Effective communication in palliative care from the perspectives of patients and relatives: A systematic review

Abstract

Objectives. In palliative care, effective communication is essential to adequately meet the needs and preferences of patients and their relatives. Effective communication includes exchanging information, facilitates shared decision-making and promotes an empathic care relationship. We explored the perspectives of patients with an advanced illness and their relatives on effective communication with healthcare professionals. Methods. A systematic review was conducted. We searched Embase, Medline, Web of Science, CINAHL and Cochrane for original empirical studies published between January 1, 2015 and March 4, 2021. Results. In total, 56 articles on 53 unique studies were included. We found 7 themes that from the perspectives of patients and relatives contribute to effective communication: (1) open and honest information. However, this open and honest communication can also trigger anxiety, stress, and existential disruption. Patients and relatives also indicated that they preferred (2) healthcare professionals aligning to the patient’s and relative’s process of uptake and coping with information; (3) empathy; (4) clear and understandable language; (5) leaving room for positive coping strategies, (6) committed healthcare professionals taking responsibility; and (7) recognition of relatives in their role as caregiver. Most studies in this review concerned communication with physicians in a hospital setting. Significance of results. Most patients and relatives appreciate healthcare professionals to not only pay attention to strictly medical issues, but also to who they are as a person and the process they are going through. More research is needed on effective communication by nurses, in non-hospital settings and on communication by healthcare professionals specialized in palliative care.