Journal
HEALTH EXPECTATIONS
Volume 19, Issue 4, Pages 883-896Publisher
WILEY
DOI: 10.1111/hex.12384
Keywords
advance care planning; end-of-life communication; mixed methods; patient preference; physician-patient relations
Categories
Funding
- Technology Evaluation in the Elderly, a Government of Canada Network Centre of Excellence Program [2013-RFP2012-03-01]
- Research Early Career Award from Hamilton Health Sciences
Ask authors/readers for more resources
Background Despite the recognized importance of end-of-life (EOL) communication between patients and physicians, the extent and quality of such communication is lacking. Objective We sought to understand patient perspectives on physician behaviours during EOL communication. Design In this mixed methods study, we conducted quantitative and qualitative strands and then merged data sets during a mixed methods analysis phase. In the quantitative strand, we used the quality of communication tool (QOC) to measure physician behaviours that predict global rating of satisfaction in EOL communication skills, while in the qualitative strand we conducted semi-structured interviews. During the mixed methods analysis, we compared and contrasted qualitative and quantitative data. Setting and Participants Seriously ill inpatients at three tertiary care hospitals in Canada. Results We found convergence between qualitative and quantitative strands: patients desire candid information from their physician and a sense of familiarity. The quantitative results (n = 132) suggest a paucity of certain EOL communication behaviours in this seriously ill population with a limited prognosis. The qualitative findings (n = 16) suggest that at times, physicians did not engage in EOL communication despite patient readiness, while sometimes this may represent an appropriate deferral after assessment of a patient's lack of readiness. Conclusions Avoidance of certain EOL topics may not always be a failure if it is a result of an assessment of lack of patient readiness. This has implications for future tool development: a measure could be built in to assess whether physician behaviours align with patient readiness.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available