Skip to main content

Table 2 Factors determining knowledge and attitudes in end-of-life care (corresponding question numbers in the questionnaire are denoted as Qx in the left column)

From: Knowledge and attitudes about end-of-life decisions, good death and principles of medical ethics among doctors in tertiary care hospitals in Sri Lanka: a cross-sectional study

Characteristic Gender Done postgraduate ICU work Had in-service/PG EOL training Years of work experience
Male
226
Female
164
Yes
162
No
228
Yes
122
No
268
Yes
107
No
283
 < 15 years
291
 ≥ 15
99
Breaking bad news           
Knows that doctor should break bad news to patient Q1 175
77.4%
121
73.8%
131
80.9%
165
72.4%
90
73.8%
206
76.9%
86
80.4%
210
74.2%
233
80.1%
63
63.6%
Crude OR* 1.22 (0.76–1.95) 1.61 (0.99–2.63) 0.85 (0.52–1.39) 1.42 (0.82–2.46) 2.29 (1.39–3.79)
Adjusted OR** 1.99 (1.19–3.32) 2.71 (1.6–4.57)
Favours breaking bad news to terminally ill patient Q2 141
62.4%
116
70.7%
109
67.3%
148
64.9%
81
66.4%
176
65.7%
77
72.0%
180
63.6%
195
67.0%
62
62.6%
Crude OR* 0.69 (0.45–1.06) 1.1 (0.72–1.69) 1.0 (0.66–1.62) 1.47 (0.9–2.39) 1.21 (0.75–1.95)
Adjusted OR**
Advance directives           
Adequately aware of advance directives Q3 72
31.9%
36
22.0%
76
46.9%
32
14.0%
33
27.0%
75
28.0%
52
48.6%
56
19.8%
68
23.4%
40
40.4%
Crude OR* 1.66 (1.05–2.64) 5.26 (3.33–9.09) 0.95 (0.59–1.54) 3.83 (2.37–6.19) 0.45 (0.28–0.73)
Adjusted OR** 4.15 (2.49–6.94) 2.34 (1.39–3.94)
Withholding/withdrawing life-sustaining treatment           
Favours not placing a metastatic cancer patient on ventilator Q6 120
53.1%
81
49.4%
107
66.0%
94
41.2%
57
46.7%
144
53.7%
66
61.7%
135
47.7%
142
48.8%
59
59.6%
Crude OR* 1.16 (0.78–1.74) 2.77 (1.83–4.22) 0.75 (0.49–1.16) 1.76 (1.12–2.78) 0.65 (0.41–1.03)
Adjusted OR** 2.77 (1.83–4.22)
Favours disconnecting a brain-dead patient from ventilator Q7 194
85.8%
139
84.8%
132
81.5%
201
88.2%
96
78.7%
237
88.4%
85
79.4%
248
87.6%
249
85.6%
84
84.8%
Crude OR* 1.09 (0.62–1.92) 0.59 (0.34–1.04) 0.48 (0.27–0.86) 0.55 (0.3–0.98) 1.06 (0.56–2.01)
Adjusted OR** 0.49 (0.28–0.88)
Knows that time of death is the time of brain death Q8 38
16.8%
19
11.6%
34
21.0%
23
10.1%
22
18.0%
35
13.1%
20
18.7%
37
13.1%
43
14.8%
14
14.1%
Crude OR* 1.54 (0.85–2.79) 2.37 (1.33–4.2) 1.47 (0.82–2.62) 1.53 (0.84–2.78) 1.05 (0.55–2.02)
Adjusted OR** 2.37 (1.33–4.2)
More comfortable withholding than withdrawing ventilation Q9 160
70.8%
114
69.5%
118
72.8%
156
68.4%
97
79.5%
177
66.0%
81
75.7%
193
68.2%
206
70.8%
68
68.7%
Crude OR* 1.06 (0.69–1.65) 1.24 (0.79–1.93) 1.99 (1.2–3.31) 1.45 (0.87–2.41) 1.11 (0.67–1.81)
Adjusted OR** 1.99 (1.2–3.31)
DNACPR           
Adequately aware of DNACPR Q10 147
65.0%
88
53.7%
105
64.8%
130
57.0%
86
70.5%
149
55.6%
75
70.1%
160
56.5%
170
58.4%
65
65.7%
Crude OR* 1.61 (1.07–2.42) 1.39 (0.92–2.11) 1.91 (1.21–3.02) 1.8 (1.12–2.9) 0.74 (0.46–1.18)
Adjusted OR** 1.76 (1.11–2.81)
Aware when to consider DNACPR Q11 53
23.5%
32
19.5%
44
27.2%
41
18.0%
33
27.0%
52
19.4%
36
33.6%
49
17.3%
67
23.0%
18
18.2%
Crude OR* 1.26 (0.77–2.07) 1.7 (1.05–2.76) 1.54 (0.93–2.54) 2.42 (1.46–4.02) 1.35 (0.75–2.4)
Adjusted OR** 2.48 (1.49–4.14)
Aware that the medical team makes the DNACPR decision in an unconscious patient Q12 45
19.9%
31
18.9%
30
18.5%
46
20.2%
20
16.4%
56
20.9%
24
22.4%
52
18.4%
51
17.5%
25
25.3%
Crude OR* 1.07 (0.64–1.78) 0.89 (0.54–1.49) 0.74 (0.42–1.3) 1.29 (0.75–2.22) 0.63 (0.37–1.09)
Adjusted OR**
Knows that DNACPR does not entail withdrawing life-sustaining treatment Q13 152
67.3%
96
58.5%
107
66.0%
141
61.8%
89
73.0%
159
59.3%
78
72.9%
170
60.1%
190
65.3%
58
58.6%
Crude OR* 1.46 (0.96–2.21) 1.2 (0.79–1.83) 1.85 (1.16–2.95) 1.79 (1.1–2.92) 1.33 (0.83–2.12)
Adjusted OR** 1.74 (1.08–2.79) 1.84 (1.1–3.06)
No reluctance to make DNACPR decision Q14 153
67.7%
89
54.3%
114 70.4% 128
56.1%
81
66.4%
161
60.1%
77
72.0%
165
58.3%
181
62.2%
61
61.6%
Crude OR* 1.77 (1.17–2.67) 1.86 (1.21–2.84) 1.31 (0.84–2.05) 1.83 (1.13–2.98) 1.02 (0.64–1.64)
Adjusted OR** 1.64 (1.08–2.5) 1.74 (1.13–2.68)
  1. DNACPR do-not-attempt cardiopulmonary resuscitation; EOL end-of-life; ICU intensive care unit; PG postgraduate
  2. *Crude odds ratio (OR) calculated in univariate analysis on factors associated with knowledge and attitudes relevant to selected aspects of end-of-life care
  3. **Adjusted odds ratio (OR) calculated in logistic regression analysis on factors associated with knowledge and attitudes relevant to selected aspects of end-of-life care after adjusting for confounders