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Table 4 Characteristics associated with difficult consultations as perceived by SCEN physicians, 2016–2017

From: Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

 Difficult (N = 203)Not difficult (N = 735)Univariable Odds ratio (95% CI)Multivariable Odds ratio (95% CI)
 N (%)N (%)  
SCEN physician
 Number of consultations per year
   < 511 (5.5)52 (7.1)1
  5–953 (26.5)190 (25.9)1.32 (0.64–2.7) 
  10–1452 (26)212 (28.9)1.16 (0.57–2.38) 
   ≥ 1584 (42)280 (38.1)1.42 (0.71–2.84) 
Attending physician
 Profession
  General practitioner151 (81.2)665 (92.7)11
  Medical specialist17 (9.1)23 (3.2)3.26 (1.7–6.24)1.23 (0.48–3.17)
  Elderly care physician18 (9.7)29 (4)2.73 (1.48–5.05)0.73 (0.31–1.69)
 Works at End of life clinic46 (22.8)49 (6.7)4.13 (2.66–6.4)1.44 (0.71–2.94)
 Certainty of decision before consultation
  Already promised to grant the request29 (14.3)186 (25.4)11
  Decided to grant the request78 (38.4)353 (48.2)1.42 (0.89–2.25)0.76 (0.43–1.33)
  Probably wants to grant the request75 (36.9)177 (24.1)2.72 (1.69–4.37)1.58 (0.88–2.82)
  Doubts about/doesn’t want to grant the request21 (10.3)17 (2.3)7.92 (3.74–16.77)4.48 (1.73–11.58)
Patient
 Age
   < 70 years78 (39)260 (35.6)11
  70–79 years36 (18)240 (32.9)0.5 (0.33–0.77)0.38 (0.21–0.68)
   ≥ 80 years86 (43)230 (31.5)1.25 (0.88–1.78)0.53 (0.31–0.93)
 Sex (female)104 (51.7)339 (46.2)1.25 (0.91–1.71)
 Residency
  Home136 (67.7)615 (84)11
  Care/nursing home33 (16.4)57 (7.8)2.62 (1.64–4.18)1.31 (0.7–2.47)
  Hospital17 (8.5)20 (2.7)3.84 (1.96–7.53)3.01 (1.15–7.85)
  Hospice15 (7.5)40 (5.5)1.7 (0.91–3.16)2.01 (0.9–4.49)
 Main diagnosis
  Cancer73 (36.1)551 (75.1)11
  Heart failure/CVA23 (11.4)35 (4.8)4.96 (2.78–8.86)4.43 (2.08–9.42)
  MS/ALS7 (3.5)22 (3)2.4 (0.99–5.82)0.85 (0.25–2.87)
  COPD7 (3.5)33 (4.5)1.6 (0.68–3.75)0.7 (0.2–2.46)
  Accumulation of age-related health problems/dementia/psychiatric disorder64 (31.7)40 (5.4)12.08 (7.59–19.21)6.94 (3.58–13.46)
  Other28 (13.9)53 (7.2)3.99 (2.37–6.7)3.42 (1.77–6.6)
 Besides main diagnosis alsoa
  Physical illness94 (50.5)299 (49.9)1.03 (0.74–1.43)
  Psychiatric disorder29 (15.6)53 (8.8)5.17 (2.28–11.71)3.91 (1.41–10.83)
  Accumulation of age-related health problems29 (15.6)53 (8.8)1.9 (1.17–3.1)1.58 (0.77–3.24)
  Dementia6 (3.2)9 (1.5)2.19 (0.77–6.22)
  Psychosocial or existential problems34 (18.3)31 (5.2)4.1 (2.44–6.88)2.25 (1.13–4.5)
 Reasons to request EAS
  Loss of dignity90 (44.3)364 (49.6)0.81 (0.59–1.11)
  Overall weakness86 (42.4)457 (62.3)0.45 (0.33–0.61)0.78 (0.51–1.2)
  Being tired with life17 (8.4)20 (2.7)3.26 (1.68–6.35)0.95 (0.37–2.43)
  Pointless suffering45 (22.2)156 (21.3)1.06 (0.73–1.54)
  Knowing that suffering will not get better93 (45.8)382 (52)0.78 (0.57–1.06)
  Fear of suffocation15 (7.4)89 (12.1)0.58 (0.33–1.02)0.73 (0.32–1.67)
  Invalidity42 (20.7)115 (15.7)1.4 (0.95–2.08)
  Depressionb12 (5.9)1 (0.1)
  Dependency92 (45.3)353 (48.1)0.9 (0.66–1.22)
  Not wanting to be a burden for family22 (10.8)32 (4.4)2.67 (1.51–4.7)1.32 (0.58–2.99)
  Physical sufferingc72 (35.5)405 (55.2)0.45 (0.32–0.62)0.62 (0.4–0.96)
  1. N number, CI confidence interval; ¶, not significant in univariable analysis, thus not included in multivariable analysis; aMissing values = 153; bNot included in analysis due to small sample size; cIncludes pain, vomiting and dyspnea; Missing values ranging from 1 to 35