Navigating Grief in the Realm of Patient Mortality: Insights from Trainee Doctors from a Tertiary Medical Hospital in India- A Qualitative Study.

Background: Physician grief, as defined by Kenneth Doka as disenfranchised grief, refers to "the grief that individuals experience when they incur a loss that is not openly acknowledged, publicly mourned, or socially supported." The experience of patient deaths on the emotional health of young doctors is unknown. The after-effects like stress, anxiety, burnout, depression, and others indirectly have a potential impact on decision-making and patient care. The study aims to shed light on this underexplored dimension and advocate for appropriate training and support to promote physician well-being. Methods: A qualitative study with a phenomenological approach was used to help explore the lived experience of trainee doctors confronted with patient deaths. The data collection was done through focused group discussions (FGDs) with three groups of trainee doctors. A semi-structured interview guide was framed and focused on their experiences of initial reactions, coping, reflections, and unmet needs among participants. Each interview was manually coded, organized into subthemes, and further into larger themes. All authors agreed upon themes and subthemes. Results: The findings are elaborated with necessary quotes taken from the transcripts of the FGDs. The main themes identified were (a) Losing a patient's emotions behind the screen, (b) Psychological and Environmental battles, and (c) Identifying lacunae and expressing unmet needs. Conclusion: The study findings were corroborated by concepts of disenfranchised grief, iatrogenic distress, emotionally unavailable doctors, and poor coping abilities. It also advocates for protocols and proactive measures to support interns and resident doctors.