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Family Perspectives on Communication With Healthcare Providers During End-of-Life Cancer Care

Renee Royak-Schaler
Shahinaz M. Gadalla
Jeanne P. Lemkau
Douglas D. Ross
Carla Alexander
Deborah Scott
ONF 2006, 33(4), 753-760 DOI: 10.1188/06.ONF.753-760

Purpose/Objectives: To assess healthcare provider communication about end-of-life (EOL) and hospice care with patients with terminal cancer and their families, from the perspective of the family members.

Design: Exploratory, qualitative study using focus group discussion.

Setting: University of Maryland Greenebaum Cancer Center.

Sample: 24 spouses and first-degree relatives of deceased patients with cancer who had been treated at the cancer center from 2000-2002.

Methods: Family members participated in one of two focus group discussions and completed a short questionnaire regarding their sociodemographic characteristics and the type of EOL care their deceased relatives had received. Quantitative data were analyzed using descriptive statistics. Qualitative data were audiotaped and analyzed by comparing, contrasting, and summarizing content themes from the focus groups using NUD*IST 5(N5) software.

Main Research Variables: Family perceptions of communication with the healthcare team in EOL cancer care.

Findings: Participants associated the information, content, style, language, and timing of communication about EOL and hospice care from healthcare professionals with patient age, attitudes, and compliance with medical decisions. Informed decisions about EOL care by patients and their family members, including the use of hospice services, appeared to be compromised by these types of communication biases.

Conclusions: Satisfaction with EOL care was associated with the perceived quality of communication among patients, family members, and the healthcare team.

Implications for Nursing: Study findings highlight the importance of training healthcare professionals in the content, timing, and potential biases associated with information delivery to facilitate informed decisions about EOL and hospice care to dying patients and their families.

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