Advance Directives and Communication Skills of Prehospital Physicians Involved in the Care of Cardiovascular XXXX .

@entity1 @entity1442 @entity65
@entity1442 ( @entity1442 ) were developed to respect @entity1 autonomy. However, very few @entity1 have @entity1442 , even in cases when major @entity65 surgery is to follow. To understand the reasons behind the low prevalence of @entity1442 and to help decision making when @entity1 are incompetent, it is necessary to focus on the impact of prehospital practitioners, who may contribute to an increase in @entity1442 by discussing them with @entity1 . The purpose of this study was to investigate self-rated communication skills and the attitudes of physicians potentially involved in the care of @entity65 @entity1 toward @entity1442 .Self-administered questionnaires were sent to general practitioners, cardiologists, internists, and intensivists, including the Quality of Communication Score, divided into a General Communication score (QOCgen 6 items) and an End-of-life Communication score (QOCeol 7 items), as well as questions regarding opinions and practices in terms of @entity1442 .One hundred sixty-four responses were received. QOCgen (mean (  SD)): 9.0/10 (1.0); QOCeol: 7.2/10 (1.7). General practitioners most frequently start discussions about @entity1442 (74/149 [47%]) and are more prone to designate their own specialty (30/49 [61%], P<0.0001). Overall, only 57/159 (36%) physicians designated their own specialty; 130/158 (82%) physicians ask potential @entity65 @entity1 if they have @entity1442 and 61/118 (52%) physicians who care for @entity65 @entity1 talk about @entity1442 with some of them.The characteristics of physicians who do not talk about @entity1442 with @entity1 were those who did not personally have @entity1442 and those who work in private practices.One hundred thirty-three (83%) physicians rated the systematic mention of @entity1 ' @entity1442 in the correspondence between physicians as good, while 114 (71%) at the @entity1 ' first registration in the private practice.Prehospital physicians rated their communication skills as good, whereas end-of-life communication was rated much lower. Only half of those surveyed speak about @entity1442 with @entity65 @entity1 . The majority would prefer that physicians of another specialty, most frequently general practitioners, initiate conversation about @entity1442 . In order to increase prehospital @entity1442 incidence, efforts must be centered on improving practitioners' communication skills regarding death, by providing trainings to allow physicians to feel more at ease when speaking about end-of-life issues.
