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Identifying Challenges to Communicating with Patients about Their Imminent Death.

Hoff, Lena LU and Hermerén, Göran LU (2014) In Journal of Clinical Ethics 25(4). p.296-306
Abstract
The research literature suggests that physicians' attitudes regarding disclosing a diagnosis of cancer have changed, from nondisclosure to full disclosure. Physicians' attitudes towards disclosing a patient's prognosis are likewise said to have changed, although not to the same degree. The aim of this study was to identify inherent challenges in communicating information about imminent death. It included one set of interviews with patients and another set with doctors, and subsequent discussions of ways to overcome obstacles to patients' understanding their situation. Patients were diagnosed with leukemia, myeloma, or lung cancer; the doctors were hematologists and lung oncologists. The two sets of interviews were analyzed separately using... (More)
The research literature suggests that physicians' attitudes regarding disclosing a diagnosis of cancer have changed, from nondisclosure to full disclosure. Physicians' attitudes towards disclosing a patient's prognosis are likewise said to have changed, although not to the same degree. The aim of this study was to identify inherent challenges in communicating information about imminent death. It included one set of interviews with patients and another set with doctors, and subsequent discussions of ways to overcome obstacles to patients' understanding their situation. Patients were diagnosed with leukemia, myeloma, or lung cancer; the doctors were hematologists and lung oncologists. The two sets of interviews were analyzed separately using a content analysis model developed by Graneheim and Lundman. For each set of interviews, eight content areas were defined as belonging to an area of interest and scrutinized for the information they included regarding communicating prognoses to patients. The main finding was a discrepancy between patients' desire to be fully informed regarding their prognosis and physicians' reluctance to offer a prognosis until a patient had overt signs of approaching death. We conclude that existing guidelines for disclosure of bad news should be modified to encourage disclosure and discussion of uncertain prognostic information, unless a patient is clearly opposed to receiving such information or otherwise not a suitable partner for dialogue. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Ethics
volume
25
issue
4
pages
296 - 306
publisher
Journal of Clinical Ethics
external identifiers
  • PMID:25517566
  • Scopus:84922535618
ISSN
1046-7890
language
English
LU publication?
yes
id
08ef3583-d4ad-4f56-8e99-ef9b3de99aea (old id 4908049)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25517566?dopt=Abstract
date added to LUP
2015-01-07 15:36:36
date last changed
2016-10-13 04:32:18
@misc{08ef3583-d4ad-4f56-8e99-ef9b3de99aea,
  abstract     = {The research literature suggests that physicians' attitudes regarding disclosing a diagnosis of cancer have changed, from nondisclosure to full disclosure. Physicians' attitudes towards disclosing a patient's prognosis are likewise said to have changed, although not to the same degree. The aim of this study was to identify inherent challenges in communicating information about imminent death. It included one set of interviews with patients and another set with doctors, and subsequent discussions of ways to overcome obstacles to patients' understanding their situation. Patients were diagnosed with leukemia, myeloma, or lung cancer; the doctors were hematologists and lung oncologists. The two sets of interviews were analyzed separately using a content analysis model developed by Graneheim and Lundman. For each set of interviews, eight content areas were defined as belonging to an area of interest and scrutinized for the information they included regarding communicating prognoses to patients. The main finding was a discrepancy between patients' desire to be fully informed regarding their prognosis and physicians' reluctance to offer a prognosis until a patient had overt signs of approaching death. We conclude that existing guidelines for disclosure of bad news should be modified to encourage disclosure and discussion of uncertain prognostic information, unless a patient is clearly opposed to receiving such information or otherwise not a suitable partner for dialogue.},
  author       = {Hoff, Lena and Hermerén, Göran},
  issn         = {1046-7890},
  language     = {eng},
  number       = {4},
  pages        = {296--306},
  publisher    = {ARRAY(0xaff8838)},
  series       = {Journal of Clinical Ethics},
  title        = {Identifying Challenges to Communicating with Patients about Their Imminent Death.},
  volume       = {25},
  year         = {2014},
}