Project Description
A desire to die (DD) is frequent in palliative care. However, uncertainty remains as to the appropriate therapeutic response. To support health practitioners' (HPs) reactions to a patient’s DD, a training program and a first draft of a semi-structured clinical interview schedule with prompts (CISP) has been developed. This research project aims at revising and finding consensus on the CISP. The CISP is then meant to be used in addressing death and dying and dealing with DD in everyday clinical practice. To this end, the CISP too will be tested and then evaluated in clinical practice.
The study comprises a three step study design: (1) revision of the CISP and consensus finding based on semi-structured interviews with patients and a Delphi process with (inter-)national experts, patient representatives and relatives; (2) increasing confidence in HPs through a 2 day training program using the consented CISP; (3). a formative quantitative evaluation of conversations between HPs and patients (at three time points) and a qualitative evaluation based on interview triads of patients, relatives and HPs. The evaluation of conversations will include patient-oriented outcomes, including perceived relationships with HPs and death and dying distress.
Those interventions aim at providing a framework for open conversation and should strengthen the relationship between HPs and patients so that even difficult subjects can be discussed. Overall, the quality of life of patients with DD as well as the conversation skills and action taking of HPs should thus increase in relevant ways.
