Dissertations and Theses @ UNI

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Open Access Thesis

Keywords

Hospice care--Iowa; Physicians--Iowa--Attitudes; Hospice care; Physicians--Attitudes; Iowa;

Abstract

The hospice movement is just over 20 years old in this country. Hospice programs are dependent on physicians to educate and refer their terminal patients to hospice care. The purpose of this study was to identify factors which influence physicians in rural Iowa to refer terminal patients to selected hospice programs. The study involved Medicare-certified hospice programs and non-certified programs located in rural communities in Iowa. One hundred and fifty licensed physicians were randomly selected to complete a 14-item questionnaire. A total of 86 questionnaires were returned. The survey tool addressed demographic information, as well as identifying factors that influenced physicians to refer patients to hospice care. Demographic results showed the respondents to be primarily male, in medical practice for over 10 years, and family practitioners. Respondents indicated minimal education in the area of death and dying having 10 hours or less of formal death education. Respondents served by Medicare-certified hospices were aware of the certification status. However, 87% of the respondents from non-certified programs identified the certification status incorrectly, or they were unaware of the status. Physicians reported to be comfortable discussing the terminal diagnosis. The general understanding of hospice care was strong. Overall satisfaction with hospice care was rated either good or excellent. The majority of physicians referred to hospice care 50% or more of the time. However, 32% of respondents from certified programs referred less than 50% of the time or not at all. A referral to hospice was less likely by respondents from non-certified programs, with 47% indicating they referred 50% or less of the time or not at all. The factors influencing the physician not to refer to hospice was the six-month prognosis requirement, and the physicians' belief in their inability to make such a prediction. Another factor was the patient/ family decline of the hospice referral. Factors identified that influenced the respondents to refer to hospice included emotional support and the desire to die at home.

Year of Submission

1998

Degree Name

Master of Arts

Department

School of Health, Physical Education, and Leisure Services

First Advisor

Sue Joslyn

Second Advisor

Dennis Cryer

Third Advisor

Susan

Comments

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Date Original

1998

Object Description

1 PDF file (79 leaves)

Language

en

File Format

application/pdf

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