Communication in Palliative Care and About End of Life: A State-of-the-Art Literature Review of Conversation-Analytic Research in Healthcare

Figures & data

TABLE 1 Publications Included in Chronological Order, and Mapped to Review Themes, Showing Which Publications Contribute to Which Theme/s

Publication	Themes
	Initiation and management of the topic of dying	Initiation and management of the topic of prognosis	Initiation and management of the topic of advance care planning	Interactional management of emotion	Interactional consequences of companions accompanying patients	Pain assessment
Peräkylä (1993)	●		●	●
Lutfey and Maynard (1998)	●	●		●
Maynard (2006)				●
Pino et al. (2016)	●	●		●
Singh et al. (2017)		●
Kawashima (2017)	●	●		●
Shaw et al. (2017)	●		●	●
Land et al. (2019)	●		●
Pino and Parry (2019a)		●		●
Ford et al. (2019)				●
Shaw et al. (2019)			●	●
Anderson et al. (2020)		●		●
Pino et al. (2020)					●
Anderson et al. (2021)		●		●
Briedé et al. (2021)	●		●	●
Jenkins et al. (2021)						●
Sterie et al. (2021)	●		●
Beach (2022)				●
Jenkins et al. (2022)						●
Pino and Land (2022)	●				●
Tate (2022)	●			●
Van Meurs et al. (2021)				●

TABLE 2 Recurrent Interactional Features Documented in 18 of the 22 Included Publications

	The interaction progresses via gradual, step-by-step sequence.	Patients and HCPs recurrently refer to death and dying via indirect reference forms.	Rather than raise or impose a topic or propose a response, HCPs encourage patients/companions to be volunteer the matter, and to bring it to the interactional surface.
Peräkylä (1993)	●		●
Lutfey and Maynard (1998)	●	●	●
Pino et al. (2016)	●	●	●
Singh (2016)		●
Kawashima (2017)	●	●	●
Shaw et al. (2017)	●	●
Land et al. (2019)	●		●
Pino (2018)	●	●	●
Shaw et al. (2019)	●
Anderson et al. (2020)	●	●	●
Pino et al. (2020)	●
Anderson et al. (2021)	●
Briedé et al. (2021)	●
Jenkins et al. (2021)			●
Sterie et al. (2021)	●		●
Jenkins et al. (2022)			●
Pino and Land (2022)	●
Tate (2022)	●	●

Peräkylä, A. (1993). Invoking a hostile world: Discussing the patient’s future in AIDS counselling. Text, 13(2), 291–316. https://doi.org/10.1515/text.1.1993.13.2.291

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Lutfey, K., & Maynard, D. W. (1998). Bad news in oncology: How physician and patient talk about death and dying without using those words. Social Psychology Quarterly, 61(4), 321–341. https://doi.org/10.2307/2787033

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Maynard, D. W. (2006). “Does it mean I’m gonna die?”: On meaning assessment in the delivery of diagnostic news. Social Science & Medicine, 62(8), 1902–1916. https://doi.org/10.1016/j.socscimed.2005.09.011

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Pino, M., Parry, R., Land, V., Faull, C., Feathers, L., & Seymour, J. (2016). Engaging terminally ill patients in end of life talk: How experienced palliative medicine doctors navigate the dilemma of promoting discussions about dying. PLoS One, 11(5), e0156174. https://doi.org/10.1371/JOURNAL.PONE.0156174

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Singh, S., Cortez, D., Maynard, D., Cleary, J. F., Dubenske, L., & Campbell, T. C. (2017). Characterizing the nature of scan results discussions: Insights into why patients misunderstand their prognosis. Journal of Oncology Practice, 13(3), e231–e239. https://doi.org/10.1200/JOP.2016.014621

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Kawashima, M. (2017). Four ways of delivering very bad news in a Japanese emergency room. Research on Language and Social Interaction, 50(3), 307–325. https://doi.org/10.1080/08351813.2017.1340724

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Shaw, C., Chrysikou, V., Davis, S., Gessler, S., Rodin, G., & Lanceley, A. (2017). Inviting end-of-life talk in initial CALM therapy sessions: A conversation analytic study. Patient Education and Counseling, 100(2), 259–266. https://doi.org/10.1016/j.pec.2016.08.024

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Land, V., Parry, R., Pino, M., Jenkins, L., Feathers, L., & Faull, C. (2019). Addressing possible problems with patients’ expectations, plans and decisions for the future: One strategy used by experienced clinicians in advance care planning conversations. Patient Education and Counseling, 102(4), 670–679. https://doi.org/10.1016/j.pec.2018.11.008

