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Discrepant perceptions about end-of-life communication: a systematic review
Karen Hancock1, Josephine M Clayton, Sharon M Parker
1Medical Psychology Research Unit, NHMRC Clinical Trials Centre, School of Psychology, University of Sydney, Camperdown, New South Wales, Australia.
Journal of Pain and Symptom Management
|June 5, 2007
Summary
Health professionals often misjudge how much patients and caregivers understand about prognosis and end-of-life issues. Repeatedly checking patient comprehension and information preferences is crucial for effective communication.
Area of Science:
- Medical Communication
- Palliative Care
- Patient-Centered Care
Background:
- Limited research exists comparing health professional (HP), patient, and caregiver perceptions of prognostic information communication.
- Effective communication of prognosis is vital for patients with life-limiting illnesses.
Purpose of the Study:
- To review patient, caregiver, and HP perceptions of prognostic and end-of-life (EoL) information.
- To assess patient understanding of prognosis and factors influencing it.
- To examine HP disclosure decisions and compare HP and patient/caregiver concordance on information provided.
Main Methods:
- Systematic literature review of studies published up to November 2004.
- Searched major databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Central).
- Included studies of any design involving adult patients with advanced life-limiting illnesses, caregivers, and HPs.
Main Results:
- Significant discrepancies found between patients/caregivers and HPs regarding the amount of information received.
- Patient understanding of prognosis often conflicted with HP perceptions of patient awareness.
- HPs tended to underestimate patient information needs and overestimate patient understanding of prognosis and EoL issues.
Conclusions:
- HPs frequently misperceive patients' understanding and information needs regarding prognosis and EoL.
- There is a need for improved communication strategies, emphasizing repeated checks of patient understanding and preferences.
- Enhancing HP-patient communication can improve care for individuals with life-limiting illnesses.
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