Despite evidence that doctor-patient communication affects important patient outcomes, patient expectations are often not met.
Communication is especially important in terminal illness, when the appropriate course of action may depend more on patient values than on medical dogma.
We sought to describe the issues important to terminally ill patients receiving palliative care and to determine whether patient characteristics influence the needs of these patients.
We utilized a multimethod approach, first conducting interviews with 22 terminally ill individuals, then using these data to develop a more structured instrument which was administered to a second population of 56 terminally ill patients.
Patient needs and concerns were described and associations between patient characteristics and issues of importance were evaluated.
Seven key issues were identified in the initial interviews :
change in functional status or activity level ;
role change ;
symptoms, especially pain ;
stress of the illness on family members ;
loss of control ;
financial burden and conflict between wanting to know what is going on and fearing bad news.
Overall, respondent needs were both disease-and illness-oriented.
Few easily identifiable patient characteristics were associated with expressed concerns or needs, suggesting that physicians need to individually assess patient needs.
Terminally ill patients receiving palliative care had needs that were broad in scope. (...)
Mots-clés Pascal : Soin palliatif, Maladie, Stade terminal, Relation médecin malade, Epidémiologie, Besoin, Evaluation, Communication information, Homme
Mots-clés Pascal anglais : Palliative care, Disease, Terminal stage, Physician patient relation, Epidemiology, Need, Evaluation, Information communication, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0253985
Code Inist : 002B30A11. Création : 16/11/1999.