Which Critical Communication Skills Are Essential for Interdisciplinary End-of-Life Discussions?

doi:10.1001/amajethics.2018.724

Cited by 22 publications

(32 citation statements)

References 13 publications

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“…HCPs also suggested that communication training should be tailored to their scope of practice. The literature supports a team-based model for successful conversations by dividing responsibilities among team members and alleviating pressure [ 1 ]. Physicians were often seen as HCPs responsible for conducting prognostic and decision-making conversations, while nurses often promoted FCs’ understanding by translating what physicians had said into jargon-free information and bringing together information from different sources [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…End-of-life conversations are some of the most challenging of all communication contexts and occur in a variety of healthcare settings, including nursing homes (NHs) [ 1 , 2 ]. These conversations may involve patients and/or their family caregivers (FCs) and cover discussions about clinical conditions, course of disease and prognosis, treatment goals and options, symptom management, end-of-life wishes, and plans for the future care [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study

Gonella

Giulio

Antal

et al. 2022

IJERPH

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End-of-life conversations are among the most challenging of all communication scenarios and on the agenda of several healthcare settings, including nursing homes (NHs). They may be also difficult for experienced healthcare professionals (HCPs). This study explores the difficulties experienced by Italian NH staff in end-of-life conversations with family caregivers (FCs) during COVID-19 pandemic to uncover their educational needs. A qualitative descriptive study based on inductive thematic analysis was performed. Twenty-one HCPs across six Italian NHs were interviewed. Four themes described their experiences of end-of-life conversations: (1) communicating with FCs over the overall disease trajectory; (2) managing challenging emotions and situations; (3) establishing a partnership between HCPs and FCs; (4) addressing HCPs’ communication skills needs. HCPs had to face multiple challenging situations that varied across the care period as well as complex emotions such as anxiety, guilt, uncertainty, fear, anger, or suffering, which required tailored answers. COVID-19 pandemic increased FCs’ aggressive behaviors, their distrust, and uncertainty due to visitation restrictions. HCPs had to overcome this by developing a set of strategies, including adoption of an active-listening approach, supportive communication, and explicit acknowledgement of FCs’ emotions. Since communication needs were mostly practical in nature, HCPs valued practical communication training.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study

Gonella

Giulio

Antal

et al. 2022

IJERPH

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“…There are already many strategies and frameworks designed to inform the conduct of discussions about illness progression and end of life [ 73 , 74 ]. Prominent contemporary approaches include the SPIKES protocol [ 75 ], VitalTalk [ 76 ], and the Serious Illness Conversation Guide (SICG) [ 77 ].…”

Section: Discussionmentioning

confidence: 99%

Communicating with patients and families about illness progression and end of life: a review of studies using direct observation of clinical practice

et al. 2021

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Background There is growing recognition that a diverse range of healthcare professionals need competence in palliative approaches to care. Effective communication is a core component of such practice. This article informs evidence-based communication about illness progression and end of life through a rapid review of studies that directly observe how experienced clinicians manage such discussions. Methods The current rapid review updates findings of a 2014 systematic review, focussing more specifically on evidence related to illness progression and end-of-life conversations. Literature searches were conducted in nine bibliographic databases. Studies using conversation analysis or discourse analysis to examine recordings of actual conversations about illness progression or end of life were eligible for inclusion in the review. An aggregative approach was used to synthesise the findings of included studies. Results Following screening, 26 sources were deemed to meet eligibility criteria. Synthesis of study findings identified the structure and functioning of ten communication practices used in discussions about illness progression and end-of-life. Conclusion The ten practices identified underpin five evidence-based recommendations for communicating with patients or family members about illness progression and end of life.

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“…Over the past 30 years, numerous strategies and frameworks for end-of-life (EOL) discussions have been developed and implemented with success. Such frameworks include the SPIKES 6-step protocol, the ABCDE Plan, and VitalTalk [29]. A collaborative approach that engages a team of professionals, including doctors, nurses, social workers, and psychologists, can facilitate EOL discussion.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

Bai

Yao

et al. 2019

BMC Med Educ

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Background Effective doctor-patient communication (DPC) is important to improve the quality of care and treatment outcomes. This study aimed to evaluate the effectiveness of a modified DPC training programme designed for surgical residents in China. Methods A total of 210 surgical residents from 7 specialties were recruited to participate in a communication skills training programme. The extended SEGUE scale was administered to supervisors, and a visual analogue scale (VAS) was administered to standardized patients (SPs) and trainees. Evaluations were conducted by comparing the pre-post scale scores (before, immediately after and 1 month after the programme). Training effects were assessed using the Friedman test and the intraclass correlation coefficient (ICC). Results Compared to the extended SEGUE scale total scores before the programme, the scores both immediately after and 1 month after the program increased significantly (15.88 ± 1.93 vs. 26.40 ± 1.47 and 26.15 ± 1.36, respectively, p < 0.001). The scores of five of the six dimensions in the extended SEGUE scale significantly increased (p < 0.001), except for the patient’s perspective dimension score, which had no change ( p = 0.162). With respect to this dimension, a subgroup analysis by gender indicated an increase among females ( p < 0.001) and a decrease among males (p < 0.001). The VAS scores, which were evaluated for the SPs and trainees, increased significantly compared to the scores before the program, both immediately after and 1 month after the programme (4.31 ± 1.35 vs. 7.36 ± 1.62 and 7.34 ± 1.24, p < 0.001; 7.31 ± 1.25 vs. 8.39 ± 1.32 and 8.30 ± 1.24, p < 0.001, respectively). The consistency of the VAS between the SPs and surgical residents was 0.26 ( p < 0.001), 0.70 (p < 0.001), and 0.70 (p < 0.001) before, immediately after and 1 month after the programme, respectively. Conclusion This training programme improved the DPC competency of surgical residents, effectively increased the levels of satisfaction of both SPs and surgical residents, and improved the consistency of evaluation between SPs and surgical residents during doctor-patient encounters. The registration UIN is ChiCTR1800019790 from November 28, 2018. Electronic supplementary material The online version of this article (10.1186/s12909-019-1776-7) contains supplementary material, which is available to authorized users.

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Which Critical Communication Skills Are Essential for Interdisciplinary End-of-Life Discussions?

Cited by 22 publications

References 13 publications

Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study

Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study

Communicating with patients and families about illness progression and end of life: a review of studies using direct observation of clinical practice

Effectiveness of a modified doctor–patient communication training Programme designed for surgical residents in China: a prospective, large-volume study at a single Centre

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