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Early palliative care integration trial: consultation content and interaction dynamics.
Kleiner, Nadine; Zambrano, Sofia C; Eychmüller, Steffen; Zwahlen, Susanne.
Afiliación
  • Kleiner N; University Centre for Palliative Care, Oncology Department, Inselspital University Hospital Bern, Bern, Switzerland.
  • Zambrano SC; University Centre for Palliative Care, Oncology Department, Inselspital University Hospital Bern, Bern, Switzerland sofia.zambrano@extern.insel.ch.
  • Eychmüller S; University Centre for Palliative Care, Oncology Department, Inselspital University Hospital Bern, Bern, Switzerland.
  • Zwahlen S; University Centre for Palliative Care, Oncology Department, Inselspital University Hospital Bern, Bern, Switzerland.
BMJ Support Palliat Care ; 2021 Jan 08.
Article en En | MEDLINE | ID: mdl-33419859
OBJECTIVES: Evidence for the positive impact of the early integration of palliative care (EPC) continues to grow. Less is known about how EPC improves patient and family outcomes, including the content of EPC consultations. Therefore, we aimed to better understand the content of EPC consultations including areas addressed, percentage covered per area and interaction style. METHODS: As part of a trial in which EPC in addition to oncology care was compared with oncology care alone, we audio recorded 10 interventions. The palliative care team led the interventions using SENS, a conversation structure, which stands for: Symptoms, End-of-life decision-making, Network and Support. We employed two approaches to analysis: the Roter interaction analysis system (RIAS) to analyse interaction dynamics and SENS as a framework for content analysis. RESULTS: Physician-patient communication covered 91% of the interaction. According to RIAS, the consultations were evenly dominated between physicians and patients (ratio=1.04) and highly patient-centred (ratio=1.26). Content wise, rapport was the largest category covering 27% of the consultation, followed by decision-making (21%) and by symptom assessment/management (17%) including 8.1% for physical symptoms and 5.4% for psychosocial aspects. Network discussions covered 17%, and lastly, support for the family 7%. CONCLUSIONS: EPC consultations cover a variety of end-of-life topics while putting a high value in establishing rapport, developing a relationship with patients, and on providing reassurance and positive emotional talk. EPC consultations using predefined structures may guarantee that a minimum of important aspects are addressed in a way in which the relationship with the patient remains at the centre.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Aspecto: Patient_preference Idioma: En Revista: BMJ Support Palliat Care Año: 2021 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Aspecto: Patient_preference Idioma: En Revista: BMJ Support Palliat Care Año: 2021 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Reino Unido