SynthesisBMJ supportive & palliative care2014
How to communicate with patients about future illness progression and end of life: a systematic review.
Synthesis in BMJ supportive & palliative care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Communication practices for delivering health behaviour change conversations in primary care: a systematic review and thematic synthesis.BMC family practice · 2019Pooled it
- Advance care planning: A systematic review about experiences of patients with a life-threatening or life-limiting illness.Palliative medicine · 2018Pooled it
- Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research.Health expectations : an international journal of public participation in health care and health policy · 2017Pooled it
- Training general practitioners contributes to the identification of palliative patients and to multidimensional care provision: secondary outcomes of an RCT.BMJ supportive & palliative care · 2019Trial
- Article
- Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations.European geriatric medicine · 2025Article
- Initiating Prognostic Talk During Hospice Multidisciplinary Team Meetings: A Conversation Analytic Study.Journal of palliative care · 2025Article
- Staff's Knowledge and Self-Confidence in Difficult Communication: Evaluation of a Short Experiential-Based Training Program.Nursing reports (Pavia, Italy) · 2025Article
- Communicating about the end of life: The path of prognostic awareness.Palliative & supportive care · 2025Article
- Ethnographic closeness: methodological reflections on the interplay of engagement and detachment in immersive ethnographic research.The journal of the Royal Anthropological Institute · 2023Article
- Giving a voice to patients at high risk of dying in the intensive care unit: a multiple source approach.Intensive care medicine · 2023Article
- RealTalk evidence-based communication training resources: development of conversation analysis-based materials to support training in end-of-life-related health and social care conversations.BMC medical education · 2022Article
- Coding linguistic elements in clinical interactions: a step-by-step guide for analyzing communication form.BMC medical research methodology · 2022Article
- To Accompany, Always: Psychological Elements of Palliative Care for the Dying Patient.Journal of palliative medicine · 2022Article
- Cross Cultural Adaptation and Cognitive Testing of a Psycho-Social-Spiritual Healing Measure, the NIH Healing Experiences in All Life Stressors-NIH-HEALS.Global advances in health and medicine · 2022Article
- 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 · 2021Review
- Multi-disciplinary supportive end of life care in long-term care: an integrative approach to improving end of life.BMC geriatrics · 2021Article
- Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians.Journal of pain and symptom management · 2020Article
- Advance care planning in patients referred to hospital for acute medical care: Results of a national day of care survey.EClinicalMedicine · 2020Article
- Systematic identification of critically ill and dying patients in primary care using the German version of the Supportive and Palliative Care Indicators Tool (SPICT-DE).German medical science : GMS e-journal · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConversation and discourse analytic research has yielded important evidence about skills needed for effective, sensitive communication with patients about illness progression and end of life.
objectivesTo: ▸ Locate and synthesise observational evidence about how people communicate about sensitive future matters; ▸ Inform practice and policy on how to provide opportunities for talk about these matters; ▸ Identify evidence gaps.
designSystematic review of conversation/discourse analytic studies of recorded interactions in English, using a bespoke appraisal approach and aggregative synthesis.
results19 publications met the inclusion criteria. We summarised findings in terms of eight practices: 'fishing questions'-open questions seeking patients' perspectives (5/19); indirect references to difficult topics (6/19); linking to what a patient has already said-or noticeably not said (7/19); hypothetical questions (12/19); framing difficult matters as universal or general (4/19); conveying sensitivity via means other than words, for example, hesitancy, touch (4/19); encouraging further talk using means other than words, for example, long silences (2/19); and steering talk from difficult/negative to more optimistic aspects (3/19).
conclusionsPractices vary in how strongly they encourage patients to engage in talk about matters such as illness progression and dying. Fishing questions and indirect talk make it particularly easy to avoid engaging-this may be appropriate in some circumstances. Hypothetical questions are more effective in encouraging on-topic talk, as is linking questions to patients' cues. Shifting towards more 'optimistic' aspects helps maintain hope but closes off further talk about difficulties: practitioners may want to delay doing so. There are substantial gaps in evidence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.