Examining Conversation Analysis in Palliative Care: A Systematic Review

Area of Science:

• Medical Communication
• Palliative Care Research
• Conversation Analysis (CA)

Background:

• Effective communication is crucial in palliative care.
• Conversation Analysis (CA) has been used to study healthcare professional (HCP)-patient communication in palliative care.
• No prior synthesis of CA studies in palliative care exists.

Purpose of the Study:

• To synthesize existing conversation analytic studies on HCP-patient/companion communication in palliative care.
• To identify key communication themes and practices within palliative care settings.
• To explore the utility of CA for palliative care research and practice.

Main Methods:

• Systematic review of peer-reviewed studies published in English before September 10, 2022.
• Inclusion criteria focused on CA studies of HCP-patient/companion communication in palliative care.
• Thematic analysis of 16 eligible studies identified from database and manual searches.

Main Results:

• Five major themes emerged: promoting patient agency/autonomy, pain information gathering/navigation, end-of-life discussions, shared decision-making, and navigating sensitive topics/prognostic uncertainty.
• Conversation analysis offers valuable insights into complex palliative care communication dynamics.
• Identified themes provide a framework for enhancing communication skills in palliative care.

Conclusions:

• Conversation analysis is a valuable methodology for researching palliative care communication.
• The synthesized themes have direct implications for improving communication practices between HCPs and patients/companions.
• Further research using CA can refine our understanding of effective palliative care communication.