Having the difficult conversations about end of life care

A discussion paper exploring research evidence and experiences of clinicians in

• general practice
• oncology

of the issues that make end of life conversations difficult for patients and clinicians.

It also provides practical suggestions to address these.

Barclay S, Maher J (2010) Having the difficult conversations about end of life care BMJ 25 September 2010

Read this report on the BMJ website (accessed 11/05/2011)

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Communication difficulties and intellectual disability in end-of-life care

A review paper that explores the communication challenges for people with intellectual disability on end of life care and outlines strategies for managing communication.

Tuffrey-Wijne I, McEnhill L (2008) Communication difficulties and intellectual disability in end-of-life care International Journal of Palliative Nursing; Vol 14, No4: pp192-197

Download this paper form the Developmental Disabilities Hospice & Palliative Care website (accessed 11/05/2011)

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What do patients receiving palliative care for cancer and their families want to be told? A Canadian and Australian qualitative study

This qualitative study explored information sharing experiences of palliative care patients. It found that information delivery for patients needs to be individualised with particular attention to process at all stages of illness.

Peter Kirk Ingrid Kirk, Linda J Kristjanson (2004) What do patients receiving palliative care for cancer and their families want to be told? A Canadian and Australian qualitative study BMJ; Volume 328 Number 7452: pp1343-1347

Read this paper on the BMJ website (accessed 11/05/2011)

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Communication and planning at the end-of-life: A survey of women with advanced stage breast cancer’

A survey of women diagnosed with advanced breast cancer about their end of life conversations. The study found that women were most likely to have discussions with family, least likely to discuss it with healthcare professionals or clergy.

Over one-third had not discussed EOL decisions with anyone. Older age, having dependent children and not being affiliated with a religion were significantly associated with documentation of end of life preferences. Practical suggestions to promote effective communication are discussed.

Bauer-Wu et al. (2009) Communication and planning at the end-of-life: A survey of women with advanced stage breast cancer Journal of Communications in Healthcare; 2 (4): pp371-386

read the abstract on – or download the full article from the ingentaconnect website (accessed 11/05/2011)

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Implementing advance care planning: a qualitative study of community nurses’ views and experiences

Qualitative study exploring community nurses views. Among the greatest challenges that nurses perceived to be associated with ACP were their own and colleagues’ knowledge and skills about communication practice, recording and follow up. Recommendations made for communication skills training

Seymour J, Almack K, Kennedy S (2010) Implementing advance care planning: a qualitative study of community nurses’ views and experiences Biomed Central, Palliative Care, 9,4

Read this article on the Biomed Central website (accessed 11/05/2011)

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Conversation analysis, doctor-patient interaction and medical communication

This paper introduces the use of a conversational analysis approach to improve communication between doctors and their patients.

Maynard, D.W, Heritage, J (2005) Conversation analysis, doctor-patient interaction and medical communication Medical Education; Volume 39, Issue 4: pp 428-435

Read the abstract on the Wiley Online Library website (accessed 11/05/2011)