School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia; Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia.
Centre for Children's Health Research, Brisbane, Australia; School of Early Childhood & Inclusive Education, Queensland University of Technology, Brisbane, Australia.
Patient Educ Couns. 2019 Feb;102(2):198-206. doi: 10.1016/j.pec.2018.08.014. Epub 2018 Aug 31.
To consider whether and how family members and clinicians discuss end of life during paediatric palliative care consultations.
Nine naturally occurring paediatric palliative care consultations were video recorded and analysed using conversation analytic methods.
Focusing on three consultations in which end of life was treated as a certain outcome, analysis explored ways in which end of life was made either implicit or explicit within these consultations. Our analysis suggests that end of life was made explicit when: 1) ancillary to the current focus of discussion, 2) in relation to someone else's child, or 3) specifically relevant to the local context of the discussion. More commonly, in all other instances in the data, end of life was made implicit during discussions relating to this matter.
This preliminary research indicates that the local context of a conversation can influence how end of life is mentioned and discussed.
Clinicians often are encouraged to promote honest and 'open' discussions about end of life. Our findings show that it is not necessary to explicitly mention end of life in order to discuss it.
探讨在儿科姑息治疗咨询中，家属和临床医生是否以及如何讨论临终事宜。
对 9 次自然发生的儿科姑息治疗咨询进行视频记录，并使用会话分析方法进行分析。
本研究聚焦于其中 3 次将临终视为确定结果的咨询，分析探讨了在这些咨询中，临终在哪些情况下被明确提及，哪些情况下被隐含提及。我们的分析表明，当临终：1）作为当前讨论焦点的辅助内容；2）与他人的孩子有关；或 3）与讨论的当地背景特别相关时，临终被明确提及。在数据中的所有其他情况下，临终更常见的情况是在与该问题相关的讨论中被隐含提及。
这项初步研究表明，对话的当地背景会影响临终的提及和讨论方式。
临床医生经常被鼓励促进关于临终的诚实和“开放”讨论。我们的研究结果表明，为了讨论临终事宜，不一定需要明确提及临终。
