Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Palliat Support Care. 2023 Oct;21(5):890-913. doi: 10.1017/S1478951523001165.
In palliative care, effective communication is essential to adequately meet the needs and preferences of patients and their relatives. Effective communication includes exchanging information, facilitates shared decision-making, and promotes an empathic care relationship. We explored the perspectives of patients with an advanced illness and their relatives on effective communication with health-care professionals.
A systematic review was conducted. We searched Embase, Medline, Web of Science, CINAHL, and Cochrane for original empirical studies published between January 1, 2015 and March 4, 2021.
In total, 56 articles on 53 unique studies were included. We found 7 themes that from the perspectives of patients and relatives contribute to effective communication: (1) open and honest information. However, this open and honest communication can also trigger anxiety, stress, and existential disruption. Patients and relatives also indicated that they preferred (2) health-care professionals aligning to the patient's and relative's process of uptake and coping with information; (3) empathy; (4) clear and understandable language; (5) leaving room for positive coping strategies, (6) committed health-care professionals taking responsibility; and (7) recognition of relatives in their role as caregiver. Most studies in this review concerned communication with physicians in a hospital setting.
Most patients and relatives appreciate health-care professionals to not only pay attention to strictly medical issues but also to who they are as a person and the process they are going through. More research is needed on effective communication by nurses, in nonhospital settings and on communication by health-care professionals specialized in palliative care.
在姑息治疗中，有效的沟通对于充分满足患者及其家属的需求和偏好至关重要。有效的沟通包括信息交流、促进共同决策以及建立共情的医护关系。我们探讨了处于疾病晚期的患者及其家属对与医护人员进行有效沟通的看法。
进行了系统综述。我们在 Embase、Medline、Web of Science、CINAHL 和 Cochrane 中检索了 2015 年 1 月 1 日至 2021 年 3 月 4 日期间发表的原始实证研究。
共纳入了 56 篇关于 53 项独特研究的文章。我们发现了 7 个主题，从患者和家属的角度来看，这些主题有助于实现有效的沟通：（1）坦诚的信息交流。然而，这种坦诚的沟通也可能引发焦虑、压力和存在性困扰。患者和家属还表示，他们更希望（2）医护人员与患者和家属的信息接受和应对过程保持一致；（3）同理心；（4）清晰易懂的语言；（5）为积极的应对策略留出空间；（6）有担当的医护人员承担责任；（7）承认家属在照顾者角色中的作用。本综述中的大多数研究都涉及到在医院环境中与医生的沟通。
大多数患者和家属希望医护人员不仅关注严格的医疗问题，还关注他们作为个体以及他们正在经历的过程。需要更多关于护士在非医院环境中的有效沟通、医护人员在姑息治疗方面的沟通的研究。
