GPs' Recognition of Death in the Foreseeable Future
GPs' Recognition of Death in the Foreseeable Future
A retrospective cross-sectional design was used based on survey data.
A random sample of 850 Dutch GPs participated in this survey. The sample was drawn from a national registration base (NIVEL) with the addresses and background characteristics of all GPs working in the Netherlands.
The content of the questionnaire was largely based on existing questionnaires: in particular a questionnaire about end-of life care by GPs and a registration form used by GPs participating in the Dutch Sentinel General Practice Network. GPs were asked to base their answers on the case of their last patient with a non-sudden death. We explained in the questionnaire that this could be a patient who died of cancer, heart failure, COPD, stroke, dementia, other chronic diseases or "gradual decline because of frailty and old age".
The questions used for answering the research questions addressed in this paper are shown in Additional file 1.
Face validity, content validity and comprehensibility of the draft questionnaire were assessed by the steering committee, which included three scientists in the field of end-of-life care and two GPs. The usability and comprehensibility were tested further among ten other GPs. This resulted in some minor revisions, e.g. regarding the time period to which questions relate. The final version of the questionnaire consisted of 44 semi-structured questions.
The random sample of 850 GPs received the final questionnaire, together with an explanatory letter and return envelope, in the summer of 2010. Reminders were sent after four weeks and seven weeks.
All questionnaires were scrutinised for errors and missing data, and the data were digitised by scanning. A random sample of 15 questionnaires was checked for errors arising during scanning. No errors were found.
Descriptive analyses and Chi-square analyses were used to answer the research questions addressed in this paper. A Fisher exact test was used instead of a Chi-square test if the expected value for one or more of the cells was less than five.
GPs received information about the aim and content of the research in an explanatory letter, which was sent together with the questionnaire. The anonymity of the GPs and their patients was strictly preserved throughout the data entry and analysis process.
According to Dutch law, no approval of a Medical Ethics Committee is needed for surveys among care professionals and for post-mortem anonymous patient data.
Methods
Design
A retrospective cross-sectional design was used based on survey data.
Study Population and Setting
A random sample of 850 Dutch GPs participated in this survey. The sample was drawn from a national registration base (NIVEL) with the addresses and background characteristics of all GPs working in the Netherlands.
Pilot and Content of the Questionnaire
The content of the questionnaire was largely based on existing questionnaires: in particular a questionnaire about end-of life care by GPs and a registration form used by GPs participating in the Dutch Sentinel General Practice Network. GPs were asked to base their answers on the case of their last patient with a non-sudden death. We explained in the questionnaire that this could be a patient who died of cancer, heart failure, COPD, stroke, dementia, other chronic diseases or "gradual decline because of frailty and old age".
The questions used for answering the research questions addressed in this paper are shown in Additional file 1.
Face validity, content validity and comprehensibility of the draft questionnaire were assessed by the steering committee, which included three scientists in the field of end-of-life care and two GPs. The usability and comprehensibility were tested further among ten other GPs. This resulted in some minor revisions, e.g. regarding the time period to which questions relate. The final version of the questionnaire consisted of 44 semi-structured questions.
The random sample of 850 GPs received the final questionnaire, together with an explanatory letter and return envelope, in the summer of 2010. Reminders were sent after four weeks and seven weeks.
Statistical Analysis
All questionnaires were scrutinised for errors and missing data, and the data were digitised by scanning. A random sample of 15 questionnaires was checked for errors arising during scanning. No errors were found.
Descriptive analyses and Chi-square analyses were used to answer the research questions addressed in this paper. A Fisher exact test was used instead of a Chi-square test if the expected value for one or more of the cells was less than five.
Ethics
GPs received information about the aim and content of the research in an explanatory letter, which was sent together with the questionnaire. The anonymity of the GPs and their patients was strictly preserved throughout the data entry and analysis process.
According to Dutch law, no approval of a Medical Ethics Committee is needed for surveys among care professionals and for post-mortem anonymous patient data.
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