Research Article
How do Physicians Talk and what do They Say in the Difficult Conversations with Patients and their Loved Ones in Palliative Care? A Qualitative Study to Investigate Strategies to Help Improve Difficult Conversations
Benkel I1* and Molander U2,31Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, S-413 45, Sweden
2Department of Geriatric Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
3Senior Consultant at the Palliative Care Unit, Sahlgrenska University Hospital, Gothenburg, S-413 45, Sweden
- *Corresponding Author:
- Inger Benkel
PhD, The Palliative Care Unit
Department of Geriatric Medicine Sahlgrenska University Hospital
Hogsbo, Box 301 10 S- 400 43 Gothenburg, Sweden
Tel: + 46 31 342 5546
Fax: + 46 31 1679 21
E-mail: inger.benkel@vgregion.se
Received Date: September 15, 2016; Accepted Date: September 26, 2016; Published Date: September 29, 2016
Citation: Benkel I, Molander U (2016) How do Physicians Talk and what do They Say in the Difficult Conversations with Patients and their Loved Ones in Palliative Care? A Qualitative Study to Investigate Strategies to Help Improve Difficult Conversations. J Palliat Care Med 6:285. doi: 10.4172/2165-7386.1000285
Copyright: © 2016 Benkel I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective: Although having difficult conversations is part of their role, many professionals feel that they are often ill-equipped to deal with them. Professionals need training in how best to meet difficult questions so that the conversation can flow effectively. This study is a continuation of an earlier study on how healthcare professionals described strategies to facilitate difficult conversations. Methods: A qualitative method with in-depth interviews was chosen to acquire a deeper understanding of the participants' strategies in having these conversations. In order to strengthen the knowledge of and strategies for conducting their difficult conversations in particular, we examined the interviews with the physicians who participated in the study. Results: The study describes a conversation pattern to help in dealing with difficult conversations. This conversation pattern can help physicians to have conversations that flow effectively and that move in a straightforward way. The different strategic areas described in this study were: Introduction; Finding out what the patient and loved ones already know; Discuss the actual problem; Find out how the patient feels and what is most urgent for the patient to deal with; Planning for the future; and Summary. There are important factors that need to be considered in having these conversations which, in addition to the medical knowledge, include the strategies adopted by patients and families, hope, and how the family constellation might influence the conversation. Conclusion: This framework for difficult conversations can be helpful for physicians to improve conversations with the patient and her/his family in their life situation where a fatal disease has influenced their life within many dimensions. Developing their conversational skills and strategies in combination with a carefully planned structure appeared to facilitate difficult conversations with patients, families and loved ones.
