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The nature of conflict in palliative care: A qualitative exploration of the experiences of staff and family members
François, Karemah Lobb, Elizabeth Barclay, Sarah Forbat, Liz
François, Karemah
Lobb, Elizabeth
Barclay, Sarah
Forbat, Liz
Abstract
Objectives: Conflict is a significant and recurring problem in healthcare. This study aimed to understand staff and relatives’ perspectives on the characteristics of conflict and serious disagreement in adult palliative care, including triggers, risk factors and the impact on themselves and clinical care. Methods: Qualitative study of 25 staff and seven bereaved relatives using individual interviews, recruited from a multidisciplinary specialist palliative care setting in Australia. Data were analysed thematically. Results: Communication was frequently cited as a cause of conflict. Further, different understandings regarding disease process, syringe drivers and providing nutrition/hydration caused conflict. Staff applied empathy to moderate their responses to conflict. Relatives’ reactions to conflict followed a trend of anger/frustration followed by explanations or justifications of the conflict. Relatives identified systemic rather than interpersonal issues as triggering conflict. Conclusions: The data illustrate connections with conflict literature in other clinical areas, but also points of convergence such as the compassion shown by both families and staff, and the identification of systemic rather than always individual causes. Practice implications: Family meetings may fruitfully be applied to prevent and de-escalate conflict. Clinical audits may be useful to identify and provide support to families where there may be unresolved conflict impacting grief process.
Keywords
conflict, empathy, grief, palliative, end-of-life, carers, staff
Date
2017
Type
Journal article
Journal
Patient Education and Counseling
Book
Volume
100
Issue
8
Page Range
1459-1465
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled