The majority of elderly or seriously ill Canadians prefer to avoid aggressive life-sustaining treatment at end of life, and remain at home to receive comfort-oriented care. Yet most Canadians die in an institution, often receiving aggressive care that is associated with a poor quality of life. One of the major contributors to unwanted aggressive end-of-life care is that fact that very few patients discuss their wishes with a physician and develop a care plan before they become seriously ill. Studies show that patients are ready and willing to have these discussions, but physicians often lack the training and comfort to initiate them when patients are admitted to hospital.
In order to improve communication skill and comfort, physicians need to be trained to have these conversations. We would like to measure the patient-level effects of communication training, but first we need to demonstrate that our data collection methods are feasible.
In this project, we will pilot the collection of patient survey data about satisfaction with physician communication and empathy, to see if we could use this technique to evaluate the effectiveness of a multimodal communication intervention in a future multi-centre study (DECIDE II COMMUNICATE).
Dr. James Downar