1 School of Nursing, Capital Medical University, Beijing, China.
2 Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.
Palliat Med. 2018 Jan;32(1):195-205. doi: 10.1177/0269216317734696. Epub 2017 Nov 13.
Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other.
To develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk, explore anticipated benefits and challenges of using Dignity Talk, and solicit suggestions for protocol improvement.
A convergent parallel mixed-methods design. Dignity Talk, a self-administered question list, was designed to prompt end-of-life conversations, adapted from the Dignity Therapy question framework. Participants were surveyed to evaluate the Dignity Talk question framework. Data were analyzed using qualitative and quantitative methods.
SETTING/PARTICIPANTS: A total of 20 palliative patients, 20 family members, and 34 healthcare providers were recruited from two inpatient palliative care units in Winnipeg, Canada.
Most Dignity Talk questions were endorsed by the majority of patients and families (>70%). Dignity Talk was revised to be convenient and flexible to use, broadly accessible, clearly stated, and sensitively worded. Participants felt Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business. Participants suggested that patients and family members be given latitude to respond only to questions that are meaningful to them and within their emotional capacity to broach.
Dignity Talk may provide a gentle means of facilitating important end-of-life conversations.
有效的医患沟通可以减轻患者的心理困扰，缓解家属的当前痛苦和随后的悲伤。然而，临终患者及其家属在相互交流真实感受、关注和需求方面常常遇到很大困难。
开发一种促进姑息治疗患者及其家属进行有意义对话的新方法，称为尊严对话，探讨使用尊严对话的预期益处和挑战，并征求对方案改进的建议。
一种收敛并行混合方法设计。尊严对话是一种自我管理的问题清单，旨在促进临终对话，它是从尊严治疗问题框架改编而来的。参与者接受调查，以评估尊严对话问题框架。使用定性和定量方法分析数据。
地点/参与者：共招募了来自加拿大温尼伯的两家住院姑息治疗病房的 20 名姑息治疗患者、20 名家属和 34 名医疗保健提供者。
大多数尊严对话问题得到了大多数患者和家属（>70%）的认可。对尊严对话进行了修订，使其使用方便灵活，广泛适用，表述清晰，措辞敏感。参与者认为尊严对话在促进对话、增强家庭联系和关系、增强患者的价值和尊严感、促进有效互动以及处理未完成的事务方面将具有价值。参与者建议患者和家属有一定的回旋余地，只回答对他们有意义且在他们的情感能力范围内的问题。
尊严对话可能为促进重要的临终对话提供一种温和的方法。
