Communication in palliative care: a review of recent literature.
OBJECTIVE
The quality of communication with patients, family, and team members is an extremely important element in palliative cancer care. The current paper reviews the literature on these topics as published in 2004.


RESULTS
Trust was found to be a major factor for relationship building. Information gathered by patient self-report is the method of choice, given improved insight in symptom prevalence, duration, frequency, and interference. Cultural factors in information giving, the optimal process and content, and the difficulty of conveying hope were addressed. Decision making in palliative care requires a complex integration of conceptual knowledge, ethical and legal implications, and communication skills. Aspects of manageability are explored. Although health care providers must communicate about emotions, the existential distress of cancer patients and carers often goes overlooked in the last phases of life.


CONCLUSIONS
Themes included the education of health care providers, the need to care for carers, and interdisciplinary communication. Little attention was given to the growing population of elderly patients. Observer-based studies are unfortunately scarce, making the practice of palliative communication unseen. Finally, few studies report the cost-effectiveness of palliative care interventions though such studies may enhance palliative care and convince policy makers of the need to support such care. More empirical work is needed to improve the level of quality needed to ensure a good remaining lifetime for cancer patients whose disease cannot be cured.
de Haes
Hanneke
H
Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands. hdehaes@planet.nl
Teunissen
Saskia
S
D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D011369:Professional-Patient Relations