The role of hope for health professionals in rehabilitation: A qualitative study on unfavorable prognosis communication
Autoři:
Mirjam Amati aff001; Nicola Grignoli aff002; Sara Rubinelli aff001; Julia Amann aff001; Claudia Zanini aff001
Působiště autorů:
Department of Health Sciences and Medicine, University of Lucerne and Swiss Paraplegic Research, Lucerne/Nottwil, Switzerland
aff001; Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland
aff002; Rehabilitation Clinic, Ente Ospedaliero Cantonale, Novaggio, Switzerland
aff003; Psychiatry Consultation Liaison Service, Organizzazione Sociopsichiatrica Cantonale, Mendrisio, Switzerland
aff004; Swiss Paraplegic Research, Nottwil, Switzerland
aff005
Vyšlo v časopise:
PLoS ONE 14(10)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0224394
Souhrn
Background
The communication of prognosis represents an ethical and clinical challenge in medical practice due to the inherent uncertain character of prognostic projections. The literature has stressed that the mode of communicating prognoses has an impact on patients’ hope, which is considered to play a major role in adapting to illness and disability. In light of this, this study aims to explore health professionals’ (HPs) perceptions of the role of hope in rehabilitation and to examine if and how they use strategies to maintain hope when discussing prognostic information with patients.
Methods
Eleven qualitative semi-structured interviews with a purposive sample of HPs were conducted at two rehabilitation clinics in the Canton of Ticino, Switzerland. The interviews were analyzed using thematic analysis.
Results
The HPs perceive hope in rehabilitation as a double-edged sword. Three main strategies were identified to maintain hope while avoiding false hope: 1) giving space for self-evaluation; 2) tailoring the communication of prognostic information; and 3) supporting the patient in dealing with the prognosis. These strategies are particularly suitable when HPs consider that patients might not be ready to accept the prognosis, due to their expectations for recovery.
Conclusions
The strategies identified here support a person-centered approach to the communication of prognosis and are in line with existing protocols for the communication of unfavorable medical information. The findings emphasize the need for strengthening communication and inter-professional collaboration skills of rehabilitation HPs.
Klíčová slova:
Communications – Medical doctors – Nurses – Patients – Oncology – Prognosis – Neurorehabilitation – Medical ethics
Zdroje
1. Goodman SN (1999) Probability at the bedside: The knowing of chances or the chances of knowing? Ann Inter Med 130: 604–606.
2. Smith AK, White DB, Arnold RM (2013) Uncertainty: The Other Side of Prognosis. N Engl J Med 368: 2448–2450. doi: 10.1056/NEJMp1303295 23802514
3. Sarafis P, Tsounis A, Malliarou M, Lahana E (2013) Disclosing the truth: a dilemma between instilling hope and respecting patient autonomy in everyday clinical practice. Glob J Health Sci 6: 128–137. doi: 10.5539/gjhs.v6n2p128 24576372
4. Lally J, Cantillon P (2014) Uncertainty and ambiguity and their association with psychological distress in medical students. Acad Psychiatry 38: 339–344. doi: 10.1007/s40596-014-0100-4 24718768
5. Bhise V, Meyer AND, Menon S, Singhal G, Street RL, et al. (2018) Patient perspectives on how physicians communicate diagnostic uncertainty: An experimental vignette study†. Int J Qual Health Care 30: 2–8. doi: 10.1093/intqhc/mzx170 29329438
6. Hagerty RG, Butow PN, Ellis PM, Dimitry S, Tattersall MH (2005) Communicating prognosis in cancer care: a systematic review of the literature. Ann Oncol 16: 1005–1053. doi: 10.1093/annonc/mdi211 15939716
7. Snyder CR, Rand KL, Sigmon DR (2017) Hope Theory: A Member of The Positive Psychology Family. In: Gallagher MW, Lopez SJ, editors. The Oxford Handbook of Hope: Oxford University Press.
8. Roth M, Hammelstein P (2007) Hope as an emotion of expectancy: first assessment results. Psychosoc Med 4: Doc05–Doc05. 19742296
9. Lazarus R (1999) Hope: An Emotion and a Vital Coping Resource Against Despair. Soc Res 66.
10. Soundy A, Sayers J, Stubbs B, Roskell C (2014) Don't take my hope away: Understanding the patient's hope in neurological rehabilitation. Int J Ther Rehabil 21: 257–258.
