Rating: 3. Although the Paragraph Research Paper

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These included guidelines from the Australian National Breast Cancer Center and the Australian National Cancer Control Initiative; an updated systematic review of the research evidence, and a consensus by the Clinician -- Patient Communica-tions Working Panel of the Program in Evidence- Based Care of Cancer Care Ontario.

The reliability of these studies also lends credence to the outcome measures in that the study gains internal validity due to the fact that the process measures matched the objective of the study.

The fact, however, that only 33 participants responded renders the sample small and detracts from its reliability making it difficult to replicate to other instances. This renders the outcome measures unreliable.

On the other hand, similar online and offline research, both quantitative and qualitative, time and again, indicates the importance of communication in terms of hospice patient care. Cancer patients, it is shown, too profit from improved doctor-patient communication (e.g. Jaffe & Ehrlich, 1997). Studies and experience indicate the importance of the hospice nurse possessing excellent interpersonal skills with the patience and ability to listen to their patients and to help them through their challenging time. Elisabeth Kubler-Ross, for instance, time and again reiterated the importance of excellent clinician-patient communication skills in all processes of their dying. The AACN (American Association of Critical-Care Nurses, 2006; Hardin, 2005) model, likewise, which addresses importance of communication between clinician and patient also reinforces the salutatory benefits of clinician-patient communication lending further credence to this study and to outcome measures. The brunt of her job depends more on listening to, being with, and making the patient feel good than actually treating the patient. Consistent research in the nursing field in general and in the cancer domain in particular support the importance of clear, empathetic, patient-centered communication (e.g. McClain & Rosenfeld, 2003; Sandoval-Cros, 1999; Watson et al., 1999).

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This guideline delineates the descriptors of such communication. Since the sample of respondents is small, the study needs to be conducted on wider and reiterated populations.

Summarize evidence-based guidelines relevant to hospice inpatient care unit.

In short, the practice of clear, supportive, emphatic communication with hospice patients is urged. Recommendations are many, but reduction to key points relevant to hospice inpatient care unit may include the following:

Communication should be patient-centered with needs and preferences of patient considered

Decision-making should accord to patient's needs and preferences

Clinician's verbal and non-verbal behavior should be respectful of patient's ethnicity, age and personal preferences

Significant news should be given carefully, one-to-one, in a quite place

Communication should be honest and optimistic, showing concern for patient and willingness to be there for him or her

Use memory heuristics, such as visual aids, or recording the consultation to help patient remember details.

Allow patients to express feedback and articulate their feelings

Provide time for discussion and response to upsetting news

Communication should be simple and clear devoid of medical jargon

Communicate with both individuals and with their family or support system.

Reference

American Association of Critical-Care Nurses (AACN). (2006). The AACN Synergy Model for Patient Care. Retrieved November 15, 2006, from http://www.certcorp.org/certcorp/certcorp.nsf/vwdoc/SynModel? Opendocument

Hardin, S. (2005). Introduction to the AACN Synergy Model for Patient Care. In S.R. Hardin & R. Kaplow (Eds.), Synergy for clinical excellence: The AACN Synergy Model for Patient Care (pp. 3-10). Sudbury, MA: Jones and Bartlett Publishers.

Jaffe, C. & Ehrlich, C.H. (1997). All kinds of love: Experiencing hospice. New York,

NY: Baywood Publishing Co.

McClain, C.S. & Rosenfeld, B. (2003). Effect of spiritual well-being on end-of-life despair, The Lancet, 36, 1603-1607.

Rodin, G. et al. (2009) Clinician -- patient communication:….....

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