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Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence

BACKGROUND: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. AIM: To review qualitative...

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Autores principales: Anderson, Rebecca J, Bloch, Steven, Armstrong, Megan, Stone, Patrick C, Low, Joseph TS
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691601/
https://www.ncbi.nlm.nih.gov/pubmed/31184529
http://dx.doi.org/10.1177/0269216319852007
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author Anderson, Rebecca J
Bloch, Steven
Armstrong, Megan
Stone, Patrick C
Low, Joseph TS
author_facet Anderson, Rebecca J
Bloch, Steven
Armstrong, Megan
Stone, Patrick C
Low, Joseph TS
author_sort Anderson, Rebecca J
collection PubMed
description BACKGROUND: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. AIM: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. DESIGN: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. DATA SOURCES: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. RESULTS: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient’s deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. CONCLUSION: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.
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spelling pubmed-66916012019-09-16 Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence Anderson, Rebecca J Bloch, Steven Armstrong, Megan Stone, Patrick C Low, Joseph TS Palliat Med Review Articles BACKGROUND: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. AIM: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. DESIGN: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. DATA SOURCES: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. RESULTS: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient’s deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. CONCLUSION: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals. SAGE Publications 2019-06-11 2019-09 /pmc/articles/PMC6691601/ /pubmed/31184529 http://dx.doi.org/10.1177/0269216319852007 Text en © The Author(s) 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Anderson, Rebecca J
Bloch, Steven
Armstrong, Megan
Stone, Patrick C
Low, Joseph TS
Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title_full Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title_fullStr Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title_full_unstemmed Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title_short Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
title_sort communication between healthcare professionals and relatives of patients approaching the end-of-life: a systematic review of qualitative evidence
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691601/
https://www.ncbi.nlm.nih.gov/pubmed/31184529
http://dx.doi.org/10.1177/0269216319852007
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