Background Goals of care conversations are critical to patient-centred care. These are challenging for healthcare professionals (HCPs) and patients with serious illnesses. The Serious Illness Conversation Guide (SICG), a structured intervention developed by Ariadne Labs from the United States of America, supports HCPs to engage in earlier, more frequent, and better conversations with these patients.
There being no structured communication guide for serious illness conversations in Singapore, the Lien Centre for Palliative Care worked with Ariadne Labs to deliver SICG workshops.
This report aims to describe consolidated views of HCPs towards the SICG.
Methods A total of 141 HCPs (49 doctors, 50 nurses, 27 social workers, 6 therapists, 2 counsellors, 1 pharmacist, 6 administration staff) across acute hospital and community settings participated in the workshops.
Participants were surveyed during, after, and 6-months post-workshop regarding their receptivity to conducting SIC, perceived self-efficacy on the use of the SICG, and enablers and barriers to HCPs having SIC.
Results 97.4% of respondents (n=76) indicated they could apply the knowledge and skills. 98.7% felt they would use what they had learned in their practice. HCPs felt that the SICG (1) provided a structure for communication, (2) humanized patients, (3) built trust. Concerns raised, which affected frequency of conducting SIC included time constraints, clinicians’ and patients’ readiness, roles ambiguity, need for cultural adaptation of SICG, and organizational factors.
Conclusion SIC workshops equipped clinicians with a framework to integrate SIC in their practice. It normalized such conversations and allowed deeper understanding of patients’ values, goals and priorities and fears before recommending treatment. There is urgency to adapt the guide locally; which might encourage more to engage in patient-centred conversations.
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