The limits of the conspiracy of silence: a qualitative study of professionals' perception of therapeutic communication with palliative patients and their families

Identifier:  TFG:6988

Handle: https://hdl.handle.net/20.500.11797/TFG6988

Authors:  Ramos Aubia, Maria Júlia

Abstract:
Objective: the main objective of this assignment is to analyse the knowledge and the experiences of health professionals in cases of conspiracy of silence, starting from ethical and holistic care and adequate communication with the patient and family. Material and methods: qualitative descriptive study of a phenomenological nature. First, a bibliography search on the subject was conducted to develop a semi-structured interview for health professionals. Subsequently, health professionals, with an experience equal to or greater than 5 years, who worked with palliative patients in the health area of Reus (Tarragona), were interviewed. Participants entered the study by intentional sampling until reaching data saturation (n = 10). The interviews were literally recorded and transcribed. Results: the analysis revealed 8 thematic categories: causes of the conspiracy of silence; effects on the patient / consequences; professionals' feelings; communication techniques; assessment tools; knowledge about the problem; nursing role; ethical reflection of professionals. Conclusions: the family seems to be the main trigger for a conspiracy of silence under the sociocultural belief that it is the best option to protect it. Professionals do not have sufficient training in communication resources and emotional assessment of terminally ill patients and their families. The development of a conspiracy of silence also has an emotional impact for health professionals and an impediment to health care, so the patient will also suffer the consequences. The study evidences, therefore, the need to work with respect to the conspiracy of silence with health professionals and families to promote the protection of the patient's rights and a better emotional management of the situation for all the agents involved.