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dc.contributor.authorO'Connor, Moira
dc.contributor.authorWatts, K.J.
dc.contributor.authorKilburn, W.D.
dc.contributor.authorVivekananda, K.
dc.contributor.authorJohnson, C.E.
dc.contributor.authorKeesing, Sharon
dc.contributor.authorHalkett, Georgia
dc.contributor.authorShaw, J.
dc.contributor.authorColgan, V.
dc.contributor.authorYuen, K.
dc.contributor.authorJolly, R.
dc.contributor.authorTowler, S.C.
dc.contributor.authorChauhan, A.
dc.contributor.authorNicoletti, M.
dc.contributor.authorLeonard, A.D.
dc.date.accessioned2021-03-18T04:11:57Z
dc.date.available2021-03-18T04:11:57Z
dc.date.issued2020
dc.identifier.citationO’Connor, M. and Watts, K.J. and Kilburn, W.D. and Vivekananda, K. and Johnson, C.E. and Keesing, S. and Halkett, G.K.B. et al. 2020. A Qualitative Exploration of Seriously Ill Patients’ Experiences of Goals of Care Discussions in Australian Hospital Settings. Journal of General Internal Medicine. 35 (12): pp. 3572-3580.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/82965
dc.identifier.doi10.1007/s11606-020-06233-y
dc.description.abstract

© 2020, Society of General Internal Medicine.

Background: Goals of care (GOC) is a communication and decision-making process that occurs between a clinician and a patient (or surrogate decision-maker) during an episode of care to facilitate a plan of care that is consistent with the patient’s preferences and values. Little is known about patients’ experiences of these discussions.

Objective: This study explored patients’ perspectives of the GOC discussion in the hospital setting.

Design: An explorative qualitative design was used within a social constructionist framework.

Participants: Adult patients were recruited from six Australian hospitals across two states. Eligible patients had had a GOC discussion and they were identified by the senior nurse or their doctor for informed consent and interview.

Approach: Semi-structured individual or dyadic interviews (with the carer/family member present) were conducted at the bedside or at the patient’s home (for recently discharged patients). Interviews were audio-recorded and transcribed verbatim. Data were analysed for themes.

Key Results: Thirty-eight patient interviews were completed. The key themes identified were (1) values and expectations, and (2) communication (sub-themes: (i) facilitators of the conversation, (ii) barriers to the conversation, and (iii) influence of the environment). Most patients viewed the conversation as necessary and valued having their preferences heard. Effective communication strategies and a safe, private setting were facilitators of the GOC discussion. Deficits in any of these key elements functioned as a barrier to the process. Conclusions: Effective communication, and patients’ values and expectations set the stage for goals of care discussions; however, the environment plays a significant role. Communication skills training and education designed to equip clinicians to negotiate GOC interactions effectively are essential. These interventions must also be accompanied by systemic changes including building a culture supportive of GOC, clear policies and guidelines, and champions who facilitate uptake of GOC discussions.

dc.languageEnglish
dc.publisherSPRINGER
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectHealth Care Sciences & Services
dc.subjectMedicine, General & Internal
dc.subjectGeneral & Internal Medicine
dc.subjectgoals of care
dc.subjectcommunication
dc.subjectpreferences
dc.subjectpatients
dc.subjectinternal medicine
dc.subjectOF-LIFE CARE
dc.subjectLONG-TERM OUTCOMES
dc.subjectHEALTH-CARE
dc.subjectEFFECTIVE COMMUNICATION
dc.subjectDECISION-MAKING
dc.subjectEND
dc.subjectBARRIERS
dc.subjectPHYSICIANS
dc.subjectFAMILIES
dc.subjectILLNESS
dc.titleA Qualitative Exploration of Seriously Ill Patients’ Experiences of Goals of Care Discussions in Australian Hospital Settings
dc.typeJournal Article
dcterms.source.volume35
dcterms.source.number12
dcterms.source.startPage3572
dcterms.source.endPage3580
dcterms.source.issn0884-8734
dcterms.source.titleJournal of General Internal Medicine
dc.date.updated2021-03-18T04:11:53Z
curtin.note

This is a post-peer-review, pre-copyedit version of an article published in Journal of General Internal Medicine. The final authenticated version is available online at: http://doi.org/10.1007/s11606-020-06233-y.

curtin.departmentCurtin School of Allied Health
curtin.departmentCurtin School of Nursing
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidHalkett, Georgia [0000-0003-4065-4044]
curtin.contributor.orcidKeesing, Sharon [0000-0001-6893-3542]
dcterms.source.eissn1525-1497
curtin.contributor.scopusauthoridO'Connor, Moira [13610827900]
curtin.contributor.scopusauthoridHalkett, Georgia [8909188900]
curtin.contributor.scopusauthoridKeesing, Sharon [37034240900]


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