title: Physician-perceived contradictions in end-of-life communication: toward a self-report measurement scale.
abstract: Communication is undoubtedly a critical element of competent end-of-life care. However, physicians commonly lack communication skills in this particular care context. Theoretically grounded, evidence-based guidelines are needed to enhance physicians' communication with patients and their families in this important time of their lives. To address this need, this study tests and validates a Contradictions in End-of-Life Communication (CEOLC) scale, which disentangles the relational contradictions physicians commonly experience when communicating with end-of-life patients. Exploratory factors analysis confirmed the presence of eight physician-perceived dialectical tensions, reflecting three latent factors of (1) integration, (2) expression, and (3) dominance. Furthermore, a number of significant intercultural differences were found in cross-cultural comparisons of the scale in U.S., Swiss, and Italian physician samples. Thus, this investigation introduces a heuristic assessment tool that aids a better understanding of the dialectical contradictions physicians experience in their interactions with end-of-life patients. The CEOLC scale can be used to gather empirical evidence that may eventually support the development of evidence-based guidelines and skills training toward improved end-of-life care.
authors.affiliation: a Institute of Communication and Health , University of Lugano.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Amati
authors.forename: Annegret F
authors.initials: AF
authors.lastname: Hannawa
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D003431:Cross-Cultural Comparison; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D057566:Self Report; D011795:Surveys and Questionnaires; D013557:Switzerland; D013727:Terminal Care; D014481:United States