Psychology, Department of

 

Document Type

Article

Date of this Version

August 2003

Comments

Published in Journal of Evaluation in Clinical Practice, 9:3 (2003), pp. 363–372. http://www.blackwellpublishing.com/journal.asp?ref=1356-1294 Copyright © 2003 Blackwell Publishing Ltd. Used by permission.

Abstract

Due to its comprehensive and cost-saving design, hospice has become a critical component of health care. Physicians have become the primary gatekeepers to information on hospice and sources of referral to hospice. However, many physicians do not discuss hospice options until late in the disease course, when patients and their families are no longer able to benefit from hospice services. Although physicians, as well as patients and hospice personnel, cite patient and hospice structure factors as barriers, the present article will focus on barriers physicians have more control over, such as their discomfort discussing terminality and fear of losing contact with patients. Focusing on the American hospice model, the present article will review past findings, examine gaps in the research, and propose systematic ways to discern whether the factors physicians claim are barriers actually affect their decision making about hospice referral.

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