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Patient Educ Couns. 2019 Feb;102(2):198-206. doi: 10.1016/j.pec.2018.08.014. Epub 2018 Aug 31.

Discussing death: Making end of life implicit or explicit in paediatric palliative care consultations.

Author information

1
School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia; Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia. Electronic address: stuart.ekberg@qut.edu.au.
2
Centre for Children's Health Research, Brisbane, Australia; School of Early Childhood & Inclusive Education, Queensland University of Technology, Brisbane, Australia.
3
College of Arts and Social Sciences, Australian National University, Canberra, Australia.
4
Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, Australia; School of Nursing, Queensland University of Technology, Brisbane, Australia.
5
Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Centre for Children's Health Research, Brisbane, Australia; School of Nursing, Queensland University of Technology, Brisbane, Australia.

Abstract

OBJECTIVE:

To consider whether and how family members and clinicians discuss end of life during paediatric palliative care consultations.

METHODS:

Nine naturally occurring paediatric palliative care consultations were video recorded and analysed using conversation analytic methods.

ANALYSIS:

Focusing on three consultations in which end of life was treated as a certain outcome, analysis explored ways in which end of life was made either implicit or explicit within these consultations. Our analysis suggests that end of life was made explicit when: 1) ancillary to the current focus of discussion, 2) in relation to someone else's child, or 3) specifically relevant to the local context of the discussion. More commonly, in all other instances in the data, end of life was made implicit during discussions relating to this matter.

CONCLUSION:

This preliminary research indicates that the local context of a conversation can influence how end of life is mentioned and discussed.

PRACTICE IMPLICATIONS:

Clinicians often are encouraged to promote honest and 'open' discussions about end of life. Our findings show that it is not necessary to explicitly mention end of life in order to discuss it.

KEYWORDS:

Communication; Conversation analysis; Death; Dying; Professional-patient relations

PMID:
30236971
DOI:
10.1016/j.pec.2018.08.014
[Indexed for MEDLINE]

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