The perspectives of GPs with regard to facilitators and barriers for GP–patient communication in palliative care were studied in 2004 in two 90-minute focus group discussions with 10 GPs in each. The choice for focus groups was made because this qualitative method capitalises on group dynamics to obtain information that may not be available through individual interviews or quantitative methods. The first group was a convenience sample of GPs who met to discuss scientific topics during monthly meetings. The second group was recruited by purposeful sampling to ensure heterogeneity of the members (sex, age, experience, and urban or rural practice). The GPs in the focus groups discussed which facilitators and barriers for GP–patient communication in palliative care they considered to be most important. The discussions were facilitated by a moderator, audiotaped, transcribed verbatim, and anonymised. Fragments from the transcriptions concerning facilitators and barriers for GP–patient communication were identified and classified. This content analysis of the transcriptions was performed by two of the authors. During the analysis the validity was ensured by critical discussion, and after the analysis by sending all participants a summary of the findings and asking them for their consent and comments (member check).
How this fits in
This qualitative study suggests that GP–patient communication in palliative care in the Netherlands could be improved. Palliative care patients want friendly and committed GPs who take the initiative in discussing end-of-life issues. End-of-life consultants advise GPs to clarify the patient's problems and concerns more explicitly and to pay attention to their own personal barriers. The results of this study can contribute to the development of training programmes that enable GPs to improve their communication skills in palliative care.
