TY - JOUR
T1 - Communicating with dying patients within the spectrum of medical care from terminal diagnosis to death
AU - Wenrich, Marjorie D.
AU - Curtis, J. Randall
AU - Shannon, Sarah E.
AU - Carline, Jan D.
AU - Ambrozy, Donna M.
AU - Ramsey, Paul G.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2001/3/26
Y1 - 2001/3/26
N2 - Background: Efforts to improve communication between physicians and dying patients have been unsuccessful, and guidelines for improving patient-physician communication about end-of-life care are based primarily on expert opinion. This study assessed which aspects of communication between patients and physicians are important in end-of-life care. Methods: Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care professionals from hospice or acute care settings, and physicians with expertise in end-of-life care. Focus group analyses determiMed domains of physician skill at end-of-life care. Communication with patients was identified as one of the most important domains. Analyses of components important in communicating with dying patients and their families were performed. Results: The following 6 areas were of central importance in communicating with dying patients: talking with patients in an honest and straightforward way, being willing to talk about dying, giving bad news in a sensitive way, listening to patients, encouraging questions from patients, and being sensitive to when patients are ready to talk about death. Within these components, subthemes emerged that provide guidelines for physicians and educators. Dying patients also identified the need to achieve a balance between being honest and straightforward and not discouraging hope. Conclusions: Several areas emerged for physicians to focus their attention on when communicating with dying patients. These findings provide guidance in how to improve this communication. They also highlight the need to approach communication about end-of-life care as a spectrum that requires attention from the time of a terminal diagnosis through death.
AB - Background: Efforts to improve communication between physicians and dying patients have been unsuccessful, and guidelines for improving patient-physician communication about end-of-life care are based primarily on expert opinion. This study assessed which aspects of communication between patients and physicians are important in end-of-life care. Methods: Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care professionals from hospice or acute care settings, and physicians with expertise in end-of-life care. Focus group analyses determiMed domains of physician skill at end-of-life care. Communication with patients was identified as one of the most important domains. Analyses of components important in communicating with dying patients and their families were performed. Results: The following 6 areas were of central importance in communicating with dying patients: talking with patients in an honest and straightforward way, being willing to talk about dying, giving bad news in a sensitive way, listening to patients, encouraging questions from patients, and being sensitive to when patients are ready to talk about death. Within these components, subthemes emerged that provide guidelines for physicians and educators. Dying patients also identified the need to achieve a balance between being honest and straightforward and not discouraging hope. Conclusions: Several areas emerged for physicians to focus their attention on when communicating with dying patients. These findings provide guidance in how to improve this communication. They also highlight the need to approach communication about end-of-life care as a spectrum that requires attention from the time of a terminal diagnosis through death.
UR - http://www.scopus.com/inward/record.url?scp=0035953141&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035953141&partnerID=8YFLogxK
U2 - 10.1001/archinte.161.6.868
DO - 10.1001/archinte.161.6.868
M3 - Article
C2 - 11268231
AN - SCOPUS:0035953141
SN - 0003-9926
VL - 161
SP - 868
EP - 874
JO - Archives of internal medicine
JF - Archives of internal medicine
IS - 6
ER -