Epidemiology of Connectional Silence in specialist serious illness conversations.

Communication Critical Illness / epidemiology Humans Neoplasms / epidemiology Palliative Care Physician-Patient Relations Referral and Consultation
Cancer Communication Conversation Palliative care Pause Silence

Journal

Patient education and counseling
ISSN: 1873-5134
Titre abrégé: Patient Educ Couns
Pays: Ireland
ID NLM: 8406280

Informations de publication

Date de publication:
07 2022
Historique:
received: 22 08 2021
revised: 27 10 2021
accepted: 28 10 2021
pubmed: 21 11 2021
medline: 18 6 2022
entrez: 20 11 2021
Statut: ppublish

Résumé

Human connection can reduce suffering and facilitate meaningful decision-making amid the often terrifying experience of hospitalization for advanced cancer. Some conversational pauses indicate human connection, but we know little about their prevalence, distribution or association with outcomes. To describe the epidemiology of Connectional Silence during serious illness conversations in advanced cancer. We audio-recorded 226 inpatient palliative care consultations at two academic centers. We identified pauses lasting 2+ seconds and distinguished Connectional Silences from other pauses, sub-categorized as either Invitational (ICS) or Emotional (ECS). We identified treatment decisional status pre-consultation from medical records and post-consultation via clinicians. Patients self-reported quality-of-life before and one day after consultation. Among all 6769 two-second silences, we observed 328 (4.8%) ECS and 240 (3.5%) ICS. ECS prevalence was associated with decisions favoring fewer disease-focused treatments (OR Connectional Silences during specialist serious illness conversations are associated with decision-making and improved patient quality-of-life. Further work is necessary to evaluate potential causal relationships. Pauses offer important opportunities to advance the science of human connection in serious illness decision-making.

Identifiants

DOI: 10.1016/j.pec.2021.10.032 PMID: 34799186
pubmed: 34799186
pii: S0738-3991(21)00717-5
doi: 10.1016/j.pec.2021.10.032
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Pagination

2005-2011

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Cailin J Gramling (CJ)

University of Vermont, Burlington, VT, USA.

Brigitte N Durieux (BN)

University of Vermont, Burlington, VT, USA.

Laurence A Clarfeld (LA)

Department of Computer Science, University of Vermont, Burlington, VT, USA.

Ali Javed (A)

Department of Computer Science, University of Vermont, Burlington, VT, USA.

Jeremy E Matt (JE)

Complex Systems & Data Science, University of Vermont, Burlington, VT, USA.

Viktoria Manukyan (V)

InSpace Proximity, Burlington, VT, USA.

Tess Braddish (T)

Department of Family Medicine, University of Vermont, Burlington, VT, USA.

Ann Wong (A)

University of Vermont, Burlington, VT, USA.

Joseph Wills (J)

University of Vermont, Burlington, VT, USA.

Laura Hirsch (L)

University of Vermont, Burlington, VT, USA.

Jack Straton (J)

University of Vermont, Burlington, VT, USA.

Nicholas Cheney (N)

Department of Computer Science, University of Vermont, Burlington, VT, USA.

Margaret J Eppstein (MJ)

Department of Computer Science, University of Vermont, Burlington, VT, USA.

Donna M Rizzo (DM)

Department of Civil Engineering, University of Vermont, Burlington, VT, USA.

Robert Gramling (R)

Department of Family Medicine, University of Vermont, Burlington, VT, USA. Electronic address: robert.gramling@med.uvm.edu.

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Classifications MeSH

questionsmedicales.fr › Sciences de l'information › Communication › Epidemiology of Connectional Silence in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie grave › Epidemiology of Connectional Silence in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Epidemiology of Connectional Silence in...
questionsmedicales.fr › Tumeurs › Epidemiology of Connectional Silence in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Soins palliatifs › Epidemiology of Connectional Silence in...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Relations entre professionnels de santé et patients › Relations médecin-patient › Epidemiology of Connectional Silence in...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Pratique professionnelle › Orientation vers un spécialiste › Epidemiology of Connectional Silence in...