TY - JOUR
T1 - Are We Making Progress on Communication with People Who Are Near the End of Life in the Australian Health System? A Thematic Analysis
AU - Trankle, Steven A
AU - Shanmugam, Shantiban
AU - Lewis, Ebony
AU - Nicholson, Margaret
AU - Hillman, Ken
AU - Cardona, Magnolia
PY - 2020/1/28
Y1 - 2020/1/28
N2 - Initiating end-of-life (EoL) discussions with patients is often delayed or avoided altogether by healthcare practitioners even in light of imminent death. This continues despite the availability of guidelines and conceptual frameworks on how to communicate prognoses at EoL. We surveyed healthcare practitioners to elicit their exposure to and confidence in EoL discussions and to better understand factors that enable or challenge the initiation of discussions in Australian healthcare settings. Thematic analysis identified that EoL discussions could be emotionally burdensome for healthcare practitioners but were regarded as valuable. Effective communications were challenged by conflict with families and between healthcare practitioners as to appropriate care goal transition, and by prognostic uncertainty. Communication skills appeared to be developed more from experience, and beneficial strategies such as role play and mentoring particularly for younger nurses and doctors were identified. Specific training in EoL communications should target undergraduates and new healthcare practitioners.
AB - Initiating end-of-life (EoL) discussions with patients is often delayed or avoided altogether by healthcare practitioners even in light of imminent death. This continues despite the availability of guidelines and conceptual frameworks on how to communicate prognoses at EoL. We surveyed healthcare practitioners to elicit their exposure to and confidence in EoL discussions and to better understand factors that enable or challenge the initiation of discussions in Australian healthcare settings. Thematic analysis identified that EoL discussions could be emotionally burdensome for healthcare practitioners but were regarded as valuable. Effective communications were challenged by conflict with families and between healthcare practitioners as to appropriate care goal transition, and by prognostic uncertainty. Communication skills appeared to be developed more from experience, and beneficial strategies such as role play and mentoring particularly for younger nurses and doctors were identified. Specific training in EoL communications should target undergraduates and new healthcare practitioners.
UR - http://www.scopus.com/inward/record.url?scp=85057610471&partnerID=8YFLogxK
U2 - 10.1080/10410236.2018.1548335
DO - 10.1080/10410236.2018.1548335
M3 - Article
C2 - 30475078
SN - 1041-0236
VL - 35
SP - 158
EP - 167
JO - Health Communication
JF - Health Communication
IS - 2
ER -