Since class on Saturday, and after receiving the input on my IRB application and proposal, I've been working on narrowing my focus to make my project more workable and one that will be suited for participation/observation. I've decided to now study "Communication Skills in Talking About Death." This topic will incorporate some elements of physician/patient communication, but will also allow me the opportunity to observe other hospice caregivers communicating with patients and their families. I hope to learn about how death is discussed (terms, spiritual elements, broadly, specifically, sensitively, etc.) In addition, I hope to explore variables such as whether family members are communicated with differently regarding the patient's impending death when in the presence of the patient or not. As part of my research, I will explore training received for this skill set and whether it is viewed as adequate. My interviews will be with health care providers to the terminally ill, including physicians, nurses, hospice spiritual care providers.
I have also sought and obtained approval from my employer to conduct this participation/observation.
I feel better about my project, and look forward to beginning my participation observation in the next day or two! I realize this may sound "odd"--looking forward to observing people talking about death, but I am passionate about promoting quality end-of-life experiences. When one has seen the extremes of this first-hand, it becomes an important value, and one you want to share with others. I hope all of my classmates will learn something from my research!
Now to get to the revision of my IRB and the Library assignment. . . ONWARD!!
Lauren,
ReplyDeleteI think you have chosen a very intriguing topic. Certainly, this topic has not been over-researched. I am interested in what you will find, and I believe you are in a unique position to thoroughly explore this.
I will be interested in what you find... I'm curious as to whether the interviewees will be forthcoming in owning up to the real reason they avoid it... psychologically uncomfortable in being the bearer of bad news; they fear it themselves, so they don't like discussing it; they are unsure of a patient's spiritual take in passing, so they don't know whether it is something that is feared, or a transition to a wonderful new place? I'm listening to that book, Making Rounds with Oscar, and it's quite interesting. It speaks a lot about what caregivers, families and patients go through when dealing with end-stage dementia - and this cat is amazing! (A little angel, I think.) The audiobook is a great option, because you can do housework, etc. while listening... or I just downloaded the .mp3 on my phone. I recommend it.
ReplyDeleteI, too am interested to hear what you find in your research. I was just talking with my dad today about when he received his cancer prognosis about 12 years ago. He told me his doctor's wouldn't give him one. According to him, each time he asked for more information about what to expect, if he should start making arrangements, etc., they said, "Let's just see how things go." Similarly, when my step-mother was ready to make her trip (that's what I say--making the trip up to heaven--I think I heard it from my Grampa years ago), my dad asked her oncologist about hospice care and was given the total brush off. He was told it was ridiculous to even consider that, even though there was basically nothing left of her at that point. She made her trip about a month later. So, in my family's experience, there has been avoidance from medical professionals in discussing this topic. At the same time, will giving a prognosis at the time of diagnosis really help with treatment? My dad said he heard from his doctors long after he was in remission that they were mostly amazed because they all thought he would end up terminal. Interesting stuff.
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