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Palliative care in everyday practice of radiation oncologists

Results from a web-based survey among medical members of the German Society for Radiation Oncology (DEGRO)

Palliativmedizin in der täglichen Praxis der Radioonkologen

Ergebnisse einer webbasierten Untersuchung unter ärztlichen Mitgliedern der Deutschen Gesellschaft für Radioonkologie (DEGRO)

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Abstract

Purpose

Little is known about the attitudes of radiation oncologists towards palliative care, about their competences in this field, and about the collaboration with palliative care specialists. Our aim was to close this gap and understand more about the importance of an additional qualification in palliative care.

Methods

Medical members of the German Society for Radiation Oncology (DEGRO) were electronically surveyed during November–December 2016.

Results

The survey was emailed successfully to 1110 addressees, whereas a total of 205 questionnaires were eligible for analysis (response rate 18.4%). 55 (26.8%) of the respondents had an additional qualification in palliative care. Physicians who had an additional qualification in palliative care (PC qualification) reported palliative care needs for their patients more frequently than the other respondents (89.0 vs. 82.7%, p = 0.008). Furthermore, they were most likely to report a high confidence in palliative care competences, such as “communication skills & support for relatives” (83.6 vs. 59.3%, p = 0.013), “symptom control,” and “pain management” (94.5 vs. 67.7%, p < 0.001 and 90.9 vs. 73.3%, p = 0.008, respectively). Respondents with a PC qualification more often involved palliative care specialists than the other respondents (63.3 vs. 39.3%, p = 0.007). Perceived main barriers regarding palliative care in radiation oncology included time aspects (9.2%), stigmata (8.5%), and the lack of interdisciplinary collaboration (8.5%).

Conclusions

This analysis demonstrated that aspects of palliative care strongly impact on daily practice in radiation oncology. Additional qualifications and comprehensive training in palliative medicine may contribute to improved patient care in radiation oncology.

Zusammenfassung

Zielsetzung

Wenig ist bisher über die Einstellungen der Strahlentherapeuten gegenüber der Palliativmedizin, über ihre Kompetenzen und über die Zusammenarbeit der Strahlentherapeuten mit den Palliativmedizinern bekannt. Ziel ist es, diese Lücke zu schließen und mehr über die Bedeutung der Zusatzbezeichnung Palliativmedizin (ZPM) herauszufinden.

Methoden

Ärztliche Mitglieder der Deutschen Gesellschaft für Radioonkologie (DEGRO) wurden im Zeitraum von November bis Dezember 2016 elektronisch befragt.

Ergebnisse

Der Fragebogen wurde erfolgreich an 1110 DEGRO-Mitglieder gesendet, während 205 Fragebögen vollständig beantwortet wurden (Rücklaufquote 18,4 %). Von den Teilnehmern hatten 55 (26,8 %) die ZPM. Befragte mit ZPM fühlten sich signifikant häufiger sicher in palliativmedizinischen Fähigkeiten, wie z. B. im Gespräch über das Thema „keine lebensverlängernden Maßnahmen“ (89,0 % vs. 74,1 %; p < 0,001), im Überbringen schlechter Nachrichten (85,4 % vs. 59,3 %; p = 0,009), in der Gesprächsführung und psychischen Unterstützung der Angehörigen (83,6 % vs. 59,3 %; p = 0,013), in der Symptomkontrolle (94,5 % vs. 67,7 %; p < 0,001) und in der Schmerztherapie (90,9 % vs. 73,3 %; p = 0,008). Teilnehmer mit ZPM bezogen öfter Palliativmediziner in ihre Behandlung mit ein als Strahlentherapeuten ohne palliativmedizinische Weiterbildung (63,3 % vs. 39,3 %; p = 0,007). Die häufigsten genannten Barrieren waren Zeitaspekte (9,2 %), Stigmata (8,5 %) und die interdisziplinäre Zusammenarbeit (8,5 %).

Schlussfolgerung

Die vorliegende Studie zeigt, dass die Palliativversorgung einen hohen Stellenwert im Praxisalltag der Strahlentherapeuten hat. Zusätzliche Qualifikationen und klinisches Training in der Palliativmedizin können zu einer verbesserten Patientenversorgung in der Strahlentherapie beitragen.

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Abbreviations

ASCO:

American Society of Clinical Oncology

ASTRO:

American Society for Radiation Oncology

DEGRO:

Deutsche Gesellschaft für Radioonkologie—German Society for Radiation Oncology

DGP:

Deutsche Gesellschaft für Palliativmedizin—German Society for Palliative Care

ESMO:

European Society for Medical Oncology

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Acknowledgements

We would like to thank the German Society for Radiation Oncology (DEGRO) office team for providing the mailing list and data of the basic population.

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Authors and Affiliations

  1. Department of Geriatrics, Clinic of Vitanas, Berlin, Germany

    Janina Fels

  2. Department of RadioOncology, Technical University, Munich, Germany

    Steffi Pigorsch MD

  3. Department of Radiation Oncology, Philipps-University, Marburg, Germany

    Hilke Vorwerk &  Rita Engenhart-Cabillic

  4. Interdisciplinary centre for palliative medicine and Department of Radiation Oncology, Julius-Maximilians-University, Würzburg, Germany

    Birgitt van Oorschot

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  1. Janina Fels
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Correspondence to Janina Fels.

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J. Fels, S. Pigorsch, H. Vorwerk, R. Engenhart-Cabillic, and B. van Oorschot declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Fels, J., Pigorsch, S., Vorwerk, H. et al. Palliative care in everyday practice of radiation oncologists. Strahlenther Onkol 195, 659–667 (2019). https://doi.org/10.1007/s00066-018-1403-2

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