Exploring provider-surrogate communication during POLST discussions for individuals with advanced dementia
- Authors
- Kim, H.; Bradway, C.; Hickman, S.E.; Ersek, M.
- Issue Date
- Jun-2019
- Publisher
- ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
- Keywords
- Surrogate decision making; end-of-life care planning; palliative care; dementia; physician orders for life-sustaining treatment
- Citation
- AGING & MENTAL HEALTH, v.23, no.6, pp 781 - 791
- Pages
- 11
- Journal Title
- AGING & MENTAL HEALTH
- Volume
- 23
- Number
- 6
- Start Page
- 781
- End Page
- 791
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/63745
- DOI
- 10.1080/13607863.2018.1452899
- ISSN
- 1360-7863
1364-6915
- Abstract
- Objectives: This qualitative descriptive study explored provider-surrogate communication during Physician Orders for Life-Sustaining Treatment (POLST) discussions for patients with advanced dementia. Methods: Data from participant observations and audio-recordings of ten POLST discussions were analyzed using directed content analysis within the context of an existing conceptual model of Communication and Surrogate Decision Making. Results: Surrogates primarily focused on making sense of the clinical information about life-sustaining treatments during POLST conversations. Providers delivered clinical information about the trajectory of dementia, life-sustaining treatments, and/or features of POLST. They also demonstrated emotional support, by valuing what the surrogate said, acknowledging the surrogate's emotions, listening carefully, understanding the patient as a person, and eliciting questions. However, providers rarely conveyed comprehensive information about the patient's current condition and end-of-life treatment options. Also, open communication of expectations and preferred decision-making roles was rarely observed during the discussions. Conclusion: Findings highlight areas that require providers' attention to conduct effective communication, such as delivering comprehensive information about life-sustaining treatments including discussion of risks and benefits in the context of dementia. Findings also support the use of the conceptual model as a framework to examine provider-surrogate communication in the context of POLST discussions, advanced dementia, and non-hospital settings. Additional research is necessary to confirm these findings in larger, more diverse groups of patients, surrogates, and providers.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Red Cross College of Nursing > Department of Nursing > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/63745)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.