Evidence map›Paper›PMID 32590962›Full record

ArticleBMC palliative care2020

Negotiating the turning point in the transition from curative to palliative treatment: a linguistic analysis of medical records of dying patients.

Laila Hov, Oddgeir Synnes, Guri Aarseth

Open access · goldAbstract read
In one paragraph

Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Laila HovVID Specialized University, Diakonveien 14, 0370, Oslo, Norway. Laila.hov@vid.no.ORCID http://orcid.org/0000-0002-4724-4972
Oddgeir SynnesVID Specialized University, Diakonveien 14, 0370, Oslo, Norway.
Guri AarsethLarvik Municipality, Sentrum Legekontor, Sigurds gate 4, 3256, Larvik, Norway.
VID Specialized University · NOLarvik kommune · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany deaths in Norway occur in medical wards organized to provide curative treatment. Still, medical departments are obliged to meet the needs of patients at the end of life. Here, we analyse the electronic patient record regarding documentation of the transition from curative to palliative care (i.e. the 'turning point'). Considering the consequences of these decisions for patients, they have received surprisingly little attention from researchers. This study aims to investigate how the patient record denotes reasons for the shift from curative treatment to palliation and how texts involve voices of the patient and their families.

methodsThe study comprised excerpts from electronic patient records retrieved from medical wards in three urban hospitals in Norway. We executed a retrospective analysis of anonymized extracts from 16 electronic patient records, searching for documentation on the transition from curative to palliative care.

resultsIn the development of the turning point, the texts usually shift from statements about the patient's clinical status and technical findings to displaying uncertainty and openness to negotiation with different textual voices. This shift may represent a need to align or harmonize the attitudes of colleagues, family, and patient towards the turning-point decision. The patient's voice is mostly absent or reported only briefly when, in their notes, nurses gave an account of the patient's opinion. None of the physicians' notes provided a detailed account of patient attitudes, wishes, and experiences.

conclusionIn this article, we have analysed textual representations of patient transitions from curative to end-of-life care. The 'reality' behind the text has not been our concern. As the only documentation left, the patient record is an adequate basis for considering how patients are estimated and cared for in their last days of life.

Indexed as

Attitude of Health PersonnelDecision MakingFemaleHumansLinguisticsMaleMiddle AgedNorwayRetrospective StudiesTerminal CareTransitional CareDying patientsHospitalsLinguistic analysisMedical recordsPalliative care

Identifiers

PMID32590962
PMCPMC7320586
OpenAlexW3037419708

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.