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Communication And Relationship In Palliative Care Assignment Sample

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Introduction : Communication And Relationship In Palliative Care

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Palliative care is marked as a specific approach that is quite effective to develop the quality of life of patients including children and adults. Besides that, it is also helpful to show a generic approach towards patient families who are actively suffering from certain issues associated with some most relevant life-threatening illnesses. Although, communication is highly important to act as a therapeutic tool that creates an optimal sense of security and trust for both the patient family and the patient. This essay mainly showcases the core reason behind the urgency of effective communication, evaluating several communication systems to explore the value and influence of contemporary communication theories in this care delivery field. The thesis statement of this essay focuses on the communication process along with an examination of its core relationship towards palliative care in Australia. Besides that, underpinning theories are also used in this essay which can be helpful to understand the exact way of communication procedure. In this essay, while highlighting part is palliative care, communication basis principles are also outlined which have applicability and relevance to healthcare working in different clinical settings.

Communication and relationships in palliative care

Effective communication process in palliative care is a mode of an instrument in terms of enhancement of basic therapeutic relationships which exist between healthcare professionals and patients. In Australia, well-maintained communication is systematically recognized by healthcare professionals’ work including a nurse, doctors, and practitioners in specialist practice areas (Aihw.gov.au, 2022). In recent days, the majority of Australian adult people in need of palliative care suffer from chronic diseases like diabetes, AIDS, chronic respiratory disease, cancer along with cardiovascular disease (Palliaged.com.au, 2020). As opined by Pollens (2020), the patient or patient family having professional communication with a nurse or doctor reduce stress level, and experience regularly. In recent Australian healthcare statistics, from 2020 to 2021, nearly 15,890 patients have received more than 77,500 palliative medicine specialist services (Aihw.gov.au, 2022). Hence, it can be analyzed that well-developed communication is marked as an effective factor in the progress rate of pediatric palliative care in terms of building strong relationships with patients and health professionals. In terms of connecting with patients and reducing disease, major complications can be addressed through communicative support to acknowledge the disease risk in a specific supportive way (Walter et al. 2019). As a result, it can make necessary infrared decisions regarding care delivery structure within the higher quality of community-based palliative care. From a case study example, language and speech therapists help to assess patient-based communication to understand their needs. As a result, it is suitable to provide necessary health progress-related advice to critically manage the health disturbance of patients.

Models and theories are utilized in a stage of program planning to acknowledge and explain particular health behaviour which is further useful to the development, identification and implementation of necessary interventions. According to "humanising nursing communication theory”, it can emphasise a state of interpersonal relationship between patients and nurses (Nwozichi, 2019). Based on the above-mentioned theoretical point of view, this relationship has a specific aim to minimise inappropriate outcomes and prevent ineffective communication which is not required in palliative care for early prognosis. Certain levels of feeling, facts and humanising attitudes have been changed based on the ongoing patient's health status. On the other hand, Peplau also stated that healthcare professionals including nurses have to be cognizant of body language with gestures that are displayed during a phase of caregiver and patient interaction (Pollens, 2020). Moreover, the theoretical perspective also showcases that nurses have to strive for minimum nonverbal and maximum verbal communication interactions with patients.

Its role and importance

Handing individual patients with specific communication needs through maintaining sensitive communication skills and giving adequate time during optimal cases of illness is much necessary for sharing information, and giving medicine. Based on the Australian healthcare structure, certain diseases including neck and head cancer, Parkinson's disease, and multiple sclerosis type of illness string affect muscles and nerves which are essential for speech (Rhee et al. 2018). In addition, a well-designed communication structure ideally mitigates and relieves suffering risk through initial identification, the exact way of assessment along with specific treatment for psychological, and physical pain. In this way, this caring approach involves health-oriented service which is delivered via healthcare professionals including physiotherapists, paramedics, support healthcare workers, nursing and physicians. According to NMBA standards, registered healthcare professionals accordingly conduct systematic and comprehensive assessments to critically evaluate data and information with possible outcomes based on practice (Palliativecare.org.au, 2019).

