Terminal Illness: Attitudes in Both an Acute Care and an Extended Care Teaching Hospital

Abstract

This paper describes an attitudinal survey carried out at Sunnybrook Medical Centre, a teaching hospital with large acute and extended care sections. The study assesses and compares the attitudes and behaviour of acute care and extended care staff towards terminally ill patients and also the attitudes and beliefs of a sample on non-terminally ill patients. Six hundred and fifty-one completed questionnaires were reviewed. Respondents were asked questions regarding the management of terminally ill patients in acute beds; informing patients of the nature of their disease; management of patient's emotional and physical needs; the use of investigations in the terminally ill. A majority felt that the terminally ill should not be managed in acute hospital beds and that patients should be informed of the nature of their disease, although staff did not uniformly favour full disclosure. While physical care was thought to be quite good, staff responses were much less favourable about fulfillment of patients’ emotional needs. As well, staff in acute care, more so than in extended care, felt that investigations were being over-utilized.