How to estimate understanding: professionals' assessment of loved ones' insight into a patient's fatal disease.
BACKGROUND
Loved ones of a patient with an incurable disease will accompany the patient to the end of life. Health care professionals must discuss difficult matters with loved ones and be sure that they really understand the seriousness of the patient's disease. The study explore how the professionals do when they explore the grounds on which they make their assessment of loved ones' insight into a patient's fatal disease.


METHODS
A qualitative design was chosen to gain deeper knowledge of professionals' perception of loved ones' understanding. The transcribed interviews were analysed using content analysis giving a richer understanding of the meaning of the content.


RESULTS
The participants assessed loved ones' insight into the fatal disease based on the course and content of the conversations they had with the loved ones. The professionals' assessments were based on how the loved ones talked and expressed themselves in words and behavior and on the type of questions posed by the loved ones. The loved ones' observations and hope as denial or a strategy also contributed to their assessment.


CONCLUSIONS
Ways to communicate with loved ones are crucial when making an assessment. The different ways loved ones use hope and other strategies made it problematic for the professionals to use these as indicators of state of mind in this matter. Training in conversation skills could be one way to support professionals when discussing and managing these difficult situations.
1 Palliative Care Unit, Sahlgrenska University Hospital , Gothenburg, Sweden .
Inger
I
Benkel
Helle
H
Wijk
Ulla
U
Molander
D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D032882:Comprehension; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D011368:Professional-Family Relations; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult