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UBC Theses and Dissertations

Using interpretive description to explore and evaluate the Providence Health Care goals of care companion card : the clinicians' expreriences McNamee-Clark, Catherine


End of life conversations are challenging in all health care settings, and health care providers’ (HCPs) fears about holding end of life conversations are a barrier to quality patient centred care. This study explored HCPs’ experiences using a conversation “companion card” to structure end of life discussions and sought to understand HCPs’ experiences with goals of care (GOC) conversations. A theoretical perspective of relational ethics and a research methodology of Interpretive Description (ID) guided this research study. The methodology produced a qualitative description of experiences from a sample of HCPs. Over a two month period, the researcher gathered data during four semi-structured focus groups with twenty one participants at one urban acute care setting in Western Canada. In addition to focus groups the researcher relied on other processes to enhance her reflexivity, including journaling and memos; all of which are essential to ID inquiry. The findings of this study centre around four themes relating to participants’ experiences discussing GOC and the usefulness of the companion card in discussions. These themes are titled, the big struggle; responsibility; building relationships and the utility of the GOC companion card. Recommendations from this study addressed the need for research into the ethics of discussing GOC with patients and families with life limiting illnesses; organisational prioritisation ensuring therapeutic GOC discussions take place; incorporation of GOC discussions in educational programs across all health care sectors; and policy reform to ensure community care services can support ongoing GOC conversations.

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