Facilitators and barriers for GP–patient communication in palliative care: a qualitative study among GPs, patients, and end-of-life consultants

Slort, Willemjan; Blankenstein, Annette H.; Deliens, Luc; Horst, Henriëtte E. van der

doi:10.3399/bjgp11x567081

Cited by 52 publications

(61 citation statements)

References 17 publications

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“…5,28 In our study, staff who discussed this topic felt that discussing dying with patients could help prepare them and their families for the patients' decline, consequently relieving emotional suffering at the time of patient death. Although this approach is endorsed in the literature, 7,29,30 clinicians should attend to their own biases as well as patients' and families' cues and wishes regarding the content, style, and timing of information 31,32 and be attuned to the range of desire for disclosure concerning this topic. 25 This study had limitations.…”

Section: Discussionmentioning

confidence: 97%

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

SeccarecciaDori

Wentlandt

KevorkNanor

et al. 2015

Journal of Palliative Medicine

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Section: Discussionmentioning

confidence: 97%

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

SeccarecciaDori

Wentlandt

KevorkNanor

et al. 2015

Journal of Palliative Medicine

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“…The results of our recent studies yielded three categories of factors reported to be relevant for GP-patient communication in palliative care: the availability of the GP for the patient, current issues that should be raised by the GP, and the GP anticipating various scenarios [6,7]. We used the first letters of the three categories (ACA) as an acronym for the training programme.…”

Section: Training Programme On Gp-patient Communication In Palliativementioning

confidence: 99%

The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

et al. 2012

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We describe the development of a new training programme on GP-patient communication in palliative care, and the applicability to GPs and GP Trainees. This ‘ACA training programme’ focuses on A vailability of the GP for the patient, C urrent issues that should be raised by the GP, and A nticipating various scenarios. Evaluation results indicate the ACA training programme to be applicable to GPs and GP Trainees. The ACA checklist was appreciated by GPs as useful both in practice and as a learning tool, whereas GP Trainees mainly appreciated the list for use in practice.

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“…21–25 In addition, physicians have cited time constraints and patient and family fears, emotions and lack of knowledge as barriers. 21,26,27 They have also cited their own emotional bonds with patients and feelings of failure. 21 In contrast, bedside nurses identified unclear communication roles and difficulty prognosticating as barriers.…”

Section: Introductionmentioning

confidence: 99%

“I Just Felt Like I Was Stuck in the Middle”: Physician Assistants' Experiences Communicating With Terminally Ill Patients and Their Families in the Acute Care Setting

Chuang

Lamkin

Hope

et al. 2017

Journal of Pain and Symptom Management

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Context Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance Practice Providers such as Physician Assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs’ current experiences in their daily practices. Objectives This study aimed to explore: 1) roles PAs serve in communicating with terminally ill patients/families; 2) PAs’ attitudes and opinions about communication roles and 3) perceived barriers and facilitators of communication with patients/families in the hospital setting. Methods Five focus groups were conducted with PAs practicing on adult medical services at three acute care hospitals of an academic medical center in the Bronx, NY. An open-ended question guide was used. An inductive thematic analysis strategy was used to examine the data from transcribed audiotapes of focus group sessions to identify emergent concepts and themes. Results The overarching theme that emerged was being Stuck in the Middle. PAs experienced 1) ambiguity around their roles and responsibilities in communications between the medical team and patients and families; 2) gaps in knowledge and skills and 3) organizational or structural deficits in the patient care systems that placed them in uncomfortable situations. Conclusion Interventions aimed at improving PA communication with terminally ill patients and their families should target institutional structures, systems and culture around roles and responsibilities in addition to skill and knowledge gaps in order to be most effective.

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Facilitators and barriers for GP–patient communication in palliative care: a qualitative study among GPs, patients, and end-of-life consultants

Cited by 52 publications

References 17 publications

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

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

The ACA training programme to improve communication between general practitioners and their palliative care patients: development and applicability

“I Just Felt Like I Was Stuck in the Middle”: Physician Assistants' Experiences Communicating With Terminally Ill Patients and Their Families in the Acute Care Setting

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