The experience of providing end‐of‐life care at home: The emotional experiences of young family physicians

BACKGROUND: End‐of‐life care is now a major issue in Japan as a result of the rapidly aging population; hence, the need for fostering family physicians to be engaged in end‐of‐life care at home is increasing. Studies in the United States and the United Kingdom have shown that physicians feel emotional and moral distress in end‐of‐life care, and that they develop detachment and dehumanizing attitudes toward patients as a coping mechanism. However, few studies have explored the emotional experiences that family physicians have during home‐based end‐of‐life care. The aim of this study is to explore the emotional experiences of young family physicians in such situations. METHODS: We conducted a qualitative analysis of interviews with family medicine residents or family physicians who had just completed their residency. The interviews were audio‐recorded and transcripts were prepared. The coded data were analyzed according to thematic analysis using NVivo 10 software. RESULTS: Study participants were 12 family physicians of PGY 5–11, with experienced end‐of‐life care cases of 3–20. Thirteen themes were extracted from the data, which were categorized into five domains: difficulties in end‐of‐life discussion, emotions of physicians, the role of physicians, communicating with the family, and positivity in end‐of‐life care. The physicians experienced various emotions and struggles within these domains, but they also felt something positive through providing care for the dying patients and their families. CONCLUSION: Family physicians experience various emotional difficulties during end‐of‐life home care. However, positive emotions at the end of life were also experienced through their care.