End-of-Life Communication: A Retrospective Survey of Representative General Practitioner Networks in Four Countries

Abstract

The prevalence of end-of-life discussions varied across the four countries. In all countries, training priorities should include the identification and discussion of spiritual and social problems and early end-of-life discussions with older patients, those with cognitive decline if possible, and those with non-malignant diseases.

Communication and Quality of Care on Palliative Care Units: A Qualitative Study

“…Failure to establish a mutual understanding can lead to misaligned expectations, distress, unmet needs, and a perceived low quality of care. 11,15 Ensuring that conversations about goals of care were initiated soon after admission, and including families in this process, served to clarify understanding of the illness, educate about available services, and set realistic expectations. Solidifying the care plan made staff aware of patients' and families' level of understanding and allowed them the opportunity to align their expectations with the care that would be provided.…”

“…13 Physician surveys of communication with patients at the end of life have revealed poor knowledge of communication strategies 14 and a neglect of social and spiritual issues. 15 However, to our knowledge, no previous studies have described qualitatively which specific elements of communication are important for satisfaction with palliative care.…”

Palliative care for patients with end-stage renal disease: approach to treatment that aims to improve quality of life and relieve suffering for patients (and families) with chronic illnesses

“…Such communication, which takes into consideration a patient's culture and religious values, is pivotal to ensure the patient's understanding of their medical condition and what care and treatment options are available to them [21]. This approach encourages patient participation in decision making, while demonstrating ‘cultural sensitivity’ by health care professionals, which is an important factor determining the level of patient satisfaction and those overseeing their end-of-life care [22]. In addition, the patient's family also plays an important role in this process.…”

Palliative Care Case Managers in Primary Care: A Descriptive Study of Referrals in Relation to Treatment Aims

“…This resonates with a generally found lack of attention to spiritual issues in palliative care. 22 On the other hand, it would be unlikely that the need for existential/spiritual care was mentioned as a main reason for referral to a case manager, as referral to an existential/spiritual counsellor would be the more obvious path in that situation.…”