Inviting end-of-life talk in initial CALM therapy sessions: A conversation analytic study

Shaw, Chloë; Chrysikou, Vasiliki; Davis, Sarah; Gessler, Sue; Rodin, Gary; Lanceley, Anne

doi:10.1016/j.pec.2016.08.024

Cited by 25 publications

(15 citation statements)

References 54 publications

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“…Fifty-three articles were included [33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85]. Seventeen were quantitative studies [33,34,36,37,40,43,50,51,54,61,66,67,69,71,74,81,82], of which the majority ( n = 11) were survey studies, 27 qualitative studies […”

Section: Resultsmentioning

confidence: 99%

“…Seventeen were quantitative studies [33,34,36,37,40,43,50,51,54,61,66,67,69,71,74,81,82], of which the majority ( n = 11) were survey studies, 27 qualitative studies [38,39,41,42,44,45,46,48,49,53,55,56,57,58,59,60,63,64,68,73,76,78,79,80,83,84,85], most of which were interview studies ( n = 13), and nine mixed-methods studies [35,47,52,62,65,70,72,75,77]. Most studies were conducted in Western Europe ( n = 37), especially in the UK ( n = 10), Germany ( n = 8), and the Netherlands ( n = 13).…”

Section: Resultsmentioning

confidence: 99%

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Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature

et al. 2019

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Many studies on spiritual care in palliative care are performed in the US, leaving other continents unexplored. The objective of this systematic review is to map the recent studies on spiritual care in palliative care in Europe. PubMed, CINAHL, ATLA, PsycINFO, ERIC, IBSS, Web of Science, EMBASE, and other databases were searched. Included were European studies published in a peer-reviewed journal in 2015, 2016, or 2017. The characteristics of the included studies were analyzed and a narrative synthesis of the extracted data was performed. 53 articles were included. Spiritual care was seen as attention for spirituality, presence, empowerment, and bringing peace. It implied creative, narrative, and ritual work. Though several studies reported positive effects of spiritual care, like the easing of discomfort, the evidence for spiritual care is low. Requirements for implementation of spiritual care in (palliative) care were: Developing spiritual competency, including self-reflection, and visibility of spirituality and spiritual care, which are required from spiritual counselors that they participated in existing organizational structures. This study has provided insight into spiritual care in palliative care in Europe. Future studies are necessary to develop appropriate patient outcomes and to investigate the effects of spiritual care more fully.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature

et al. 2019

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“…The open question design meant that such talk was not an interactional requirement, such that its frequent and early emergence presumably reflects a pressing need of individuals with advanced disease to share their fears and concerns about mortality. [4] One context for end-of-life talk with individuals with advanced disease is advance care planning for the end-of-life. [5] Analyzing talk between palliative care specialists and terminally ill patients in a hospice setting, Pino et al (2016) demonstrated that palliative care doctors used elaboration solicits to invite further talk about thoughts and fears, thereby providing patients with the opportunity to volunteer talk about end-of-life.…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Mentalization in CALM psychotherapy sessions: Helping patients engage with alternative perspectives at the end of life

Shaw

Chrysikou

Lanceley

et al. 2019

Patient Education and Counseling

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To identify how therapists invite patients with advanced cancer to engage with alternative perspectives about their illness trajectory and their end of life. Methods: Sequences of talk in which a therapist introduced a patient to alternative perspectives, were transcribed and analysed using the method of conversation analysis. Results: The analysis identifies one subtle way a patient is invited to consider an alternative perspective relating to their disease progression. Meaning expansion enquiries invite the patient to expand on the meaning of an utterance and in doing so, implicitly problematize the singularity of the patient's assumptions, without directly challenging them. The questions work as preliminary moves, providing the patient with the opportunity to expand on their assumptions. This enables the therapist to subsequently present an alternative perspective in a way that incorporates the patient's expanded perspective. Conclusion: The analysis reveals a skilful way in which therapists can cautiously and collaboratively introduce a patient to alternative perspectives concerning end-of-life, without invalidating the patient's perspective in this particularly delicate context. Practice Implications: Whilst mentalization is considered an important therapeutic process, the present study reveals precisely how this phenomenon can be enacted in therapy and within the particularly challenging context of end-of-life.

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“…32 Patients and family members sometimes responded to these types of questions by raising matters related to illness progression or end of life. 36 Also, by first soliciting a patient or family member's perspective, the clinician can then take the patient's or family member's perspective into account when providing their own perspective. 34,63 How clinicians, patients, and family members refer indirectly to the future There are a diverse range of practices that can be used to more or less indirectly refer to illness progression or end of life.…”

Section: How Clinicians Provide Opportunities For Patients or Family mentioning

confidence: 99%

Communicating with patients and families about difficult matters: A rapid review in the context of the COVID-19 pandemic

Ekberg

2020

Preprint

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Background: Pandemics pose significant challenges for healthcare systems, including an increase in difficult discussions about future illness progression and end of life.Objectives: To synthesise existing evidence about communication practices used to discuss difficult matters, including prognosis and end of life, and to use this evidence to make recommendations for clinical practice. The aim of this study was to use rapid review methods to update findings from a previous systematic review published in 2014.Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science, Scopus, ASSIA and Amed.Study eligibility criteria: Studies using conversation analysis or discourse analysis to examine recordings of actual conversations about difficult matters relating to future illness progression and end of life.Study appraisal and synthesis methods: Data appraisal and extraction procedures used in the 2014 review were modified for this rapid review.Results: Following screening, 18 sources were deemed to meet eligibility criteria, which were added to the 19 sources included in the 2014 systematic review. Synthesis of study findings identified 11 communication practices: providing opportunities for patient or family members to propose matters to discuss (7 out of 37 included sources); seeking a patient or family member's perspective (6/37); discussing the future indirectly (11/37); discussing the future explicitly (7/37) linking to something previously said or done (11/37); using hypothetical scenarios (13/37); framing a difficult matter as universal (5/37); acknowledging uncertainty (3/37); exploring options (2/37); displaying sensitivity (7/37); emphasising the positive (7/37).Limitations: Dividing work amongst the study authors to enable rapid review may have created inconsistencies. Conclusions and implications of key findings:This synthesis of high-quality evidence from actual clinical practice supports a series of recommendations for communicating about difficult matters during and beyond the COVID-19 pandemic. : medRxiv preprint Emphasising positive things, such as what can be done for a patient, can be useful for sustaining hope. When people are discussing difficult matters, however, starting to talk about positive things can end the difficult discussion. For this reason, consider when is the right time to move from the difficult aspects of a discussion, to the more positive dimensions. DiscussionThis rapid review has synthesised findings from studies examining difficult conversations about illness progression and end of life. The review focuses on high-quality evidence delivered by studies examining real-world conversations to understand how specific communication practices function in particular contexts. 14,17,18 Since publication of a systematic review on this topic in 2014, 19 evidence in this area has almost doubled. As reported in Box 1, the synthesis of findings from these studies has enabled the generation of 10 recommendations for clinicians who find themselves needing to discuss diff...

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Inviting end-of-life talk in initial CALM therapy sessions: A conversation analytic study

Cited by 25 publications

References 54 publications

Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature

Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature

Mentalization in CALM psychotherapy sessions: Helping patients engage with alternative perspectives at the end of life

Communicating with patients and families about difficult matters: A rapid review in the context of the COVID-19 pandemic

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