identification of depression, pain, and patient-centered goals to allow value-congruent care were high in priorities for improvement. Trainees cited the lack of an educational curriculum on end-of-life care as a barrier to improving care and expressed a desire for formal education on this topic.
  
  
  CONCLUSIONS
  Urology trainees believe that end-of-life care can be improved and are interested in participating as part of a multidisciplinary team to better care for these individuals. There was consensus that end-of-life care should be formally taught to all intern and resident physicians and care at the end of life should be integrated to pursue value-congruent care for each patient.
authors.affiliation: Department of Urology, University of California, Los Angeles, CA, USA. jbergman@mednet.ucla.edu
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bergman
authors.forename: Karl A
authors.initials: KA
authors.lastname: Lorenz
authors.forename: Sadie
authors.initials: S
authors.lastname: Acquah-Asare
authors.forename: Charles D
authors.initials: CD
authors.lastname: Scales
authors.forename: Gery
authors.initials: G
authors.lastname: Ryan
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Saigal
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Bennett
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D008297:Male; D010348:Patient Care Team; D057240:Patient Preference; D010819:Physician's Role; D010820:Physicians / Q000523:psychology*; D058996:Quality Improvement; D011787:Quality of Health Care; D013727:Terminal Care; D014572:Urology