title: Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review.
abstract: While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic review seven computerized databases were searched to find empirical studies on GP-patient communication in palliative care. Fifteen qualitative studies and seven quantitative questionnaire studies were included. The main perceived barriers were GPs' lack of availability, and patients' and GPs' ambivalence to discuss 'bad prognosis'. Main perceived facilitators were GPs being available, initiating discussion about several end-of-life issues and anticipating various scenarios. Lack of availability and failure to discuss former mistakes appear to be blind spots of GPs. GPs should be more forthcoming to initiate discussions with palliative care patients about prognosis and end-of-life issues. Empirical studies are needed to investigate the effectiveness of the perceived barriers and facilitators.
authors.affiliation: Department of General Practice, and EMGO+ Institute for Health and Care Research, VU University Medical Centre, The Netherlands. w.slort@vumc.nl
authors.forename: W
authors.initials: W
authors.lastname: Slort
authors.forename: B P M
authors.initials: BP
authors.lastname: Schweitzer
authors.forename: A H
authors.initials: AH
authors.lastname: Blankenstein
authors.forename: E A
authors.initials: EA
authors.lastname: Abarshi
authors.forename: I I
authors.initials: II
authors.lastname: Riphagen
authors.forename: M A
authors.initials: MA
authors.lastname: Echteld
authors.forename: N K
authors.initials: NK
authors.lastname: Aaronson
authors.forename: He
authors.initials: H
authors.lastname: van der Horst
authors.forename: L
authors.initials: L
authors.lastname: Deliens
mesh_terms: D003142:Communication; D004493:Education; D058005:General Practitioners; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D010166:Palliative Care / Q000523:psychology / Q000592:standards*; D010465:Perception; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D035501:Uncertainty