• Inger Benkel, Helle Wijk, and Ulla Molander.
• 1 Palliative Care Unit, Sahlgrenska University Hospital , Gothenburg, Sweden .
• J Palliat Med. 2014 Apr 1;17(4):448-52.

BackgroundLoved ones of a patient with an incurable disease will accompany the patient to the end of life. Health care professionals must discuss difficult matters with loved ones and be sure that they really understand the seriousness of the patient's disease. The study explore how the professionals do when they explore the grounds on which they make their assessment of loved ones' insight into a patient's fatal disease.MethodA qualitative design was chosen to gain deeper knowledge of professionals' perception of loved ones' understanding. The transcribed interviews were analysed using content analysis giving a richer understanding of the meaning of the content.ResultThe participants assessed loved ones' insight into the fatal disease based on the course and content of the conversations they had with the loved ones. The professionals' assessments were based on how the loved ones talked and expressed themselves in words and behavior and on the type of questions posed by the loved ones. The loved ones' observations and hope as denial or a strategy also contributed to their assessment.ConclusionWays to communicate with loved ones are crucial when making an assessment. The different ways loved ones use hope and other strategies made it problematic for the professionals to use these as indicators of state of mind in this matter. Training in conversation skills could be one way to support professionals when discussing and managing these difficult situations.

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