A quantitative study exploring the differences in communication between patients, the family care giver and health care professionals in a palliative care clinic setting.

Author: Kate Swetenham

Swetenham, Kate, 2017 A quantitative study exploring the differences in communication between patients, the family care giver and health care professionals in a palliative care clinic setting., Flinders University, School of Health Sciences

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Background: Southern Adelaide Palliative Care Services introduced a nurse-led early introduction to palliative care clinic in 2011. The clinic offers a thorough psychosocial assessment and the provision of information and an introduction to future care planning. The patients and their caregivers are seen together by the nurse practitioner initially for a physical assessment. They are then seen by a social worker to focus on advanced care planning and assessment of social and emotional factors. After the social work visit, the patient and caregiver are separated, and the patient sees the psychosocial nurse for coping and adjustment to illness and the carer sees the caregiver network facilitator to assess their informal supports to assist in the role of community-based caregiving. The pilot study looks at the nature of communication in the clinic where patient and carer are together and compares that to when they are separated.

Methods: A total of 33 patients and their caregivers agreed for their conversations to be tape recorded between May and November of 2013. All tape recordings were transcribed verbatim. Ten patient and caregiver transcripts (n=40) have been coded for quantitative analysis. The codes identify content and function of speech, cues for information and emotion and whether they are responded to by clinicians.

Results: Pilot results reveal that caregivers contribute little in the combined consultations but dominate the conversation in the individual consultations. Patients, when seen alone, predominantly express emotional cues, rather than cues for information. The clinicians focus on their area of specialty, which results in little duplication in this clinical setting.

Conclusion: An earlier evaluation of this clinic found that patients and their caregivers appreciate being given separate opportunities to meet with health professionals and the privacy to reveal fears and feelings related to end-of-life care. This current study quantifies the patient and caregiver experience and builds on these earlier findings.

Keywords: Palliative Care, Communication, Triadic Communication, Dyadic Communication, Family caregiver, Psychosocial outpatient clinic

Subject: Health Sciences thesis

Thesis type: Masters
Completed: 2017
School: School of Health Sciences
Supervisor: Professor David Currow