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Perspectives of Vancouver Island Hospice Palliative Care Team Members on Barriers to Communication at the End of Life: A Preliminary Study

Kirk, Ingrid MA, MEd; Kirk, Peter MB, ChB, CCFP, FCFP; Kuziemsky, Craig PhD; Wagar, Lori RN, MA

Journal of Hospice & Palliative Nursing: January-February 2010 - Volume 12 - Issue 1 - p 59-68
doi: 10.1097/NJH.0b013e3181c72eec

This preliminary study seeks to establish a baseline of barriers to communication as identified by healthcare professionals (HCPs) working as part of interdisciplinary palliative care teams. A survey of barriers and difficulties in communicating with patients, families, and team members was distributed via e-mail to 138 palliative care health professionals working in different palliative care settings in Vancouver Island, Canada. Sixty-eight responses were received. Four major areas of difficulty were identified: (1) communication with patients and their families, (2) communication with team members, (3) lack of skills, and (4) related to the system in which the HCPs were working. Difficulties most frequently mentioned included information sharing about transitions to palliative care, inefficient team communication processes, role issues, frustration with lack of availability of GPs, need for specialized skills in communication, lack of time, and lack of coordination of information between agencies. Recommendations include interdisciplinary training, palliative care guidelines, organizational support for interdisciplinary delivery of care, specific communication protocols for teams, assigned team-meeting time, and training opportunities to help members function as a team.

Author Affiliations: Ingrid Kirk, MA, MEd, is Researcher and Adjunct Assistant Professor, Faculty of Human and Social Development, University of Victoria, British Columbia, Canada.

Peter Kirk, MB, ChB, CCFP, FCFP, is Clinical Professor, Universities of Victoria and British Columbia, and Medical Director, Palliative Care Program, Vancouver Island Health Authority, British Columbia, Canada.

Craig Kuziemsky, PhD, is Assistant Professor, Telfer School of Management, University of Ottawa, Ontario, Canada.

Lori Wagar, RN, MA, is Research Capacity Building Coordinator, Vancouver Island Health Authority, British Columbia, Canada.

This research was supported by the Canadian Institute of Health Research New Emerging Team grant on "Barriers to Communication in the Transitions to Palliative/End-of-Life Care."

Address correspondence to Peter Kirk, MB, ChB, CCFP, FCFP, Division of Palliative Care, Department of Family Practice, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6 (

© 2010 The Hospice and Palliative Nurses Association