Challenges of Inter-Professional Communication in End-of-Life Decision Making
Explore the challenges faced by Swiss doctors in end-of-life decision-making through inter-professional communication. The research delves into the role of communication, main challenges, and strategies to address them. Findings highlight fragmented information affecting decision quality and care outcomes.
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Presentation Transcript
Multiple Professional Visions and Inter- Professional Communication at the End-Of- Life: Challenges for Swiss Doctors Chiara Piccini, Antonella Carassa, Vanessa Alvarado, Brigitte Liebig
The Project NRP 67: End-Of-Life (SNF, 2011-2017) Project: Decision-Making in General Practice Settings at the End of Life (2012-2014) Piccini, Carassa, Alvarado & Liebig 2
Research Questions What is the role of inter-professional communication in end-of-life decision making? Which are the main challenges? Which are the possible strategies to face the perceived challenges? Piccini, Carassa, Alvarado & Liebig 3
Theoretical Framing Inter-professional collaboration is a qualitative indicator of end- of-life palliative care (Kauss et al. 1998, Binder/Wartburg 2009) Good communication practices as a condition of collaboration Inter-relationship between institutional framework (resources and constraints) and communication practice (Piccini/Carassa/Colombetti 2006) Professional visions (Godwin 1994) and communities of practice (Wenger 1998) 4 Piccini, Carassa, Alvarado & Liebig
Methods Case studies in 3 language regions of Switzerland, Expert Questionnaires, Expert Interviews Group discussions: 91 Family Doctors (FDs), 72 nurses, and 21 relatives Qualitative analysis of data, Grounded Theory (Glaser/Strauss, 1974) Perspectives of FDs, nurses, and relatives have been triangulated Piccini, Carassa, Alvarado & Liebig 5
Overview of Results Piccini, Carassa, Alvarado & Liebig 6
Findings Relevant information to make decisions appears to be fragmented Fragmented information challenges the quality of care at the end-of-life loss of decision making quality unreasonable aggressive treatments and painful death Spontaneous non-institutional communicative strategies prevent fragmentation of information Piccini, Carassa, Alvarado & Liebig 7
Discussion Communication practices rely on interpersonal relationship and the strategies are not elaborated enough with respect to defined processes This is critical in a globalized multicultural context, characterized also by frequent professional mobility A more flexible retribution system for doctors and arrangements in hospitals work organization may be useful Development of collaboration practices and alignment between visions Piccini, Carassa, Alvarado & Liebig 8