11. Phillips BN, Smedema SM, Fleming AR, Sung C, Allen MG (2016) Mediators of disability and hope for people with spinal cord injury. Disabil Rehabil 38: 1672–1683. doi: 10.3109/09638288.2015.1107639 26677914
12. Schiavon CC, Marchetti E, Gurgel LG, Busnello FM, Reppold CT (2016) Optimism and Hope in Chronic Disease: A Systematic Review. Front Psychol 7: 2022. doi: 10.3389/fpsyg.2016.02022 28101071
13. Kortte KB, Stevenson JE, Hosey MM, Castillo R, Wegener ST (2012) Hope predicts positive functional role outcomes in acute rehabilitation populations. Rehabil Psychol 57: 248–255. doi: 10.1037/a0029004 22946612
14. Calman KC (1984) Quality of life in cancer patients—an hypothesis. J Med Ethics 10: 124–127. doi: 10.1136/jme.10.3.124 6334159
15. Carr AJ, Gibson B, Robinson PG (2001) Is quality of life determined by expectations or experience? Bmj 322: 1240–1243. doi: 10.1136/bmj.322.7296.1240 11358783
16. Hudon C, Fortin M, Haggerty J, Loignon C, Lambert M, et al. (2012) Patient-centered care in chronic disease management: A thematic analysis of the literature in family medicine. Patient Educ Couns 88: 170–176. doi: 10.1016/j.pec.2012.01.009 22360841
17. Entwistle VA, Watt IS (2013) Treating Patients as Persons: A Capabilities Approach to Support Delivery of Person-Centered Care. Am J Bioeth 13: 29–39.
18. Rathert C, Wyrwich MD, Boren SA (2012) Patient-Centered Care and Outcomes: A Systematic Review of the Literature. Med Care Res Review 70: 351–379.
19. Olsman E, Willems D, Leget C (2016) Solicitude: balancing compassion and empowerment in a relational ethics of hope-an empirical-ethical study in palliative care. Med Health Care Philos 19: 11–20. doi: 10.1007/s11019-015-9642-9 25944316
20. Graz B, Wietlisbach V, Porchet F, Vader J-P (2005) Prognosis or “Curabo Effect?”: Physician Prediction and Patient Outcome of Surgery for Low Back Pain and Sciatica. Spine 30: 1448–1452. doi: 10.1097/01.brs.0000166508.88846.b3 15959377
21. Fallowfield L (1993) Giving sad and bad news. The Lancet 341: 476–478.
22. Baile WF, Kudelka AP, Beale EA, Glober GA, Myers EG, et al. (1999) Communication skills training in oncology. Cancer 86: 887–897. 10463990
23. Fallowfield L, Jenkins V (2004) Communicating sad, bad, and difficult news in medicine. Lancet 363: 312–319. doi: 10.1016/S0140-6736(03)15392-5 14751707
24. Shaw J, Dunn S, Heinrich P (2012) Managing the delivery of bad news: An in-depth analysis of doctors’ delivery style. Patient Educ Couns 87: 186–192. doi: 10.1016/j.pec.2011.08.005 21917397
25. Hancock K, Clayton JM, Parker SM, Wal der S, Butow PN, et al. (2007) Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review. Palliat Med 21: 507–517. doi: 10.1177/0269216307080823 17846091
26. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, et al. (2000) SPIKES—A Six-Step Protocol for Delivering Bad News: Application to the Patient with Cancer. Oncologist 5: 302–311. doi: 10.1634/theoncologist.5-4-302 10964998
27. Seifart C, Hofmann M, Bar T, Riera Knorrenschild J, Seifart U, et al. (2014) Breaking bad news-what patients want and what they get: evaluating the SPIKES protocol in Germany. Ann Oncol 25: 707–711. doi: 10.1093/annonc/mdt582 24504443
28. Rabow MW, McPhee SJ (1999) Beyond breaking bad news: how to help patients who suffer. West J Med 171: 260–263. 10578682
29. Vandekieft GK (2001) Breaking Bad News. Am Fam Physician 64: 1975–1979. 11775763
30. Snyder CR, Lehman KA, Kluck B, Monsson Y (2006) Hope for Rehabilitation and Vice Versa. Rehabil Psychol 51: 89–112.
31. Boonstra AM, Reneman MF, Waaksma BR, Schiphorst Preuper HR, Stewart RE (2015) Predictors of multidisciplinary treatment outcome in patients with chronic musculoskeletal pain. Disabil Rehabil 37: 1242–1250. doi: 10.3109/09638288.2014.961657 25228388
32. Koch T (2001) Disability and difference: balancing social and physical constructions. J Med Ethics 27: 370–376. doi: 10.1136/jme.27.6.370 11731598
33. Carod-Artal FJ, Egido JA (2009) Quality of Life after Stroke: The Importance of a Good Recovery. Cerebrovascular Dis 27(suppl 1): 204–214.
34. Meyer T, Gutenbrunner C, Bickenbach J, Cieza A, Melvin J, et al. (2011) Towards a conceptual description of rehabilitation as a health strategy. J Rehabil Med 43: 765–769. doi: 10.2340/16501977-0865 21826389
35. Wiles R, Ashburn A, Payne S, Murphy C (2004) Discharge from physiotherapy following stroke: the management of disappointment. Soc Sci Med 59: 1263–1273. doi: 10.1016/j.socscimed.2003.12.022 15210097
36. ANQ (2005) Piano di misurazione nazionale per la riabilitazione (moduli 2 e 3): Manuale sulla procedura. 2015/01 ed. Bern: ANQ.