Under the Australian care delivery field, the code of conduct of NMBA has shown an optimal process of communication depending on safe practice, and standard collaboration. As opined by Scherrens et al. (2020), the "Theory of Planned Behaviourcreates a strong link between behaviour and belief during delivery care. Moreover, this theoretical approach also positively maintains a few components named perceived behaviour control, subjective norms and attitude combinedly, to shape man behaviour intention of the patient.Although, it is required to maintain respectful relationships between the patient family and health professionals, specifically nurses, under a mode of cultural practice to build professional and therapeutic relationships. As suggested by Stiel et al. (2019), screening patients regarding palliative care has used certain criteria including dementia, frailty and other functional limitations due to illness conditions.

Nowadays, care coordination, necessary care from caregivers as well as relieving stress, pain and symptoms of a disease like fatigue, breathing shortness, and nausea need proper assessment and treatment methods for early prognosis. In this way, nurses including other health practitioners have to maintain the core ability to tolerate necessary medical treatment by providing an advanced care delivery structure with smart communication to cope with the situation. As suggested by Olsson et al. (2021), several components are essential to ensure positive communication among healthcare providers. Hence, HIPAA- compliant is secure enough with existing audit trials to deliver a better care approachcombinedly (Palliativecare.org.au, 2017). Mass communication in terms of distributing specific messages among a wider ecosystem and automated scheduling within a process of automated alert escalations are listed as other pathways to communicate between healthcare professionals during palliative care.

Some of the most relevant strategies have been identified by highlighting the deterioration of patients in terms of aiding decision-making. Besides that, gathering numerous References belonging to patient care delivery, providing necessary treatment and medication, using staging and pacing of information along with tailoring individual information help to receive patients with disruptive health issues (Who.int, 2020). In this way, a majority of Australian health professionals have stated a belief in terms of applying direct communication language by involving families in the decision-making process. Although, it is quite essential to maintain medical and healthcare standards and follow specific care delivery norms while communicating with a patient's family or directly talking to a patient.

Good way of communication through maintaining ethical norms, healthcare professionals have been generating strong support for patients' families during palliative care along with giving emotional strength to loved ones. Hence, it can be determined that patient-centred and effective communication is a high-priority mode of giving quality care. In this way, a good communication system is intensively imperative as well as essential to informed consent. As stated by Walter et al. (2019), effective patient engagement and strong relationships mean avoiding a maximum range of difficulties and errors. As a result, it can develop quality and also achieve better and disease-free health outcomes.;

Barriers and challenges faced during the communication process with palliative care patients and their families

Commonly reported certain barriers under a mode of critical care setting including lesser access to healthcare education, difficult end-of-life deacons and communication gaps. Challenges in the cycle of palliative care can be due to poor optimisation of standard communication structure (Walter et al. 2019). On the other hand, communication errors can be life-threatening during two different phases such as "breaking bad news (BBN)” and “Clinician-patient interviewing (CPI)”. These two fundamental protocols have been marked as strategies or templates such as the “B-R-E-A-K-S protocol and the S-P-I-K-E-S protocol for BBN” whereas the “C-L-A-S-S strategy for CPI” (Health.gov.au, 2019). Recent healthcare reports help to record that, nearly 3 patients out of five have died in hospitals in Australia due to a poor range of palliative care in the final stage of hospitalisation. In this regard, the lesser involvement of standard communication approaches creates a greater risk to enhance certain healthcare issues. As opined by Steigleder, Kollmar & Ostgathe (2019), lack of communication between caregivers, nurses along with other healthcare professionals is marked as a major complaint from patient families during the end of patient life. As an example from the case study scenario, healthcare professionals report has detected end of life communication is quite challenging and often waits for the patient family of the patient for initiating strategic conversation.

