older patients attitudes towards and experiences of patient-physician end-of-life communication a secondary analysis of interviews from british, dutch and belgian patients医患临终老年患者的态度和经验交流的二次分析采访从英国,荷兰和比利时的病人.pdfVIP

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older patients attitudes towards and experiences of patient-physician end-of-life communication a secondary analysis of interviews from british, dutch and belgian patients医患临终老年患者的态度和经验交流的二次分析采访从英国,荷兰和比利时的病人.pdf

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older patients attitudes towards and experiences of patient-physician end-of-life communication a secondary analysis of interviews from british, dutch and belgian patients医患临终老年患者的态度和经验交流的二次分析采访从英国,荷兰和比利时的病人

Evans et al. BMC Palliative Care 2012, 11:24 /1472-684X/11/24 RESEARCH ARTICLE Open Access Older patients’ attitudes towards and experiences of patient-physician end-of-life communication: a secondary analysis of interviews from British, Dutch and Belgian patients 1* 1 2 3 4 Natalie Evans , H Roeline W Pasman , Sheila A Payne , Jane Seymour , Sabine Pleschberger , 5 1 Reginald Deschepper , Bregje D Onwuteaka-Philipsen and On behalf of EuroImpact Abstract Background: Older patients often experience sub-standard communication in the palliative phase of illness. Due to the importance of good communication in patient-centred end-of-life care, it is essential to understand the factors which influence older patients’ communication with physicians. This study examines older patients’ attitudes towards, and experiences of, patient-physician end-of-life (EoL) communication in three European countries. Methods: A secondary analysis of interviews from British, Dutch and Belgian patients over the age of 60 with a progressive terminal illness was conducted. Cross-cutting themes were identified using a thematic approach. Results: Themes from 30 interviews (Male n = 20, Median age 78.5) included: confidence and trust; disclosure and awareness; and participation in decision-making. Confidence and trust were reinforced by physicians’ availability, time and genuine attention and hindered by misdiagnoses and poor communication style. Most participants preferred full disclosure, though some remained deliberately ill-informed to avoid distress. Patients expressed a variety of preferences for and experiences of involvement in medical EoL decision-making a