Screening for the Desire to Die in the First Palliative Care Encounter: A Proof-of-Concept Study

Crespo, Iris; Monforte-Royo, Cristina; Balaguer, Albert; Pergolizzi, Denise; Cruz-Sequeiros, Claudia; Luque-Blanco, Ana; Porta-Sales, Josep

doi:10.1089/jpm.2020.0276

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…11 The initial encounter must therefore provide patients the opportunity to express all their needs, which includes broaching the difficult topic of death and dying. 13 This is important as unmet needs are associated with greater emotional distress and increased costs of end-of-life care. [14][15][16][17] As in the triangle of care model that has been described in relation to dementia, 18 palliative care involves a collaborative relationship between patient, family carers and health professionals, one for which the initial encounter can set the tone.…”

Section: Introductionmentioning

confidence: 99%

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What makes the palliative care initial encounter meaningful? A descriptive study with patients with cancer, family carers and palliative care professionals

et al. 2023

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Background: The palliative care initial encounter can have a positive impact on the quality of life of patients and family carers if it proves to be a meaningful experience. A better understanding of what makes the encounter meaningful would reinforce the provision of person-centred, quality palliative care. Aim: To explore the expectations that patients with cancer, family carers and palliative care professionals have of this initial encounter. Design: Qualitative descriptive study with content analysis of transcripts from 60 semi-structured interviews. Setting/participants: Twenty patients with cancer, 20 family carers and 20 palliative care professionals from 10 institutions across Spain. Results: Four themes were developed from the analysis of interviews: (1) the initial encounter as an opportunity to understand what palliative care entails; (2) individualised care; (3) professional commitment to the patient and family carers: present and future; and (4) acknowledgement. Conclusion: The initial encounter becomes meaningful when it facilitates a shared understanding of what palliative care entails and acknowledgement of the needs and/or roles of patients with cancer, family carers and professionals. Further studies are required to explore how a perception of acknowledgement may best be fostered in the initial encounter.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What makes the palliative care initial encounter meaningful? A descriptive study with patients with cancer, family carers and palliative care professionals

et al. 2023

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“…Potential taboos can come from a widespread misbelief that addressing a desire to die might cause or increase it, which may trigger health professionals to act defensively (Hvidt et al, 2017). A lack of training in communication about desire to die and the fear of being emotionally overwhelmed by such a conversation may lead to an avoidance of the topic altogether (Lenherr et al, 2012;Galushko et al, 2016) even though patients explicitly wish for their health professionals to address these issues proactively (An et al, 2017;Crespo et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

How do trained palliative care providers experience open desire to die-conversations? An explorative thematic analysis

et al. 2022

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Objectives Despite the potential benefits of open communication about possible desires to die for patients receiving palliative care, health professionals tend to avoid such conversations and often interpret desires to die as requests for medical aid in dying. After implementing trainings to foster an open, proactive approach toward desire to die, we requested trained health professionals to lead and document desire to die-conversations with their patients. In this article, we explore how trained health professionals experience an open (proactive) approach to desire to die-conversations with their patients. Methods Between April 2018 and March 2020, health professionals recorded their conversation-experiences on documentation sheets by answering seven open questions. A subsample was invited to offer deeper insights through semi-structured qualitative interviews. Interviews and documentation sheets were transcribed verbatim and analyzed thematically, then findings from both sources were compared and synthesized. Results Overall, N = 29 trained health professionals documented N = 81 open desire to die-conversations. A subsample of n = 13 health professionals participated in qualitative interviews. Desire to die-conversations after the training were reported as a complex but overall enriching experience, illustrated in seven themes: (1) beneficial (e.g., establishing good rapport) and (2) hindering aspects (e.g., patients’ emotional barriers) of desire to die-conversations, (3) follow-up measures, (4) ways of addressing desire to die, as well as (5) patient reactions to it. The interviews offered space for health professionals to talk about (6) content of desire to die-conversation and (7) (self-)reflection (e.g., on patients’ biographies or own performance). Significance of results As part of an open (proactive) approach, desire to die-conversations hold potential for health professionals’ (self-)reflection and a deeper understanding of patient background and needs. They may lead to a strengthened health professional–patient relationship and potentially prevent suicide.

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Development of a Guide to Multidimensional Needs Assessment in the Palliative Care Initial Encounter (MAP)

Goni-Fuste

Pergolizzi

Monforte-Royo

et al. 2023

Journal of Pain and Symptom Management

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Screening for the Desire to Die in the First Palliative Care Encounter: A Proof-of-Concept Study

Cited by 5 publications

References 15 publications

What makes the palliative care initial encounter meaningful? A descriptive study with patients with cancer, family carers and palliative care professionals

What makes the palliative care initial encounter meaningful? A descriptive study with patients with cancer, family carers and palliative care professionals

How do trained palliative care providers experience open desire to die-conversations? An explorative thematic analysis

Development of a Guide to Multidimensional Needs Assessment in the Palliative Care Initial Encounter (MAP)

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