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Perils and payoffs for patients in serious illness conversations as described by physicians: a qualitative study
Umeå University, Faculty of Medicine, Department of Nursing. Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden.ORCID iD: 0000-0001-6595-6298
Umeå University, Faculty of Medicine, Department of Nursing. Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden.ORCID iD: 0000-0002-4773-8796
Umeå University, Faculty of Medicine, Department of Nursing. Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden.ORCID iD: 0000-0002-1728-5722
Department of Health and Caring Sciences, Linneaus University, Växjö, Sweden.ORCID iD: 0000-0002-3155-575X
2024 (English)In: BMJ Open Quality, E-ISSN 2399-6641, Vol. 13, no 2, article id e002734Article in journal (Refereed) Published
Abstract [en]

Background: The Serious Illness Care Programme was developed to promote more, better and earlier serious illness conversations. Conversations about goals and values are associated with improved experiences and outcomes for seriously ill patients. Clinicians’ attitudes and beliefs are thought to influence the uptake and performance of serious illness conversations, yet little is known about how clinicians perceive the impact of these conversations on patients. This study aimed to explore physicians’ perceptions regarding the impact of serious illness conversations for patients.

Methods: The Serious Illness Care Programme was implemented as a quality improvement project in two hospitals in Southern Sweden. Focus group evaluation discussions were conducted with 14 physicians and inductive thematic analysis was undertaken.

Results: The results revealed that physicians considered potential perils and optimised potential payoffs for patients when engaging in serious illness conversations. Potential perils encompassed inappropriate timing, damaging emotions and shattering hopes. Potential payoffs included reflection time, secure space, and united understandings.

Conclusions: Physicians depicted a balance in evaluating the perils and payoffs of serious illness conversations for patients and recognised the interrelation of these possibilities through continual assessment and adjustment.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 13, no 2, article id e002734
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-225091DOI: 10.1136/bmjoq-2023-002734Scopus ID: 2-s2.0-85194129877OAI: oai:DiVA.org:umu-225091DiVA, id: diva2:1861174
Funder
The Kamprad Family Foundation, 20172014Available from: 2024-05-27 Created: 2024-05-27 Last updated: 2024-06-03Bibliographically approved

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Baxter, RebeccaPusa, SusannaAndersson, Sofia

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CiteExportLink to record
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