{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:30:46Z","timestamp":1768530646490,"version":"3.49.0"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1478951522000219_sec_a1\"><jats:title>Context<\/jats:title><jats:p>End-of-life care (EOLC) communication is beneficial but underutilized, particularly in conditions with a variable course such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). Physicians\u2019 emotional distress intolerance has been identified as a barrier to EOLC communication. However, studies of emotional distress intolerance in EOLC have largely relied on anecdotal reports, qualitative data, or observational studies of physician\u2013patient communication. A free-standing measure of multiple dimensions of distress tolerance is warranted to enable the identification of individuals experiencing distress intolerance and to facilitate the effective targeting of interventions to improve distress tolerance.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522000219_sec_a2\"><jats:title>Objectives<\/jats:title><jats:p>This study provides preliminary data on the reliability and validity of the Physician Distress Intolerance (PDI) scale. We examine potential subdimensions of emotional distress intolerance.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522000219_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Family medicine and internal medicine physicians completed the PDI, read vignettes describing patients with COPD or CHF, and indicated whether they initiated or delayed EOLC communication with their patients with similar conditions.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522000219_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Exploratory and confirmatory factor analyses were performed on separate samples. Confirmatory factor analysis confirmed that a three-factor solution was superior to a two- or one-factor solution. Three subscales were created: Anticipating Negative Emotions, Intolerance of Uncertainty, and Iatrogenic Harm. The full scale and subscales had adequate internal consistency and demonstrated evidence of validity. Higher scores on the PDI, indicating greater distress intolerance, were negatively associated with initiation and positively associated with delay of EOLC communication. Subscales provided unique information.<\/jats:p><\/jats:sec><jats:sec id=\"S1478951522000219_sec_a5\"><jats:title>Significance of results<\/jats:title><jats:p>The PDI can contribute to research investigating and addressing emotional barriers to EOLC communication.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1478951522000219","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T07:21:02Z","timestamp":1649056862000},"page":"399-410","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Development and preliminary validation of a scale to assess physicians\u2019 emotional distress intolerance in end-of-life care 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