This study explored how provider comfort and experience, as perceived by providers and family, affected timing and content of end-of-life care planning. The sample consisted of 20 participants. Ten participants were registered nurses; five were physicians; five were family members of patients with a life threatening illness or recent decedents. A grounded theory study incorporating interviewing, field study, theoretical sampling, and constant comparative dimensional analysis was used. Memos and matrices tracked the evolving theory and choices made by the researcher. Credibility was maximized by prolonged engagement, peer debriefing, negative case analysis, and member checks. Provider comfort and experience emerged as conditions that shift whether or when and how providers engaged with patients and families regarding end-of-life care planning. Experience refers to the length of time providers have worked with patients with a terminal illness. Provider comfort was a willingness to engage the patient and/or family in a conversation about dying, to use the words death and dying, to be clear regarding the goals of therapy, and to be clear about the patient's terminal prognosis. Experience is necessary but not sufficient for provider comfort. Lack of comfort and/or experience were the most common reasons for shortcoming in provider communication. Though comfort and experience are clearly related, they are not the same. Identifying provider characteristics that may enhance or detract from provider communication with patients and family about end-of-life care planning is an important beginning step in improving providers' ability to communicate with patients and families near the end of life.
Learning Objectives: Explicate the differences that provider comfort and experience make in end-of-life care planning
Keywords: Elderly, End-of-Life Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.