Communication and educational gaps in end-of-life care in Italian internal medicine wards: a cross-sectional study.
Only 2.5% of Italian internists know Advance Directives for many inpatients.
Communication and educational gaps in end-of-life care in Italian internal medicine wards: a cross-sectional study.
End-of-life (EOL) care is a frequent and complex aspect of internal medicine, yet data on physicians' training, clinical practices, and perceived challenges are limited.
This study aimed to explore current practices, knowledge gaps, and unmet needs in EOL care among Italian internal medicine physicians and residents.
A cross-sectional survey was conducted under the auspices of the Piedmont-Liguria-Aosta Valley Section of the Italian Society of Internal Medicine (SIMI).
Of approximately 7,400 invited physicians, 619 completed the survey (response rate ≈ 8.4%; median age 38 years; 60.5% female; 70.8% board-certified internists).
Internal protocols and dedicated multidisciplinary discussions were infrequently used.
Most respondents reported difficulties communicating with patients and families at EOL.
Compared with residents, board-certified internists more frequently reported postgraduate/Master training, whereas residents more frequently reported undergraduate and residency training in EOL.
The study highlights substantial gaps in training, communication, and organizational support, independent of clinical setting. Structured education and integration of psychological support are urgently needed.
These findings can inform curriculum development, hospital policies, and future research to improve physician preparedness and patient-centered EOL care.