title: 'Conditional candour' and 'knowing me': an interpretive description study on patient preferences for physician behaviours during end-of-life communication.
abstract: OBJECTIVE
  To understand patients' preferences for physician behaviours during end-of-life communication.
  
  
  METHODS
  We used interpretive description methods to analyse data from semistructured, one-on-one interviews with patients admitted to general medical wards at three Canadian tertiary care hospitals. Study recruitment took place from October 2012 to August 2013. We used a purposive, maximum variation sampling approach to recruit hospitalised patients aged ≥55 years with a high risk of mortality within 6-12 months, and with different combinations of the following demographic variables: race (Caucasian vs non-Caucasian), gender and diagnosis (cancer vs non-cancer).
  
  
  RESULTS
  A total of 16 participants were recruited, most of whom (69%) were women and 70% had a non-cancer diagnosis. Two major concepts regarding helpful physician behaviour during end-of-life conversations emerged: (1) 'knowing me', which reflects the importance of acknowledging the influence of family roles and life history on values and priorities expressed during end-of-life communication, and (2) 'conditional candour', which describes a process of information exchange that includes an assessment of patients' readiness, being invited to the conversation, and sensitive delivery of information.
  
  
  CONCLUSIONS
  Our findings suggest that patients prefer a nuanced approach to truth telling when having end-of-life discussions with their physician. This may have important implications for clinical practice and end-of-life communication training initiatives.
authors.affiliation: Division of Palliative Medicine, Department of Oncology, University of Calgary, Tom Baker Cancer Center, Calgary, Alberta, Canada.
authors.forename: Amane
authors.initials: A
authors.lastname: Abdul-Razzak
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: You
authors.affiliation: School of Nursing, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Sherifali
authors.affiliation: Department of Oncology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Simon
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Brazil
mesh_terms: D032722:Advance Care Planning; D016223:Advance Directives; D000368:Aged; D002170:Canada; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013727:Terminal Care; D014342:Truth Disclosure
keywords: advance care planning; critical illness; end-of-life communication; patient preference; physician-patient relations