Communication among cancer patients, caregivers, and hospice nurses: Content, process and change over time.
Lee Ellington, Margaret F Clayton, Maija Reblin and 2 others
PMID 28964559WHAT IT FOUND
In home hospice visits, nurses spoke 54% of the time and focused mainly on physical care.
Emotional talk decreased slightly over time, but no predictable pattern emerged because conversations varied wildly based on daily events and patient status.
Key findings
01Nurses spoke 54% of total utterances during visits, with physical care information being the most frequent topic for all parties.
02Emotional talk significantly decreased over time, while physical and psychosocial talk showed no significant linear change.
03There was high variability in communication domains across visits that was not explained by time, nurse, or dyad effects.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Selection bias occurred because nurses acted as gatekeepers for recording, and 40% of eligible visits were not recorded. The study excluded other hospice team members like social workers and chaplains. Quantitative coding limited the contextual richness of the interactions. Early visits were often not recorded, potentially missing stable periods where different communication patterns might emerge.
Declared interests
Funded by N.I.H. Extramural and Non-U.S. Gov't research support. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that emotional conversations will consistently drop off as a patient approaches death. The study found significant variability in communication focus, meaning that emotional needs can spike at any visit depending on daily events and patient status.