Instrumental and affective communication with patients with limited health literacy in the palliative phase of cancer or
- PDF / 578,477 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 40 Downloads / 171 Views
RESEARCH ARTICLE
Open Access
Instrumental and affective communication with patients with limited health literacy in the palliative phase of cancer or COPD Janneke Noordman1*†, Lotte Schulze1†, Ruud Roodbeen1,2, Gudule Boland3, Liesbeth M. van Vliet4, Maria van den Muijsenbergh3,5 and Sandra van Dulmen1,5,6
Abstract Background: Patients have a ‘need to know’ (instrumental need) and a ‘need to feel known’ (affective need). During consultations with patients with limited health literacy (LHL) in the palliative phase of their disease, both the instrumental and the affective communication skills of healthcare providers are important. The study aims to explore instrumental and affective communication between care providers and LHL patients in the palliative phase of COPD or cancer. Methods: In 2018, consultations between LHL patients in the palliative phase of cancer or COPD and their healthcare providers were video-recorded in four hospitals in the Netherlands. As there was no observation algorithm available for this setting, several items were created to parameterize healthcare providers’ instrumental communication (seven items: understanding, patient priorities, medical status, treatment options, treatment consequences, prognosis, and information about emotional distress) and affective communication (six items: hope, support, reassurance, empathy, appreciation, and emotional coping). The degree of each item was recorded for each consultation, with relevant segments of the observation selected and transcribed to support the items. Results: Consultations between 17 care providers and 39 patients were video-recorded and analyzed. Care providers primarily used instrumental communication, most often by giving information about treatment options and assessing patients’ care priorities. Care providers assessed patients’ understanding of their disease less often. The patients’ prognosis was not mentioned in half the consultations. Within the affective domain, the care providers did provide support for their patients; providing hope, reassurance, empathy, and appreciation and discussing emotional coping were observed less often. (Continued on next page)
* Correspondence: [email protected] † Janneke Noordman and Lotte Schulze contributed equally to this work. 1 Nivel (Netherlands institute for health services research), PO Box 1568, 3500 BN Utrecht, Netherlands Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's C
Data Loading...
