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Palliative care physicians' experiences of end-of-life communication: A focus group study.
Högskolan Dalarna, Landstinget Dalarna.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Karolinska Institutet, Astrid Lindgrens barnsjukhus.ORCID iD: 0000-0003-4736-500X
Landstinget Dalarna.
Umeå universitet.
2018 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 1Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.e. proactively. However, BPC was often conducted as a reaction to the patient's sudden deterioration or sometimes not at all. The barriers to achieving proactive BPC included physicians' uncertainty regarding the timing of BPC, primarily due to difficulties in prognostication in terms of time of death, and uncertainty as to what BPC should include and how it should best be approached. Furthermore, there was insufficient documentation regarding previous BPC, which impeded proactive BPC. Although our study shows that physicians are ambitious when it comes to the communication of information to patients and families, there is a need for further training in how to conduct BPC and when to initiate the BPC process. Furthermore, there should be documentation that different professionals can access as this would appear to facilitate a proactive BPC process.

Place, publisher, year, edition, pages
2018. Vol. 27, no 1
Keywords [en]
Communication, End of life, Palliative care, Physicians
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
URN: urn:nbn:se:esh:diva-6627DOI: 10.1111/ecc.12728PubMedID: 28727207OAI: oai:DiVA.org:esh-6627DiVA, id: diva2:1182299
Available from: 2018-02-12 Created: 2018-02-12 Last updated: 2018-02-13Bibliographically approved

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