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

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

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