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From Theory to Practice: Measuring end-of-life communication quality using multiple goals theory.

L J Van Scoy1, A M Scott2, J M Reading3

  • 1Department of Medicine and Humanities, Penn State Milton S. Hershey Medical Center, United States.

Patient Education and Counseling
|December 25, 2016
PubMed
Summary

This study introduces a reliable and valid coding scheme based on multiple goals theory to assess end-of-life conversation quality. The method offers a superior, quantifiable approach for communication research.

Keywords:
Advance care planningCommunicationEnd of life careMeasurementPalliative careTerminal care

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Area of Science:

  • Communication Studies
  • Psychology
  • Gerontology

Background:

  • Assessing the quality of end-of-life (EOL) conversations is crucial for patient care and family support.
  • Existing methods for measuring communication quality in EOL discussions may lack theoretical grounding or empirical validation.

Purpose of the Study:

  • To present and validate a novel coding scheme derived from multiple goals theory for evaluating EOL conversation quality.
  • To establish the reliability and validity of this theory-based measure for research and clinical applications.

Main Methods:

  • Analysis of 17 audio-recorded and transcribed conversations (mean duration 91 min) involving 68 participants discussing EOL issues.
  • Three coders assessed communication quality by rating the accomplishment of task, relational, and identity goals within conversations.
  • Statistical analysis using multilevel nonlinear modeling to determine reliability and validity.

Main Results:

  • The coding scheme demonstrated strong reliability, with intra-class correlation coefficients ranging from 0.73-0.89 and Cronbach's alpha from 0.69-0.89.
  • The measure showed significant validity, evidenced by detectable variability in scores between different conversational contexts (p-values <0.02).
  • The coding scheme provides a quantifiable outcome for assessing communication quality.

Conclusions:

  • The multiple goals theory-based coding scheme offers a reliable and valid method for measuring EOL conversation quality.
  • This approach is superior to existing measures and can be adapted for communication interventions in various clinical settings.