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Pino, M., & Parry, R. (2019a). How and when do patients request life-expectancy estimates? Evidence from hospice medical consultations and insights for practice. Patient Education & Counseling, 102(2), 223–237. https://doi.org/10.1016/J.PEC.2018.03.026

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Ford, J., Hepburn, A., & Parry, R. (2019). What do displays of empathy do in palliative care consultations? Discourse Studies, 21(1), 22–37. https://doi.org/10.1177/1461445618814030

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Shaw, C., Chrysikou, V., Lanceley, A., Lo, C., Hales, S., & Rodin, G. (2019). Mentalization in CALM psychotherapy sessions: Helping patients engage with alternative perspectives at the end of life. Patient Education and Counseling, 102(2), 188–197. https://doi.org/10.1016/j.pec.2018.10.001

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Anderson, R. J., Stone, P. C., Low, J. T. S., & Bloch, S. (2020). Managing uncertainty and references to time in prognostic conversations with family members at the end of life: A conversation analytic study. Palliative Medicine, 34(7), 896–905. https://doi.org/10.1177/0269216320910934

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Pino, M., Doehring, A., & Parry, R. (2020). Practitioners’ dilemmas and strategies in decision-making conversations where patients and companions take divergent positions on a healthcare measure: An observational study using conversation analysis. Health Communication, 1–12. https://doi.org/10.1080/10410236.2020.1813952

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Anderson, R. J., Stone, P. C., Low, J. T. S., & Bloch, S. (2021). Transitioning out of prognostic talk in discussions with families of hospice patients at the end of life: A conversation analytic study. Patient Education and Counseling, 104(5), 1075–1085. https://doi.org/10.1016/J.PEC.2020.10.009

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Briedé, S., van Charldorp, T. C., & Kaasjager, K. A. H. (2021). Discussing care decisions at the internal medicine outpatient clinic: A conversation analysis. Patient Education and Counseling, 105(7), 2045. https://doi.org/10.1016/j.pec.2021.11.029

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Jenkins, L., Parry, R., & Pino, M. (2021). Providing opportunities for patients to say more about their pain without overtly asking: A conversation analysis of doctors repeating patient answers in palliative care pain assessment. Applied Linguistics, 42(5), 990–1013. https://doi.org/10.1093/applin/amaa062

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Sterie, A. C., Weber, O., Jox, R. J., & Rubli Truchard, E. (2021). “Do you want us to try to resuscitate?”: Conversational practices generating patient decisions regarding cardiopulmonary resuscitation. Patient Education and Counseling. https://doi.org/10.1016/J.PEC.2021.07.042

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Beach, W. A. (2022). Enacting woundedness and compassionate care for recurrent metastatic breast cancer. Qualitative Health Research, 32(2), 210–224. https://doi.org/10.1177/10497323211050907

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Jenkins, L., Parry, R., & Faull, C. (2022). A direct observation of pain scale use in five video-recorded palliative care consultations: Using conversation analysis to show how practitioners support patients to describe pain. Patient Education and Counseling, 105(7), 2603–2606. https://doi.org/10.1016/j.pec.2021.10.027

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Pino, M., & Land, V. (2022). How companions speak on patients’ behalf without undermining their autonomy: Findings from a conversation analytic study of palliative care consultations. Sociology of Health & Illness, 44(2), 395–415. https://doi.org/10.1111/1467-9566.13427

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Tate, A. (2022). Death and the treatment imperative: Decision-making in late-stage cancer. Social Science & Medicine, 306, 115129. https://doi.org/10.1016/J.SOCSCIMED.2022.115129

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van Meurs, J., Stommel, W., Leget, C., van de Geer, J., Kuip, E., Vissers, K., Engels, Y., & Wichmann, A. (2021). Oncologist responses to advanced cancer patients’ lived illness experiences and effects: An applied conversation analysis study. BMC palliative care. https://doi.org/10.1186/s12904-022-00917-4

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Ekberg, S., Parry, R., Land, V., Ekberg, K., Pino, M., Antaki, C., Jenkins, L., & Whittaker, B. (2021). Communicating with patients and families about illness progression and end of life: A review of studies using direct observation of clinical practice. BMC Palliative Care, 20(1). https://doi.org/10.1186/S12904-021-00876-2

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