A scoping review on palliative care communication in the South African setting

Objectives

Effective communication is crucial in palliative care, allowing patients opportunities to make decisions that preserve their personal integrity during significant and life-changing events. How patients communicate and what they prioritise in conversation with a medical professional is affected by a variety of sociocultural factors, expectations and health literacy levels. Communication therefore needs to be understood in the specific context within which it occurs. This review aimed to map existing empirical studies on palliative care communication in the South African context specifically, and is the first scoping review of this kind.

Methods

Arksey and O’Malley’s scoping review guidelines were followed, with the PRISMA-ScR checklist. English-language South Africa-specific empirical studies from 1994 onwards were identified from PubMed, Web of Science, EBSCO and Google Scholar. A search string optimisation procedure was used. Initially, 235 total hits were obtained, from which duplicates, articles irrelevant to the search criteria, and multi-site studies were removed.

Results

Full-length, original research studies located in South Africa and focused on palliative care were retained, in which communication or decision-making was a main focus, resulting in 9 articles. A need for greater research capacity and dedicated research spaces for palliative care communication was identified. Certain areas were recognised as requiring specific research focus going forward, such as communication in perinatal palliative care, the timing of certain care conversations, and the communication experiences of patients and their family members, as opposed to healthcare professionals. A lack of locally adapted tools to support palliative communication was noted.

Conclusions

Both local and international literature concur that an individualised approach to communication in palliative care is needed. Research on palliative care communication in South Africa is crucial for developing contextually appropriate policy, clinical practice and training, thereby helping healthcare professionals to navigate these complicated conversations more effectively.