Factors that influence IF conversations are initiated: | 1. Barrier of inexperience: the need for training and developing experience in advanced communication skills |
2. Judgement call on patient’s level of awareness/denial | |
3. Unwillingness of relatives to have these conversations | |
4. Uncertainty of trajectory with long term conditions (heart failure) | |
Factors that influence WHEN conversations about PPC take place | 1. Patients initiate or ask for information |
2. Judgement on timing – don’t want to concern patients/relatives too early (nor leave it too late) | |
3. Once preparatory work is carried out (getting to know the patient; planning what to say) | |
4. Because of pressure to follow policy guidelines and find out patient preferences | |
Factors that influence HOW these conversations take place | 1. Taking a ‘drip drip’ approach |
2. Use of trigger questions | |
3. Different choice of language e.g. some HCPs will use the words death and dying; some would not |