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Enabling sense-making for patients receiving outpatient palliative treatment: A participatory action research driven model for person-centered communication

Published online by Cambridge University Press:  03 August 2015

J. Öhlén ,
G. Carlsson ,
A. Jepsen ,
I. Lindberg  and
F. Friberg
J. Öhlén*
Affiliation:
Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden
G. Carlsson
Affiliation:
Department of Oncology, The Sahlgrenska University Hospital, Gothenburg, Sweden Department of Colorectal Surgery, Sahlgrenska University Hospital – East, Gothenburg, Sweden
A. Jepsen
Affiliation:
Department of Oncology, The Sahlgrenska University Hospital, Gothenburg, Sweden
I. Lindberg
Affiliation:
Department of Oncology, The Sahlgrenska University Hospital, Gothenburg, Sweden
F. Friberg
Affiliation:
University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway
*
Address correspondence and reprint requests to: Joakim Öhlén, Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden. E-mail: joakim.ohlen@gu.se
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Abstract

Objectives:

In clinical palliative cancer care, the diversity of patient concerns over time makes information provision a critical issue, the demands of information-seeking patients presenting a challenge to both the communicative and organizational skills of the health provider. This study puts forward a practice model for communication between patients, their family members, and professional health providers during ongoing palliative chemotherapy; a model which supports the providers in enabling person-centered communication.

Method:

A constant comparative analysis adapted to participatory action research was applied. The model was developed step-wise in three interrelated cycles, with results from previous studies from palliative cancer care processed in relation to professional health providers' experience-based clinical knowledge. In doing this, focus group discussions were carried out with providers and patients to develop and revise the model.

Results:

The Enabling Sense Making model for person-centered communication gave rise to three domains (which are also the major communicative actors in palliative care): the patient, the family, and the provider. These actors were placed in the context of a communicative arena. The three respective domains were built up in different layers discriminating between significant aspects of person-centered communication, from the manifest that is most usually explicated in dialogues, to the latent that tends to be implicitly mediated.

Significance of results:

The model intends to facilitate timely reorientation of care from curative treatment or rehabilitation to palliation, as well as the introduction of appropriate palliative interventions over time during palliative phases. In this way the model is to be regarded a frame for directing the awareness of the professionals, which focuses on how to communicate and how to consider the patient’s way of reasoning. The model could be used as a complement to other strategic initiatives for the advancement of palliative care communication. It needs to be further evaluated in regard to practice evidence.

Keywords

Patient care teamPalliative careNeoplasmsPerson-centerednessTheoretical models
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 3 , June 2016 , pp. 212 - 224
Copyright
Copyright © Cambridge University Press 2015 

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