Dori Seccareccia1,2, Kirsten Wentlandt1, Nanor Kevork3, Kevin Workentin2,4, Susan Blacker5, Lucia Gagliese3,6,7,8,9, Daphna Grossman2,10, Camilla Zimmermann3,11,9. 1. 1 Department of Psychosocial Oncology, Sunnybrook Health Sciences Centre , Toronto, Ontario, Canada . 2. 2 Department of Family and Community Medicine, University of Toronto , Toronto, Ontario, Canada . 3. 3 Department of Supportive Care, University Health Network , Toronto, Ontario, Canada . 4. 4 Department of Family Medicine, Toronto East General Hospital , Toronto, Ontario, Canada . 5. 5 Department of Cancer Services Planning and Performance, St. Michael's Hospital , Toronto, Ontario, Canada . 6. 6 Department of Anesthesia and Psychiatry, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada . 7. 7 School of Kinesiology and Health Sciences, York University , Toronto, Ontario, Canada . 8. 8 Department of Anesthesia, University Health Network , Toronto, Ontario, Canada . 9. 11 Campbell Family Cancer Research Institute, Ontario Cancer Institute , Toronto, Ontario, Canada . 10. 9 Department of Family and Community Medicine , Baycrest Health Sciences, Toronto, Ontario, Canada . 11. 10 Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto , Toronto, Ontario, Canada .
Abstract
BACKGROUND: Clinician-patient communication is central in palliative care, but it has not been described qualitatively which specific elements of communication are important for high-quality palliative care, particularly in the inpatient setting. OBJECTIVE: Our aim was to identify elements of communication that are central to quality of care and satisfaction with care on palliative care units (PCUs), as described by inpatients, family caregivers, and health care providers. METHODS: Qualitative interviews with patients/caregivers and focus groups with staff were conducted on four PCUs. Semi-structured interviews and focus groups elicited thoughts about the characteristics of satisfaction with care and quality of care for PCU inpatients and their family caregivers. Data were analyzed using a grounded theory method with an inductive, constant comparison approach; themes were coded to saturation. RESULTS: There were 46 interviews and eight focus groups. Communication was the most prevalent theme regarding satisfaction and quality of care, with five subthemes describing elements important to patients, caregivers, and staff. These included: 1) building rapport with patients and families to build trust and kinship; 2) addressing expectations and explaining goals of care; 3) keeping patients and families informed about the patient's condition; 4) listening actively to validate patients' concerns and individual needs; and 5) providing a safe space for conversations about death and dying. CONCLUSIONS: Patients, family caregivers, and health care providers affirmed that communication is a central element of quality of care and family satisfaction on PCUs. The five subthemes identified may serve as a structure for education and for quality improvement tools in palliative care inpatient settings.
BACKGROUND: Clinician-patient communication is central in palliative care, but it has not been described qualitatively which specific elements of communication are important for high-quality palliative care, particularly in the inpatient setting. OBJECTIVE: Our aim was to identify elements of communication that are central to quality of care and satisfaction with care on palliative care units (PCUs), as described by inpatients, family caregivers, and health care providers. METHODS: Qualitative interviews with patients/caregivers and focus groups with staff were conducted on four PCUs. Semi-structured interviews and focus groups elicited thoughts about the characteristics of satisfaction with care and quality of care for PCU inpatients and their family caregivers. Data were analyzed using a grounded theory method with an inductive, constant comparison approach; themes were coded to saturation. RESULTS: There were 46 interviews and eight focus groups. Communication was the most prevalent theme regarding satisfaction and quality of care, with five subthemes describing elements important to patients, caregivers, and staff. These included: 1) building rapport with patients and families to build trust and kinship; 2) addressing expectations and explaining goals of care; 3) keeping patients and families informed about the patient's condition; 4) listening actively to validate patients' concerns and individual needs; and 5) providing a safe space for conversations about death and dying. CONCLUSIONS:Patients, family caregivers, and health care providers affirmed that communication is a central element of quality of care and family satisfaction on PCUs. The five subthemes identified may serve as a structure for education and for quality improvement tools in palliative care inpatient settings.
Authors: Joan G Carpenter; Meghan McDarby; Dawn Smith; Megan Johnson; Joshua Thorpe; Mary Ersek Journal: J Palliat Med Date: 2017-05-04 Impact factor: 2.947
Authors: Lauren T Starr; Connie M Ulrich; Paul Junker; Scott M Appel; Nina R O'Connor; Salimah H Meghani Journal: J Pain Symptom Manage Date: 2020-05-23 Impact factor: 3.612
Authors: Eva K Masel; Anna Kitta; Patrick Huber; Tamara Rumpold; Matthias Unseld; Sophie Schur; Edit Porpaczy; Herbert H Watzke Journal: PLoS One Date: 2016-07-07 Impact factor: 3.240