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Theme: 8AA Communication skills
Abstract Title: Teaching communication skills in order to make inevitable death discussable
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Authors

  • Dorine van Woerden

Institution

  • Academic Medical Centre - Division Medical Psychology - Amsterdam - Netherlands
Background

• Too often patients are ‘over-treated’ because the nearby death is not discussed.

• A reason is that doctors are trained to provide curative treatments rather than handle

  the heavy emotions of patients facing the end of their life.

• This can cause misunderstanding about the care that is wanted by the patient.

• A timely discussion about the inevitable death of terminally ill patients is imperative

  to ensure that appropriate measures are taken.

Summary of Work

 Effective communication about inevitable death can contribute to optimal palliative care during the final phase of life.

 Therefore, we have developed a communication module for physicians.

•This 4 hour training consists of three modules:

   a) Group discussion: to make physicians aware of their own 
        emotions that may hinder effective communication with palliative
        patients.

   b) Theory: physicians are provided with the relevant theory and

        communication skills. Most importantly the phasing of this type of

        consultation is provided, namely:

  1. agenda setting (explaining the purpose of the consultation)

  2. specifying goal (reaching a well-informed decision about palliative care)

  3. evaluation of the consultation

  4. documenting the decision about palliative care

  5. follow-up appointment

   c) Role play: physicians practice these communication skills with the help of a professional actor

      .

Summary of Results

During the last 5-6 years we have offered this module to four hospitals in the Netherlands. Participants were internal oncologists, gynecologists and intensive-care physicians. Satisfaction was measured by means of a semi-structured questionnaire. Participants generally appreciated this module: “…it provides practical communication tools to initiate a consultation about inevitable death”. Results also show that this module enables physicians to initiate this consultation, cope better with emotions and tolerate the fact that they cannot offer options for cure.

Conclusion

Communication skills regarding inevitable death are helpful in initiating a discussion with patients.

Take-home Messages

A timely discussion about inevitable death requires communication skills that can be taught.

Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
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