Communication among cancer patients, caregivers, and hospice nurses: Content, process and change over time

Ellington, Lee; Clayton, Margaret F.; Reblin, Maija; Donaldson, Gary; Latimer, Seth

doi:10.1016/j.pec.2017.09.013

Cited by 31 publications

(33 citation statements)

References 44 publications

(49 reference statements)

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“…The communication in home care showed a higher positive affect tone and was primarily socio emotional. These results may be expected because home care contains everyday talk and social interaction and is similar to previous research on cancer patients in home care [46]. The social and interpersonal contacts are described as important and valued by older persons receiving home care [4].…”

Section: Discussionsupporting

confidence: 85%

Exploring patient-centered aspects of home care communication: a cross-sectional study

et al. 2020

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Background Communication is a cornerstone in nursing and aims at both information exchange and relationship building. To date, little is known about the naturally occurring communication between older persons and nurses in home care. Communication might heal through different pathways and a patient- or person-centered communication could be important for health and well-being of older persons. However, the delivery of individualized home care is challenged by routines and organizational demands such as time constraints. Therefore, the aim of this study was to explore the patient-centered aspects of home care communication between older persons and registered nurses. Methods In total 37 older persons (aged 65 years or older) and eleven RNs participated in 50 audio-recorded home care visits. Roter Interaction Analysis System (RIAS) was used to code verbal communication. A ratio from these codes, establishing the degree of patient-centeredness, was analyzed using a Generalized Linear Mixed Model. Results The present home care communication contained more socio-emotional than task-oriented communication and the emotional tone was largely positive. The global affect ratings reflected an overall positive tone (m = 39.88, sd = 7.65), with higher ratings on dimensions of, for example, responsiveness/engagement and interactivity or interest were more frequent than those that may be considered as less-positive emotions (m = 15.56, sd = 3.91), e.g. hurried, dominance or anger. The ratio of the degree of patient-centered communication in the home care visits was an average of 1.53, revealing that the communication could be considered as patient-centered. The length of the visits was the only characteristic significantly associated with the degree of patient-centeredness in the communication, with a peak in patient-centeredness in visits 8–9 min long. Sex, age or procedural focus showed no significant effects on the degree of patient-centeredness. Conclusion Overall, the degree of patient-centeredness and a positive emotional tone, which might have a positive outcome on older persons’ health, was high. Longer visits provided a higher degree of patient-centeredness, but no linear increase in patient-centeredness due to length of visit could be observed. The findings can be used for education and training of nurses, and for providing individualized care, e.g. patient- or person-centered care.

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Section: Discussionsupporting

confidence: 85%

Exploring patient-centered aspects of home care communication: a cross-sectional study

et al. 2020

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“…In this analysis, we focus on emotion‐focused caregiver and nurse communication and supportive nurse responses: caregiver and nurse positive emotion (humor and gratitude), caregiver distress, and nurse emotional response (reassurance and validation) communication statements. Examples are found in Table ; further details about communication coding can be found elsewhere . A random sample of 10% of audio‐recordings were double coded for interrater reliability and drift throughout the coding process, and the Cohen Kappa scores were good at 0.68 …”

Section: Methodsmentioning

confidence: 99%

Communication of emotion in home hospice cancer care: Implications for spouse caregiver depression into bereavement

et al. 2019

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Objective: Family caregivers of cancer hospice patients likely benefit from clinician provision of verbal support and from expression of positive emotions. Our aim was to identify the effects of hospice nurse supportive communication as well as caregiver-nurse exchange of positive emotions on family caregiver depression during bereavement. Methods: This prospective, observational longitudinal study included hospice nurses (N = 58) and family caregivers of cancer patients (N = 101) recruited from 10 hospice agencies in the United States. Digitally recorded nurse home visit conversations were coded using Roter interaction analysis system to capture emotion-focused caregiver-nurse communication and supportive nurse responses. Caregivers completed the Hospital Anxiety and Depression Scale Anxiety Subscale and Geriatric Depression Scale-Short Form at study enrollment and at 2, 6, and 12 months after patient death. Results: Caregivers had moderate levels of depression at study enrollment and throughout bereavement. Multilevel modeling revealed that caregiver positive emotion communication and nurse emotional response communication are associated with caregiver depression in bereavement. There was no significant association between caregiver distress communication and depression in bereavement.Conclusions: This is the first study to demonstrate that communication demonstrating emotional expression between cancer spouse caregivers and nurses during home hospice may have implications for caregiver depression up to a year after patient death. Our findings may help identify caregivers who may be coping well in the short term but may struggle more over time.

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“…The data for this study were derived from a large prospective observational project described in detail elsewhere [41, 42]. The study was approved by the University’s Institutional Review Board and participating hospice agencies.…”

Section: Methodsmentioning

confidence: 99%

“…In a large study of palliative nurse-caregiver-patient communication [41], we were surprised to find a significant proportion of PEC at end-of-life [42]. More surprising, during nurse visits, positive emotion occurred more frequently than distress for caregivers, and in equal amounts for patients.…”

Section: Introductionmentioning

confidence: 99%

Positive emotion communication: Fostering well-being at end of life

Terrill

Ellington

John

et al. 2018

Patient Education and Counseling

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Communication among cancer patients, caregivers, and hospice nurses: Content, process and change over time

Abstract: Communication strategies already in use by hospice nurses could be leveraged and expanded upon to better facilitate family competence and confidence.

Cited by 31 publications

References 44 publications

Exploring patient-centered aspects of home care communication: a cross-sectional study

Exploring patient-centered aspects of home care communication: a cross-sectional study

Communication of emotion in home hospice cancer care: Implications for spouse caregiver depression into bereavement

Positive emotion communication: Fostering well-being at end of life

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