title: Enhancing patient-professional communication about end-of-life issues in life-limiting conditions: a critical review of the literature.
abstract: BACKGROUND
  The End of Life Care Strategy for England highlights effective communication between patients and professionals as key to facilitating patient involvement in advance care planning. The strategy emphasizes that, currently, communication in patients with noncancer life-limiting conditions is likely to be inadequate, and research has identified that patients with chronic obstructive pulmonary disease and heart failure have a poor understanding of their condition.
  
  
  OBJECTIVE
  To identify existing interventions of patient-professional communication developed for life-limiting conditions and explore the applicability of interventions developed within a cancer framework to other diagnostic groups.
  
  
  METHODS
  A comprehensive literature review of studies describing communication interventions for patients receiving end-of-life care was undertaken. Ten electronic databases were searched. Inclusion criteria were all English language studies relating to patient-professional communication interventions for patients with life-limiting conditions receiving end-of-life care.
  
  
  RESULTS
  Of the 755 articles initially identified, 16 met the inclusion criteria. Three core themes emerged from the synthesis of the literature: using education to enhance professional communication skills, using communication to improve patient understanding, and using communication skills to facilitate advance care planning.
  
  
  CONCLUSIONS
  Although limited, evidence relating to the development and evaluation of communication interventions for patients with life-limiting illnesses would suggest that a successful intervention should include combined components of training, patient discussion, and education. In a context of limited resources and an increasing number of patients living and dying with chronic life-limiting conditions, the need for appropriate and effective communication strategies should be seen as a priority for both research and policy.
authors: School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom. s.barnes@sheffield.ac.uk
authors: Sarah
authors: S
authors: Barnes
authors: Clare
authors: C
authors: Gardiner
authors: Merryn
authors: M
authors: Gott
authors: Sheila
authors: S
authors: Payne
authors: Becky
authors: B
authors: Chady
authors: Neil
authors: N
authors: Small
authors: David
authors: D
authors: Seamark
authors: David
authors: D
authors: Halpin
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration*; D058015:Health Communication / Q000379:methods*; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods / Q000458:organization & administration*; D010817:Physician-Patient Relations; D013727:Terminal Care / Q000379:methods / Q000458:organization & administration*