Description:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Purpose</jats:title>
<jats:p>Providing state-of-the-art palliative care is crucial in all areas of in- and outpatient settings. Studies on the implementation of palliative care standards for dying patients are rare.</jats:p>
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<jats:title>Methods</jats:title>
<jats:p><jats:italic>N</jats:italic> = 141 physicians from all internal departments were polled anonymously about the treatment of dying patients using a self-designed questionnaire. Furthermore, we evaluated the terminal care of <jats:italic>n</jats:italic> = 278 patients who died in internal medicine departments at University Hospital Mannheim between January and June, 2019 based on clinical data of the last 48 h of life. We defined mandatory criteria for good palliative practice both regarding treatment according to patients' records and answers in physicians' survey.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>Fifty-six physicians (40%) reported uncertainties in the treatment of dying patients (<jats:italic>p</jats:italic> < 0.05). Physicians caring for dying patients regularly stated to use sedatives more frequently and to administer less infusions (<jats:italic>p</jats:italic> < 0.05, respectively). In multivariate analysis, medical specialization was identified as an independent factor for good palliative practice (<jats:italic>p</jats:italic> < 0.05). Physicians working with cancer patients regularly were seven times more likely to use good palliative practice (<jats:italic>p</jats:italic> < 0.05) than physicians who did not. Cancer patients received good palliative practice more often than patients dying from non-malignant diseases (<jats:italic>p</jats:italic> < 0.05).</jats:p>
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<jats:title>Conclusion</jats:title>
<jats:p>Guideline-based palliative care for dying patients was found to be implemented more likely and consistent within the oncology department. These results point to a potential lack of training of fellows in non-oncological departments in terms of good end-of-life care.</jats:p>
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