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Communication about the desire to die: Development and evaluation of a first needs-oriented training concept — A pilot study

Published online by Cambridge University Press:  05 March 2020

Gerrit Frerich Open the ORCID record for Gerrit Frerich [Opens in a new window] ,
Vanessa Romotzky Open the ORCID record for Vanessa Romotzky [Opens in a new window] ,
Maren Galushko ,
Stefanie Hamacher ,
Klaus Maria Perrar ,
Axel Doll ,
Thomas Montag ,
Heidrun Golla ,
Julia Strupp  and
Kerstin Kremeike
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Gerrit Frerich*
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Vanessa Romotzky
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Maren Galushko
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Stefanie Hamacher
Affiliation:
Faculty of Medicine and University Hospital, Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany
Klaus Maria Perrar
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Axel Doll
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Thomas Montag
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Heidrun Golla
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Julia Strupp
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Kerstin Kremeike
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany
Raymond Voltz
Affiliation:
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany Faculty of Medicine and University Hospital, Center for Integrated Oncology, University of Cologne, Cologne, Germany Faculty of Medicine and University Hospital, Clinical Trials Center Cologne (ZKS), University of Cologne, Cologne, Germany Faculty of Medicine and University Hospital, Center for Health Services Research Cologne (ZVFK), University of Cologne, Cologne, Germany
*
Author for correspondence: Gerrit Frerich, Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany. E-mail: [email protected]
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Abstract

Objective

Patients’ desire to die (DD) is rarely discussed in palliative care (PC) due to health professionals’ (HPs) feeling of uncertainty. The aim of the study was to develop and evaluate a training to increase HPs’ self-confidence in responding professionally to patient's DD and to assess the feasibility of this approach.

Methods

The training course was developed via focus groups and relevant literature and refined with an advisory board. An evaluation design was developed to evaluate training outcomes and to examine feasibility. To assess self-confidence, knowledge, skills, and attitudes: (1) standardized surveys were applied at T1 (before training), T2 (directly after), and T3 (3 months later), and were analyzed by descriptive and non-parametric statistics; and (2) participants’ open feedback was summarized by content.

Results

A two-day multi-disciplinary training was developed to improve self-confidence via diverse teaching methods. Twenty-four HPs from general and specialized PC were participated. Via self-rating on Likert scales at three time points, improvements were seen at T1, T2, and partly remained at T3, especially in the overall item of self-confidence in communicating with patients about their DD (means: 4.3. at T1, 5.7 at T2, and 5.9 at T3; on a 7-point scale with 1 = lowest value and 7 = highest value). Fewer improvements were found in skills (using different approaches) and attitudes (feeling less helplessness). Open feedback revealed a high appreciation for the training, especially the composition of participants, the role-play, and the overall increase of awareness of the topic.

Significance of results

The developed training on addressing DD meets a need and was perceived by the participants to be of added value. Future research should measure training effects with a validated instrument, including more participants, diverse participant groups, and a control group. Effects on patients should be assessed.

Keywords

CommunicationDesire for hastened deathDesire to dieEducationPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 5 , October 2020 , pp. 528 - 536
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Copyright
Copyright © Cambridge University Press 2020

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Footnotes

*

Both authors contributed equally to this work.

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