Serious illness conversations in patients with multiple myeloma and their family caregivers—A qualitative interview study

Myrhøj, Cæcilie Borregaard; Clemmensen, Stine Novrup; Røgind, Signe Sax; Jarden, Mary; Viftrup, Dorte Toudal

doi:10.1111/ecc.13537

Cited by 11 publications

(22 citation statements)

References 32 publications

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“…This would help patients and caregivers to live life better with multiple myeloma, but it might also have in uenced the conversations in general between the participating nurses and doctors. It was found in the analysis of the dyad interviews with patients and caregivers that SICP conversation had affected their communication before, during, and after the actual conversation [5]. This study could also indicate that the participating nurses and doctors were also affected before, during, and after being introduced to the importance of compassionate care and existential aspects of care and treatment.…”

Section: Findings In Relation To Other Studiesmentioning

confidence: 87%

“…The analysis of the dyad interviews with patients and caregivers has been presented elsewhere [5]. Three themes emerged concerning patients and caregivers' experiences with the concept: 1) Transforming patient-caregiver communication; the SICP conversation seemed to affect communication between patients and caregivers before, during, and after the actual conversation.…”

Section: Qualitative Evaluationmentioning

confidence: 99%

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Adaptation and Implementation of Serious Illness Conversations in a Danish Hematological Setting

Viftrup

Myrhøj

Andersen

et al. 2023

Preprint

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Backgrounds: Patients with hematological cancers and their caregivers request more realistic information about disease trajectory and prognosis. The aim of the study was to evaluate the implementation of an adapted SICP concept into the hematological department at Copenhagen University Hospital in Denmark. Methods: For evaluating the adaptation and implementation of the SICP the outlined framework in the updated guidelines for complex interventions by the UK Medical Research Council was used combined with an action research design with 5 haematological doctors, 5 nurses, 6 patients with haematological malignancies, and 4 caregivers. For evaluating the effectiveness of the adapted concept as well as understanding the processes of change, a combination of quantitative and qualitative methods was performed with two questionnaire scales, focus group, and dyad interviews. Results: There were no significant correlations between before and after on either of the two scales. Among the individual questions within the two scales, seven questions showed significant difference from before to after the course or between participants and control group. The analysis of the questionnaire data points to that participants might increase confidence in their own abilities to include existential aspects in patient care and make changes in care plan, if needed. It also seemed that nurses and doctors who found it important to care for patients’ existential concerns and believe this to be an important part of their job were more likely to participate in the SICP concept. The qualitative analysis points to the importance of interdisciplinarity of the nurse and doctor in the SICP because then the patient’s and caregiver’s preferences are integrated in the treatment and care plan, and it strengthens conversations involving medical, holistic, and existential issues. It particularly seemed how time allocated for the conversation and the preparatory materials for the conversations highly influenced outcome of the conversation. Conclusions: The implementation of adapted SICP is feasible in a hematological setting, and it facilitated overcoming barriers for offering more existential consultations in hematology. SICP concept have been implemented to all staff members of the myeloma/lymphoma clinic and to be integrated timely throughout the disease trajectory starting at the time of diagnosis.

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Section: Findings In Relation To Other Studiesmentioning

confidence: 87%

Section: Qualitative Evaluationmentioning

confidence: 99%

Adaptation and Implementation of Serious Illness Conversations in a Danish Hematological Setting

Viftrup

Myrhøj

Andersen

et al. 2023

Preprint

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“…Additionally, the adapted conversation is "unhurried" as one hour is allocated for both conversation and documentation. Patients and caregivers receive preparatory material that facilitates prior re ection about level of prognostic information, quality of life, existential issues, and helps the patient and caregiver decide which concerns to focus upon during the conversation (5).…”

Section: Methodsmentioning

confidence: 99%

“…Patients with MM have a substantial symptom burden with acute and chronic psychosocial and medical needs which require engagement of the interdisciplinary team (2)(3)(4). Due to poor survival and high symptom burden in patients with MM, preparing patients and caregivers for serious illness and end-of-life issues should be part of interdisciplinary MM cancer care (5). Research recommends an interdisciplinary team approach in serious illness and end-of-life conversations but reveal uncertainty about role responsibility (6, 7).…”

Section: Introductionmentioning

confidence: 99%

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Interdisciplinary collaboration in Serious Illness Conversations in patients with multiple myeloma and caregivers – A qualitative study

Myrhøj

Viftrup

Jarden

et al. 2023

Preprint

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Background There is growing evidence that conversations between healthcare professionals and patients with serious illness can improve the quality of end-of-life cancer care. Yet, there is lack of insight into how different professions collaborate to deliver serious illness communication as well as patients’ and caregivers’ perception of this collaboration between the nurse and physician. This study explores the interdisciplinary collaboration between nurses and physicians in serious illness conversations with patients diagnosed with multiple myeloma and their caregivers. Methods Eleven dyadic interviews were conducted with 22 patients and caregivers and two focus group interviews, one with four nurses and one with four physicians. Data analysis and reporting were conducted using reflexive thematic analysis within phenomenological epistemology. Results The interdisciplinary collaboration was characterized by three main themes: 1) Importance of relationships, 2) Complementary perspectives, and 3) The common goal. Conclusion This study highlights the importance of interdisciplinarity in serious illness conversations as it strengthens the use of existential and descriptive language in conversations involving medical, holistic, and existential issues. The use of broader language also reflects that interdisciplinary interaction strengthens each professional's expertise in patient care. Through interdisciplinary collaboration, the patient’s and caregiver’s medical preferences and hopes, and values can be integrated into the treatment plan, which is the key to providing the best care for the patient and caregiver. It is recommended to make organizational changes to support continuity in patient–healthcare professional relationships, support interdisciplinary training, and a few minutes of preparation before the conversation and debriefing afterward to avoid fragmented and uncoordinated collaboration.

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Providing Care to People Living with a Chronic Hematological Malignancy: A Qualitative Evidence Synthesis of Informal Carers’ Experiences

Cormican

Dowling²

2022

Seminars in Oncology Nursing

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Serious illness conversations in patients with multiple myeloma and their family caregivers—A qualitative interview study

Cited by 11 publications

References 32 publications

Adaptation and Implementation of Serious Illness Conversations in a Danish Hematological Setting

Adaptation and Implementation of Serious Illness Conversations in a Danish Hematological Setting

Interdisciplinary collaboration in Serious Illness Conversations in patients with multiple myeloma and caregivers – A qualitative study

Providing Care to People Living with a Chronic Hematological Malignancy: A Qualitative Evidence Synthesis of Informal Carers’ Experiences

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