How can We Improve the Communication Skills between Doctors and the Relatives of Postarrest Patients Receiving Home Palliative Care Services?

Abstract

Objective: It is more complicated to include the relatives of the patients in this process of the patients who are discharged home after cardio pulmonary resuscitation (CPR), especially those who are dependent on household mechanical ventilator and with the lack of communication skills to describe and express their own conditions. The aim of this study is to evaluate the communication between the doctors and the relatives of the postarrest patients who are followed at home, to contribute to the improvement of communication skills identifying the barriers for communication and facilitating factors.

Methods: This descriptive study was carried out with 76 relatives of 44 palliative patients who survived after cardiopulmonary arrest and were discharged from hospital between June 2016-2018. Of the patients who survived at the end of the first year; A total of 76 relatives who were over 18 years of age and were able to read/write Turkish and consented to participate were included in the study. All patient relatives consisted of family members.

Results: A communication attitude scale with a 5-point Likert scale was applied to 76 patients' relatives of total 44 palliative patients who were included in the study. There was statistically significant difference in the confidence sub dimension between the genders of the patients’ relatives. There were statistical differences in the information, empathy and confidence sub dimensions of the relatives of the patients.  Statistically significant difference occurred between the frequency of visits by the relatives of the patients who received homecare and  empathy and trust sub dimensions. There was statistical difference  between the chats of the relatives of the patients with the physicians in the sub-dimension of empathy. In terms of the characteristics of the doctors that are important for the relatives of the patients,  “giving good news” group was statistically different in the informative and empathy sub-dimensions and ” giving correct information “group was statistically different in informative, empathy and confidence sub-dimensions and “having a sympathetic attitude”group was statistically different in the information and confidence sub dimensions.

Conclusions: Patient-doctor communication is basically a communication between two people and requires mutual information support, respect and trust. Doctors may not be born with good  communication skills, but since a doctor is expected to be the professional side in this communication, a doctor should be one to direct the communication and to solve the problems.

We believe that communication between the patient's relatives and the doctor can be increased improving the existing communication skills of the doctors through various training programs and good samples of communication scenarios.