Over 50% of Australians die in a hospital. This means for most of us, the quality of our final days are primarily in the hands of health care professionals.
An important element for a positive end of life experience is effective communication between the doctor, patient and their family.
A research collaboration between ANU Medical School, ANU Institute for Communication in Health Care, and Canberra Health Services will assess actual conversations between doctors, patients at the end of their lives and their carers, to determine how such interactions could be improved, with implications for quality of care.
The project builds on a pilot undertaken in the Intensive Care Unit. This time, the researchers will review two other disciplines – aged care and respiratory medicine.
The findings will lead to the development of evidence-based ‘end of life’ communication protocols and resources for doctors to use with patients and their families, in the hospital setting.
“It has been long acknowledged that communication in health care, and particularly end of life care, is incredibly important. These conversations can be challenging but are critical. Clear and transparent communication about goals for care can alleviate anxiety and improves the likelihood that patients receive the care they want,” Dr Brett Scholz, Senior Research Fellow from ANU Medical School explained.
If the patient (or their carer) feels empowered to express their expectations around pain management and comfort, their need for emotional, social or spiritual support, and their desires around end of life goals, it can provide a sense of control during a time of ongoing uncertainty.
The barriers to effective communication are varied and complex. Research has shown they can range from physical barriers such as impeded verbal communication from the patient due to illness, through to emotional reasons such as fear of misdirected anger from the family towards the doctor.
“One of the key challenges for effective end of life communication is a lack of evidence-based training for doctors in how to conduct these conversations. Although these conversations have a profound impact on a patient’s death and how it is experienced by their family, there’s a sense that the ability to do this should be innate, which is simply untrue. Communication, like any other clinical skill, can be taught and improved” said Professor Diana Slade, Director, ANU Institute for Communication in Healthcare.
As a critical health psychologist, Dr Scholz knows such resources are needed to make a significant difference in the quality of patient care during end of life. “I’m excited that this project will work towards a patient-centred end-of-life care consultation process, which can be applied across clinical disciplines involving end-of-life care.”
- Professor Imogen Mitchell (ANU Medical School)
- Professor Diana Slade (ANU Institute for Communication in Health Care)
- Professor Michael Chapman (Canberra Health Services)
- Toni Ashmore (Canberra Health Services)
- Dr Brett Scholz (ANU Medical School)
- Liza Goncharov (ANU Institute for Communication in Health Care)