Communication Interventions to Improve Goal-Concordant Care of Seriously Ill Patients: An Integrative Review

Frank Bennett, Susan O'Conner-Von

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Effective communication between clinicians and seriously ill patients and their families about a patient's goals of care is essential to patient-centered, goal-concordant, end-of-life care. Effective goals-of-care communication between clinicians and patients is associated with improved patient and family outcomes, increased clinician satisfaction, and decreased health care costs. Unfortunately, clinicians often face barriers in goals-of-care communication and collaboration, including a lack of education, time constraints, and no standardized protocols. Without clear goals-of-care communication, patients may not be able to provide guidance to clinicians about their end-of-life preferences. The purpose of this integrative review was to examine the efficacy of goals-of-care communication interventions between patients, families, and clinicians in randomized controlled trials published between 2009 and 2018. Twenty-three studies met the inclusion criteria with an overall sample (N = 6376) of patients, family members, and clinicians. Results revealed of the 6 different intervention modes, patient decision aids and patient-clinician communication consistently increased comprehension and communication. Twelve of the studies had nurses facilitate or support the communication intervention. Because nurses are a critical, trusted nexus for communication about end-of-life care, focusing on nurse interventions may significantly improve clinical outcomes and the patient experience.

Original languageEnglish (US)
Pages (from-to)40-48
Number of pages9
JournalJournal of Hospice and Palliative Nursing
Volume22
Issue number1
DOIs
StatePublished - Feb 1 2020

Bibliographical note

Funding Information:
Financial support was provided by the Olseth Family Foundation for this integrative review. However, the Olseth Family Foundation was not involved in any way in the research, writing, or preparation of this article. The authors have no conflicts of interest to disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.jhpn.com).

Publisher Copyright:
© 2019 Lippincott Williams & Wilkins.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • communication
  • goals of care
  • palliative care
  • patient care planning
  • serious illness

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Review

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