An exploratory, interview study of oncology patients' and health‐care staff experiences of discussing resuscitation

Abstract

There is little research about how patients and their families would like discussions surrounding resuscitation to take place. The purpose of this exploratory study was to investigate the experience of a discussion of resuscitation from the perspective of the participants. In-depth interviews were undertaken with 21 patients, of whom nine were interviewed together with a relative and 14 staff in an oncology setting. Data were analysed using a constant comparative method and coded using NVIVO qualitative data analysis software. Patients appeared to be accepting resuscitation discussions as necessary and important. A minority felt that the timing of the discussion could have been better, particularly if they were newly diagnosed or had recently commenced treatment. Relatives generally found the discussions more difficult and felt that discussions should take place much closer to death. Patients identified that they needed time and privacy during the discussion. Staff identified a need to present a sensitive and individualised discussion which took into account the key elements of timing, place, space, manner and pace. Patients acknowledged that the resuscitation discussion enabled them to begin to address issues relating to dying and end of life. For staff on-going communication skills training and support in this area were seen as important but often overlooked parts of the process.

Variations Among Physicians in Hospice Referrals of Patients With Advanced Cancer

“…17,32 Furthermore, they are associated with better understanding of prognosis, 33 better family satisfaction with care, 8 and better quality of life. [34][35][36] However, despite these findings, these discussions often take place late in a patient's care, if at all. 37 Although many factors are not under the control of the oncologist, research has identified physician decision making, including inadequate physician communication and not recognizing the patient as dying, as the most frequently identified cause of late hospice referrals by patients' bereaved family members.…”

‘Do Not Attempt Cardiopulmonary Resuscitation’ discussions at the point of discharge: a case note review of hospice practice following local integrated policy implementation

“…Cox et al 11 highlighted the scarcity of evidence about how patients and families would like discussions surrounding CPR to take place. Fear of causing distress and removing hope from patients are common reasons for not discussing CPR decisions with terminally ill patients 12 13.…”

Community pharmacists and stress at the counter: qualitative exploratory initial Italian research

“…Semi‐structured interviews were implemented since they represented the best method of obtaining the information required for the study. They made it easier for interviewees to use their own definitions of the issues, thus allowing the researcher to pursue the topics of interest . Interviews were conducted by two researchers in pairs, a psychologist and a pharmacist.…”