A conceptual model of the nurse's role as primary palliative care provider in goals of care communication

Elaine Wittenberg; Joy V Goldsmith; Chiahui Kate Chen; Maryjo Prince-Paul

doi:10.1016/j.pecinn.2024.100254

A conceptual model of the nurse's role as primary palliative care provider in goals of care communication

PEC Innov. 2024 Jan 12:4:100254. doi: 10.1016/j.pecinn.2024.100254. eCollection 2024 Dec.

Authors

Elaine Wittenberg¹, Joy V Goldsmith², Chiahui Kate Chen³, Maryjo Prince-Paul⁴

Affiliations

¹ From California State University Los Angeles, Department of Communication Studies, Los Angeles, CA, USA.
² From University of Memphis, Department of Communication and Film, Memphis, TN, USA.
³ From D'Youville University, School of Nursing, Buffalo, NY, USA.
⁴ From Palliative Care and Serious Illness Consultant, Cleveland, OH, USA.

Abstract

Objective: Nurses have opportunities to engage in goals of care conversations that can promote palliative care communication. The purpose of this study was to describe nurses' experiences in goals of care communication as summarized in the literature and to present a conceptual model of communication pathways for nurses.

Methods: An integrative review of the literature (2016-2022) addressing nurses' experiences in goals of care communication was conducted using PubMed, CINAHL, and PsychInfo databases. A total of 92 articles were retrieved. A total of 12 articles were included for this review after applying the inclusion and exclusion criteria.

Results: Of the 12 articles, the majority were qualitative studies (n = 8). Qualitative analysis of findings from all articles revealed three dominant themes: nurses' ambiguous role responsibilities, goals of care as end-of-life communication, and the need for nurse communication training.

Conclusion: This article suggests an innovative conceptual model for advancing nurse communication about goals of care to facilitate primary palliative care.

Innovation: The framework characterizes two communication pathways for Advanced Practice Nurses who direct goals of care discussions and Registered Nurses who support goals of care communication. The model informs future communication training aimed at supporting primary palliative care.

Keywords: Communication; Conceptual model; Goals of care; Nursing; Palliative care.