Conversation Analysis

Conversation analytic study of communication with the relatives and friends of patients in a hospice

This conversation analytic study aims to understand communication about prognosis and end-of-life care between expert healthcare professionals and the relatives and friends of patients who are approaching the end-of-life.

Family members of patients near the end-of-life value accurate prognostic information that is communicated sensitively by experienced healthcare professionals. Current research is limited and has mostly focused on discussions early in the illness trajectory and with patients and not relatives. Near the end-of-life patients are likely to lack capacity and so it is relatives with whom these discussions will occur and who will need to be given accurate prognostic information and make decisions about care.

We will record 30 conversations between experienced healthcare professionals and relatives of inpatients at a hospice. Recordings will be analysed using conversation analysis to identify practices used by healthcare professionals and relatives to attempt and accomplish communicative tasks. These tasks are likely to include: raising prognosis and care, receipt of information by relatives, communicating uncertainty, and ending these conversations.

In addition to the recording of conversations, healthcare professionals will participate in a focus group on what makes a 'good' conversation with relatives and friends of patients approaching the end-of-life. Relatives will be invited to take part in one-to-one interviews 3-6 months later to gather their perspectives about experiences of communication about end-of-life care and prognosis.

Findings will inform recommendations for future guidelines, training materials and interventions to improve communication skills for less experienced clinicians.

For more information please contact: Rebecca Anderson