The role of hope for health professionals in rehabilitation: A qualitative study on unfavorable prognosis communication


Autoři: Mirjam Amati aff001;  Nicola Grignoli aff002;  Sara Rubinelli aff001;  Julia Amann aff001;  Claudia Zanini aff001
Působiště autorů: Department of Health Sciences and Medicine, University of Lucerne and Swiss Paraplegic Research, Lucerne/Nottwil, Switzerland aff001;  Sasso Corbaro Medical Humanities Foundation, Bellinzona, Switzerland aff002;  Rehabilitation Clinic, Ente Ospedaliero Cantonale, Novaggio, Switzerland aff003;  Psychiatry Consultation Liaison Service, Organizzazione Sociopsichiatrica Cantonale, Mendrisio, Switzerland aff004;  Swiss Paraplegic Research, Nottwil, Switzerland aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224394

Souhrn

Background

The communication of prognosis represents an ethical and clinical challenge in medical practice due to the inherent uncertain character of prognostic projections. The literature has stressed that the mode of communicating prognoses has an impact on patients’ hope, which is considered to play a major role in adapting to illness and disability. In light of this, this study aims to explore health professionals’ (HPs) perceptions of the role of hope in rehabilitation and to examine if and how they use strategies to maintain hope when discussing prognostic information with patients.

Methods

Eleven qualitative semi-structured interviews with a purposive sample of HPs were conducted at two rehabilitation clinics in the Canton of Ticino, Switzerland. The interviews were analyzed using thematic analysis.

Results

The HPs perceive hope in rehabilitation as a double-edged sword. Three main strategies were identified to maintain hope while avoiding false hope: 1) giving space for self-evaluation; 2) tailoring the communication of prognostic information; and 3) supporting the patient in dealing with the prognosis. These strategies are particularly suitable when HPs consider that patients might not be ready to accept the prognosis, due to their expectations for recovery.

Conclusions

The strategies identified here support a person-centered approach to the communication of prognosis and are in line with existing protocols for the communication of unfavorable medical information. The findings emphasize the need for strengthening communication and inter-professional collaboration skills of rehabilitation HPs.

Klíčová slova:

Communications – Medical doctors – Neurorehabilitation – Nurses – Oncology – Patients – Prognosis – Medical ethics


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