The majority of elderly and seriously--ill Canadians prefer to avoid aggressive life--sustaining treatment at the 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 the 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 have developed effective means of teaching skills and improving physician comfort using simulation workshops and expert feedback, but we have not yet determined whether this training leads to improvements at the patient level. 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 multicentre study (DECIDE II COMMUNICATE). Our primary objectives are to demonstrate feasibility. The results of this project will be used to inform DECIDE II COMMUNICATE, and could be relevant to any researcher looking to evaluate the effectiveness of an intervention using patient--level outcomes among seriously ill and hospitalized elderly patients.
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