Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Walczak, A; Butow, PN; Davidson, PM; Bellemore, FA; Tattersall, MHN; Clayton, JM; Young, J; Mazer, B; Ladwig, S; Epstein, RM

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

Walczak, A Butow, PN Davidson, PM

Bellemore, FA Tattersall, MHN Clayton, JM Young, J Mazer, B Ladwig, S Epstein, RM

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Publication Type:: Journal Article
Citation:: Patient Education and Counseling, 2013, 90 (3), pp. 307 - 314
Issue Date:: 2013-03-01

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Field	Value	Language
dc.contributor.author	Walczak, A	en_US
dc.contributor.author	Butow, PN	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Bellemore, FA	en_US
dc.contributor.author	Tattersall, MHN	en_US
dc.contributor.author	Clayton, JM	en_US
dc.contributor.author	Young, J	en_US
dc.contributor.author	Mazer, B	en_US
dc.contributor.author	Ladwig, S	en_US
dc.contributor.author	Epstein, RM	en_US
dc.date.available	2011-08-15	en_US
dc.date.issued	2013-03-01	en_US
dc.identifier.citation	Patient Education and Counseling, 2013, 90 (3), pp. 307 - 314	en_US
dc.identifier.issn	0738-3991	en_US
dc.identifier.uri	http://hdl.handle.net/10453/23928
dc.description.abstract	Objective: To explore patients' perspectives across two cultures (Australia and USA) regarding communication about prognosis and end-of-life care issues and to consider the ways in which these discussions can be optimised. Methods: Fifteen Australian and 11 US patients completed individual semi-structured qualitative interviews. A further 8 US patients participated in a focus group. Interviews and focus group recordings were transcribed verbatim and interpreted using thematic text analysis with an inductive, data-driven approach. Results: Global themes identified included readiness for and outcomes of discussions of prognosis and end-of-life issues. Contributing to readiness were sub themes including patients' adjustment to and acceptance of their condition (together with seven factors promoting this), doctor and patient communication skills, mutual understandings and therapeutic relationship elements. Outcomes included sub themes of achievement of control and ability to move on. A model of the relationships between these factors, emergent cross cultural differences, and how factors may help to optimise these discussions are presented. Conclusion: Identified optimising factors illustrate Australian and US patients' perspectives regarding how prognosis and end-of-life issues can be discussed with minimised negative impact. Practice implications: Recognition of factors promoting adjustment, acceptance and readiness and use of the communication skills and therapeutic relationship elements identified may assist in optimising discussions and help patients plan care, achieve more control of their situation and enjoy an optimal quality-of-life. © 2011 Elsevier Ireland Ltd.	en_US
dc.relation.ispartof	Patient Education and Counseling	en_US
dc.relation.isbasedon	10.1016/j.pec.2011.08.009	en_US
dc.subject.classification	Public Health	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Prognosis	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Terminal Care	en_US
dc.subject.mesh	Focus Groups	en_US
dc.subject.mesh	Communication	en_US
dc.subject.mesh	Physician-Patient Relations	en_US
dc.subject.mesh	Counseling	en_US
dc.subject.mesh	Cross-Cultural Comparison	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Patients	en_US
dc.subject.mesh	Terminally Ill	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Interviews as Topic	en_US
dc.title	Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	90	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	90	en_US

Abstract:

Objective: To explore patients' perspectives across two cultures (Australia and USA) regarding communication about prognosis and end-of-life care issues and to consider the ways in which these discussions can be optimised. Methods: Fifteen Australian and 11 US patients completed individual semi-structured qualitative interviews. A further 8 US patients participated in a focus group. Interviews and focus group recordings were transcribed verbatim and interpreted using thematic text analysis with an inductive, data-driven approach. Results: Global themes identified included readiness for and outcomes of discussions of prognosis and end-of-life issues. Contributing to readiness were sub themes including patients' adjustment to and acceptance of their condition (together with seven factors promoting this), doctor and patient communication skills, mutual understandings and therapeutic relationship elements. Outcomes included sub themes of achievement of control and ability to move on. A model of the relationships between these factors, emergent cross cultural differences, and how factors may help to optimise these discussions are presented. Conclusion: Identified optimising factors illustrate Australian and US patients' perspectives regarding how prognosis and end-of-life issues can be discussed with minimised negative impact. Practice implications: Recognition of factors promoting adjustment, acceptance and readiness and use of the communication skills and therapeutic relationship elements identified may assist in optimising discussions and help patients plan care, achieve more control of their situation and enjoy an optimal quality-of-life. © 2011 Elsevier Ireland Ltd.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/23928