The impact of time and communication on professional decision-making regarding patients with advanced lung cancer: Interpretative phenomenological analysis of focus groups with specialist palliative care professionals

Audrey Roulston

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Abstract

Background: Many medical decisions are guided by principles of autonomy, non-maleficence, beneficence, and justice, yet involve uncertainty and ethical dilemmas. It is important to understand what illness, life and death mean to each patient, alongside their values, priorities, preferences, knowledge and expectations regarding treatment and care.
Methods: Focus group meetings, conducted with 10 members of a Community Specialist Palliative Care Team in Northern Ireland, who cared for patients diagnosed with advanced lung cancer, were analysed using Interpretative Phenomenological Analysis.
Results: Three super-ordinate themes were identified: time, decision-making and communication. Timely referrals for exploratory tests, accurate communication of test results and ‘red flag’ systems for treatment or services, maximising IT systems, were recommended. Uncertainty, busy clinics, lack of privacy and perceived awkwardness impeded effective communication between professionals and patients. Having a trusting relationship, timely access to accurate diagnostic and prognostic information, competent communication skills, and respect for patient wishes, enabled communication.
Implications for practice: professionals must build effective, trusting relationships with patients, carers and other professionals. Choices and decisions need to be navigated sensitively and competently. End-of-life care wishes or priorities should be reviewed regularly and documented.
Original languageEnglish
Pages (from-to)7-25
JournalActa Missiologica
Volume15
Issue number1
Publication statusPublished - 30 Apr 2021

Keywords

  • Palliative Care
  • Focus Groups
  • Interpretative Phenomenological Analysis
  • Lung cancer
  • Decision-making

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