Personality and attitudes towards dying patients: An Italian pilot study among medical students

Dear Sir

Nowadays doctors have to deal not only with death but also with the “end-of-life” stage. That requires specific skills and attitudes, but it remains unclear what medical students’ attitudes are towards end-of-life care (EOLC).

For this reason, we designed a pilot cross-sectional study to investigate the attitudes towards EOLC and their possible relationships with personality traits in a sample of second-year medical students who attended the Turin University. Ethical approval was obtained. We used the Italian version of the Frommelt Attitude Toward the Care of the Dying Scale form-B (FATCOD-B) (Frommelt 1991) and the Temperament and Character Inventory (TCI) (Cloninger et al. 1994). Of the 280 students invited to participate, 165 returned both questionnaires (45.5% male, 54.5% female).

Regarding attitudes towards EOLC, students obtained a mean total score of 113.4 (SD = 7.8) (normative data are not available in literature), without significant differences between males and females.

Regarding personality profile, we compared total scores with normative data. Observed students scored significantly higher on Harm Avoidance and lower on the Reward Dependence, Cooperativeness and Self-Trascendence dimensions. Females scored significantly higher than males on Harm Avoidance, Reward Dependence, Self-Directedness and Cooperativeness dimensions.

Regarding the associations between FATCOD-B and TCI, significant positive associations were found between Self-Directedness (p = 0.038) and Cooperativeness (p = 0.040), while Harm Avoidance showed a significant negative association (p = 0.002).

Despite the limited sample size, this study is the first to show a relationship between personality traits of undergraduate Italian medical students and their attitudes towards the care of dying patients. Highly self-directed and cooperative students, with low Harm Avoidance, probably could develop a more mature character that helps them to be more conscious of their own and others’ life conditions and thus to be more prone to care for dying patients. Our results suggest that it may be important to consider also the personality profile for career counselling of the medical students oriented to the EOLC context.