Pain talk in hospice care: a conversation analysis

Examining Conversation Analysis in Palliative Care: A Systematic Review

Communication is an integral component in palliative care. A number of studies have used conversation analysis (CA) to examine communication between healthcare professionals (HCPs) and patients/companions in palliative care. To the best of our knowledge, however, no work has been done to synthesize these studies. Thus, the review aimed to synthesize these conversation analytic studies in the setting of palliative care. The review included peer-reviewed studies that focused on communication between HCPs and patients/companions and that were published in English before September 10 2022. The database and manual search produced 16 eligible studies. The thematic analysis generated five themes: (1) promoting patient agency and autonomy; (2) practices for gathering pain-related information and navigating pain concerns (practices for gathering pain-related information and practices for navigating patients' pain concerns); (3) initiating and managing end-of-life discussions; (4) facilitating shared decision making in palliative care; and (5) navigating sensitive topics and uncertainty in prognostic talk. The review highlighted the potential of CA for research in palliative care and had implications for communication practice.

Awareness of Hospice Care Among Community-Dwelling Elderly Participants

Background and Purpose: The main goal of hospice care is to improve the quality of life for people who are at the end-of-life phase. However, investigations on the awareness of hospice care among community-dwelling elderly participants are limited. This work aimed to reveal the awareness status of hospice care and explore the factors influencing the awareness rate among elderly participants. Methods: A questionnaire survey was conducted among individuals aged 60 years and above. Results: A total of 4,969 individuals aged 60 years and above were randomly selected from 48 primary medical institutions in Handan. The awareness rate of hospice care in the baseline survey was 19.3% (n = 959). All included individuals were divided into two groups in accordance with their awareness of hospice care. The awareness of hospice care among participants with low educational level, living alone, and afraid of talking about death was low (p < .05). Implications for Practice: The level of awareness of hospice care among community-dwelling elderly participants is low. The influencing factors included educational level, living status, and fear of talking about death. The community-dwelling elderly participants' awareness of hospice care must be improved. It is recommended that public medical education and training should be enhanced to improve knowledge and awareness of hospice care among community-dwelling elderly residents with low educational level, living alone, and afraid of talking about death.

Current status and influencing factors of spiritual needs of patients with advanced cancer: a cross-sectional study

BACKGROUND

Spiritual needs have been associated with better physical health outcomes and provide a context for patients to gain hope and significance in coping with disease. This study aimed to understand the status of spiritual needs of patients with advanced cancer and conducted a quantitative study on the relationship between patient-reported physical, psychological, and social influencing factors and spiritual needs based on a biopsychosocial-spiritual model.

METHODS

In this study, 200 oncology inpatients from Shandong Province were recruited using a convenience sampling method to conduct a cross-sectional survey using general data from December 2020 to June 2022. Correlation analysis was used to analyze the correlation between spiritual needs and cancer-related fatigue, anxiety and depression, the family care index, and social support. Multiple regression analysis was used to analyze the relationship between spiritual needs and the influencing factors.

RESULTS

The spiritual needs score of the patients with advanced cancer was high. Multiple regression analysis revealed that cancer-related fatigue, social support, and religious beliefs influenced the spiritual needs of patients with advanced cancer. Compared with married patients, widowed or divorced patients scored 8.531 points higher on spiritual needs. Cancer-related fatigue, social support, religious beliefs, and marital status (divorced or widowed) explained 21.4% of the total variation in the spiritual needs of patients with advanced cancer.

CONCLUSION

The spiritual needs of patients with advanced cancer were significantly correlated with cancer-related fatigue, depression, social support, and other factors. Religious beliefs, marital status, cancer-related fatigue, and social support were the main factors influencing the spiritual needs of patients with advanced cancer. This is a quantitative study, and medical staff can provide targeted spiritual care for patients with cancer based on the above influencing factors.