Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA; NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, USA.
Department of Family Medicine, University of Vermont College of Medicine, Burlington, USA.
Patient Educ Couns. 2021 Dec;104(12):2963-2968. doi: 10.1016/j.pec.2021.04.040. Epub 2021 May 10.
To explore how patients with advanced cancer, their families, and palliative care clinicians communicate about existential experience during palliative care conversations.
We analyzed data from the Palliative Care Communication Research Initiative (PCCRI) - a multisite cohort study conducted between 2014 and 2016 involving hospitalized adults with advanced cancer who were referred for inpatient palliative care consultations at two academic medical centers. We used a qualitative descriptive approach paired with inductive content analysis to analyze a random subsample of 30 patients from the PCCRI study (contributing to 38 palliative care conversations).
We found existential communication to be woven throughout palliative care conversations, with key themes related to: 1) time as a pressing boundary; 2) maintaining a coherent self; and 3) connecting with others.
Communication about existential experience is omnipresent and varied in palliative care conversations between individuals with advanced cancer, their families, and clinicians.
Clinicians can recognize that discussion of time, routines of daily life, and relationships in the clinical context may hold profound existential relevance in palliative care conversations. Understanding how patients and families talk about existential experience in conversation can create opportunities for clinicians to better meet these needs.
探索晚期癌症患者、其家属和姑息治疗临床医生在姑息治疗对话中如何就存在体验进行沟通。
我们分析了姑息治疗沟通研究倡议（PCCRI）的数据——这是一项多地点队列研究，于 2014 年至 2016 年期间进行，涉及在两所学术医疗中心住院的晚期癌症成人患者，他们被转介接受住院姑息治疗咨询。我们采用定性描述方法与归纳内容分析相结合，对 PCCRI 研究中的 30 名随机患者样本（涉及 38 次姑息治疗对话）进行了分析。
我们发现，存在主义沟通贯穿姑息治疗对话始终，主要主题包括：1）时间是紧迫的界限；2）保持一致的自我；3）与他人建立联系。
在晚期癌症患者、其家属和临床医生之间的姑息治疗对话中，存在体验的沟通普遍存在且形式多样。
临床医生可以认识到，在临床环境中讨论时间、日常生活的常规和人际关系可能对姑息治疗对话具有深远的存在主义意义。了解患者和家属在对话中如何谈论存在体验，可以为临床医生提供更多机会，更好地满足这些需求。