37. Linn BS, Linn MW, Gurel L (1968) Cumulative Illness Rating Scale Journal of the American Geriatrics Society 16: 622–626.
38. Patrick L, Knoefel F, Gaskowski P, Rexroth D (2001) Medical Comorbidity and Rehabilitation Efficiency in Geriatric Inpatients. J Am Geriat Soc 49: 1471–1477. doi: 10.1046/j.1532-5415.2001.4911239.x 11890585
39. Guest GS, MacQueen KM, Namey EE (2012) Applied Thematic Analysis. California: SAGE Publications.
40. FMH (2018) Art. 10. Codice deontologico della FMH. Bern.
41. ICN (2012) The ICN Code of Ethics for Nurses. Geneva.
42. Aslakson RA, Wyskiel R, Shaeffer D, Zyra M, Ahuja N, et al. (2010) Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis. Crit Care 14: 1–8.
43. Abbaszadeh A, Ehsani SR, Begjani J, Kaji MA, Dopolani FN, et al. (2014) Nurses' perspectives on breaking bad news to patients and their families: a qualitative content analysis. J Med Ethics Hist Med 7: 1–7.
44. Aslakson RA, Wyskiel R, Thornton I, Copley C, Shaffer D, et al. (2012) Nurse-perceived barriers to effective communication regarding prognosis and optimal end-of-life care for surgical ICU patients: a qualitative exploration. J Palliat Med 15: 910–915. doi: 10.1089/jpm.2011.0481 22676315
45. Thorne SE, Hislop TG, Armstrong EA, Oglov V (2008) Cancer care communication: the power to harm and the power to heal? Patient Educ Couns 71: 34–40. doi: 10.1016/j.pec.2007.11.010 18096354
46. Newman AR (2016) Nurses’ Perceptions of Diagnosis and Prognosis-Related Communication: An Integrative Review. Cancer Nurs 39: E48–E60. doi: 10.1097/NCC.0000000000000365 27035358
47. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, et al. (2018) Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity 52: 1893–1907.
48. Berger R, Malkinson R (2000) “Therapeutizing” research: The positive impact of family‐focused research on participants. Smith Coll Stud Soc Work 70: 307–314.
49. WMA (2019) WMA Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects.
50. Houghton CE, Casey D, Shaw D, Murphy K (2010) Ethical challenges in qualitative research: examples from practice. Nurse Res 18: 15–25. doi: 10.7748/nr2010.10.18.1.15.c8044 21138082
51. Ignacio JJ, Taylor BJ (2013) Ethical issues in health-care inquiry: a discussion paper. Int J Nurs Pract 19 Suppl 1: 56–61.
52. Orb A, Eisenhauer L, Wynaden D (2001) Ethics in Qualitative Research. J Nurs Scholarsh 33: 93–96. 11253591
53. Braun V, Clark V (2013) Successful Qualitative Research: A practical Guide for Beginners. London: SAGE Publications.
54. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3: 77–101.
55. Patton MQ (1999) Enhancing the quality and credibility of qualitative analysis. Health Serv Res 34: 1189–1208. 10591279
56. Johnson BR (1997) Examining the Validity Structure of Qualitative Research. Education. pp. 282–292.
57. Creswell JW, Miller DL (2000) Determining Validity in Qualitative Inquiry. Theory Into Practice 39: 124–131.
58. Buckman R, Kason Y (1992) How to Break Bad News: A Guide for Health Care Professionals: Jonhs Hopkins University Press.
59. Leventhal N (1975) Interdisciplinary teamwork: a crucial dimension in rehabilitation therapy. Am Arch Rehabil Ther 23: 26–30. 10237078
60. Boccolini F (1953) Importance of teamwork in rehabilitation. Rev Paul Med 42: 364–367. 13089249
61. Körner M, Wirtz MA, Bengel J, Göritz AS (2015) Relationship of organizational culture, teamwork and job satisfaction in interprofessional teams. BMC Health Serv Res 15: 243. doi: 10.1186/s12913-015-0888-y 26099228
62. Watkins DC (2012) Qualitative research: The importance of conducting research that doesn’t “count”. Health Promot Pract 13: 153–158. doi: 10.1177/1524839912437370 22382490
63. Johnson R, Waterfield J (2004) Making words count: the value of qualitative research. Physiother Res Int 9: 121–131. 15560669
64. Swiss Federal Office of Statistics (2018) Personnes actives occupées de 15 ans ou plus selon la profession exercée (nomenclature: NSP 2000), le sexe et la nationalité. Bern, Swizerland: Swiss Federal Office of Statistics.
65. Mudge S, Stretton C, Kayes N (2014) Are physiotherapists comfortable with person-centred practice? An autoethnographic insight. Disabil Rehabil 36: 457–463. doi: 10.3109/09638288.2013.797515 23713969
66. Foronda C, MacWilliams B, McArthur E (2016) Interprofessional communication in healthcare: An integrative review. Nurse Educ Pract 19: 36–40. doi: 10.1016/j.nepr.2016.04.005 27428690
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