Not entirely allowing for minimum time with the patient's family and patient, language issues, and care delivery patterns are listed as major barriers to effective communication in paediatric Palliative care. Although, poor privacy maintenance during meetings to share rooms or other clinical or management interruptions, poor preparation to treat patients, and effectively detecting of patient health emergencies also create another risk to handle for end life stage-patients (Suwanabol et al. 2018). It creates a major disruption to recovery from disruptive health emergencies. Effective palliative care for stroke patients in the Australian healthcare sector often encounters several barriers including financial challenges, poor management set-up, unethical workplace activity, and breaking healthcare and cafe delivery norms along with social and cultural variations (Mayland et al. 2021). For example, based on a recent case study, handling a stroke patient with multiple demands of the patient's family which is unethical in the healthcare standard is responsible for massive disturbance to building relationships with patients to understand their needs. Lesser ability to understand the pain and medication process under background noise also creates another challenging force to communicate as that strategically hinder caregivers to communicate effectively with the patient's client. As stated by Nagelschmidt et al. (2021), low health literacy, cultural differences and language differences massively interrupt healthcare communication in terms of dealing with a stage of palliative care at serious condition. As a result, palliative care for stroke patients with access to limited local language proficiency is responsible for creating difficulties to build strong relationships due to language barriers. Hence, this patient will get a poor satisfaction level from assigned healthcare professions.

Based on the above discussion and underlining certain difficulties in communication mode in palliative care, it can be effective to introduce training that is merely needed to improve care delivery patterns. As a result, it will possibly translate standard communication guidelines based on healthcare ethics under Australian healthcare regulation into basic practice to consider emotional needs. In response to criticism of end-of-lifecare,“The National Institute for Health and Care Excellence (NICE)” has set up guidelines including some communication advice for healthcare professions (Aihw.gov.au, 2022). Moreover, NICE also prepares advice including discussing what patients acknowledge as well as explaining uncertainty, offering opportunities for asking any questions and avoiding false optimism. As argued by Herrmann et al. (2019), willingness and self-awareness through developing patient care skills are the main basis of the enhanced communication process. On the other hand, the government and other healthcare management in Australia need to promote adverse intervention processes like question prompt lists which should be useful to help patient families by getting the necessary information.

Conclusion

In communication with specific patients, the caregiver needs to be respectful regarding their certain preferences based on information giving and disclosure. The above decisions help to conclude that, the stressors regarding palliative care including treatment decisions for serious patients, and organized management process for practice handling process create conflict between family members of the patient and healthcare professionals. Moreover, from this essay, it can be interpreted that, anticipating death, and witnessing the suffering stage of a patient resulting in major disagreements creates barriers in delivering care practice. Although, communication is marked as the most relevant and efficient approach to maintaining the health issues of a patient and treating them through understanding patient-centred care nature. Moreover, the necessity of support provision and building relationships between family members and caregiver is possible through the following smart way of interaction. As a result, it can resolve risk during care service as well as help cope with patients getting to the early recovery stage. Although, it is necessary to create awareness about the importance and urgency of the standard communication method followed to detect health issues and deliver better support in an emergency.

Reference list

Aihw.gov.au (2022). Palliative care services in Australia. https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia/contents/palliative-care-workforce

Health.gov.au (2019). Exploratory Analysis of Barriers to Palliative Care. https://www.health.gov.au/sites/default/files/documents/2020/01/exploratory-analysis-of-barriers-to-palliative-care-summary-policy-paper.pdf

Herrmann, A., Carey, M. L., Zucca, A. C., Boyd, L. A., & Roberts, B. J. (2019). Australian GPs’ perceptions of barriers and enablers to best practice palliative care: a qualitative study.;BMC palliative care,;18(1), 1-14.https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-019-0478-6

