Stories in patient-caregiver communication

Almost every care provider agrees that good communication with the patient is important, regarding appropriate and personalised care. In every day’s practice doctors and nurses experience a discrepancy between the ideal and the reality of that communication. Many of them feel insufficiently skilled. Moreover, there is little time and space available. Communication with seriously ill or frail elderly patients requires special competencies. Communication is a relationship. In this relationship three kind of stories can be heard: the stories of recovery, chaos or quest. The fixation on treatment and examinations (short term) threatens to disappear the long term and the attention to meaning and spirituality. The research question is threefold: (A) (How) can one recognize the stories of recovery, chaos or quest in the communication between patients, relatives and carers, and the questions about future expectations, meaning, philosophy of life or spirituality? (B) What turning points, conditions, communication patterns and persons accommodate the stories of chaos and quest, and affect communication about future expectations, meaning and spirituality? (C) Does a shorter or uncertain life expectancy affect (A) and (B)? The research project focuses on two groups: lung cancer patients with short term life expectancies and frail elderly patients with uncertain life expectancies. The objective is to achieve concrete recommendations to promote good communication: (a) patients experience a higher quality of life and are satisfied with the treatment and the choices they made in it, and (b) doctors and nurses are satisfied with the contact with their patients, and can discuss any dilemmas.