Validating patient feelings increases care compliance when transitioning to palliative care, study finds

A new study conducted by researchers at Iowa State University found patients were more likely to comply with their provider’s suggestion to move away from curative treatments and towards pain management when providers validated their patients’ feelings and detailed the realistic outcomes of continued treatment.

The paper, published in the journal Organization Studies, was co-authored by Shibashis Mukherjee, PhD, assistant professor of management and organization at Ahmedabad University in India and Thomas Clay, MS, assistant professor of teaching, management, and entrepreneurship, at Iowa State University. The study aimed to better understand how providers navigate conversations around the shift to end-of-life care with patients and which strategies are the most successful. For six months, researchers observed doctors and their methods for suggesting a switch to comfort care for end-of-life patients. After these conversations, researchers measured rates of patient compliance.

The study found that when doctors validated three specific emotions commonly experienced by chronically ill patients-- fear, hope, and guilt--patients were more likely to accept their provider’s suggestions. The results showed that when providers used this approach, patients complied with their suggestion 73 percent of the time. In contrast, when providers used a different approach, which did not address feelings of fear, hope, and guilt, patients only complied 43 percent of the time.

“There’s this understanding that, in terms of professional authority, titles and education, and status don’t cut it anymore,” Clay said in a statement. “The idea of ‘Doctor’s orders’ doesn’t carry the same weight as it used to, so providers have to use extra strategies to communicate their expert recommendations to patients.”

This study indicates that when providers validate patient concerns while suggesting they switch from curative treatment to comfort care, patient compliance is significantly increased, highlighting the importance of thoughtful patient conversations.

Integrative practitioners can refer to this study not only when they’re discussing the transition to palliative care, but with other patient conversations around difficult medical decisions as well.