Mayland, C. R., Doughty, H. C., Rogers, S. N., Gola, A., Mason, S., Hubbert, C., ... & Jack, B. A. (2021). A qualitative study exploring patient, family carer and healthcare professionals’ direct experiences and barriers to providing and integrating palliative care for advanced head and neck cancer.;Journal of palliative care,;36(2), 121-129.https://doi.org/10.1177/0825859720957817

Nagelschmidt, K., Leppin, N., Seifart, C., Rief, W., & von Blanckenburg, P. (2021). Systematic mixed-method review of barriers to end-of-life communication in the family context.;BMJ Supportive & Palliative Care,;11(3), 253-263.http://dx.doi.org/10.1136/bmjspcare-2020-002219

Nwozichi, C. U. (2019). Toward a germinal theory of knowing-revealing-Humanizing as expressions of caring in cancer palliative care.;Asia-Pacific Journal of Oncology Nursing,;6(3), 269-276.https://doi.org/10.4103/apjon.apjon_9_19

Olsson, M. M., Windsor, C., Chambers, S., & Green, T. L. (2021). A scoping review of end-of-life communication in international palliative care guidelines for acute care settings.;Journal of Pain and Symptom Management,;62(2), 425-437.https://doi.org/10.1016/j.jpainsymman.2020.11.032

Palliaged.com.au. (2020). Communication at End of Life. https://www.palliaged.com.au/tabid/4456/Default.aspx

Palliativecare.org.au (2017). Standards for Providing Quality Palliative Care for all Australians. https://palliativecare.org.au/wp-content/uploads/2015/07/Standards-for-providing-quality-palliative-care-for-all-Australians.pdf

Palliativecare.org.au (2019). National Palliative Care Standards. https://palliativecare.org.au/publication/standards/

Pollens, R. (2020). Facilitating client ability to communicate in palliative end-of-life care: Impact of speech–language pathologists.;Topics in Language Disorders,;40(3), 264-277.doi: 10.1097/TLD.0000000000000220

Rhee, J. J., Teo, P. C., Mitchell, G. K., Senior, H. E., Tan, A. J., & Clayton, J. M. (2018). General practitioners (GPs) and end-of-life care: a qualitative study of Australian GPs and specialist palliative care clinicians.;BMJ Supportive & Palliative Care.http://dx.doi.org/10.1136/bmjspcare-2018-001531

Scherrens, A. L., Cohen, J., Mahieu, A., Deliens, L., Deforche, B., & Beernaert, K. (2020). The perception of people with cancer of starting a conversation about palliative care: A qualitative interview study.;European journal of cancer care,;29(5), e13282. DOI: 10.1111/ecc.13282

Steigleder, T., Kollmar, R., &Ostgathe, C. (2019). Palliative care for stroke patients and their families: barriers for implementation.;Frontiers in neurology,;10, 164.https://doi.org/10.3389/fneur.2019.00164

Stiel, H., Nagarajan, S. V., Forster, B. C., & Clayton, J. M. (2019). Palliative care physicians’ perspectives on transferring patients to nursing homes and communication strategies to facilitate this transition: a qualitative study.;Palliative Medicine,;33(3), 323-331.https://doi.org/10.1177/0269216319827803

Suwanabol, P. A., Reichstein, A. C., Suzer-Gurtekin, Z. T., Forman, J., Silveira, M. J., Mody, L., & Morris, A. M. (2018). Surgeons' perceived barriers to palliative and end-of-life care: a mixed methods study of a surgical society.;Journal of palliative medicine,;21(6), 780-788. DOI: 10.1089/jpm.2017.0470

Walter, J. K., Hill, D. L., DiDomenico, C., Parikh, S., &Feudtner, C. (2019). A conceptual model of barriers and facilitators to primary clinical teams requesting pediatric palliative care consultation based upon a narrative review.;BMC Palliative Care,;18(1), 1-9.https://link.springer.com/article/10.1186/s12904-019-0504-8

Who.int (2020) Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care

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