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| Year : 2010
| Volume
: 52 | Issue : 2 | Page
: 198 |
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| Communication Skills in Palliative Care |
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BR Ravi Shankar Rao1, Nalini Rao2
1 MS Ramaiah Medical College, Bangalore, India
2 Radiation Oncologist, Bangalore Institute of Oncology, Bangalore, India
Click here for correspondence address and
email
| Date of Web Publication | 22-Jun-2010 |
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How to cite this article:
Ravi Shankar Rao B R, Rao N. Communication Skills in Palliative Care. Indian J Psychiatry 2010;52:198 |
By Santosh K. Chaturvedi, Prabha S. Chandra, Srinagesh Simha
Publisher: Alok Mukhopadhyay. Printed at: VHAI press, Voluntary Health Association of India, 2008. B-40, Qutub Institutional Area, New Delhi - 110 016, India
Pages: 80, Price: Rs. 100/-
This handbook-cum-manual has been written primarily for health professionals and volunteers involved in palliative care of those with advanced diseases. Communicative Skills in palliative care are important to reduce distress by addressing both the patient and physician 'agendas'.
The stated learning objectives are faithfully fulfilled by the text that follows. There is clarity, necessary depth and the message is delivered surely. Key points are summarized at the end of the chapter that facilitates learning.
Breaking bad news is dealt with in 10 steps and a model for breaking bad news makes conceptual understanding simple. A terminal diagnosis produces a great complexity in the patients and families when they have to make choices and decisions not only in the medical but also in the psychological, spiritual, interpersonal and practical issues of dying. Issues involved in communication between physician and dying patients is sensitively brought out.
Very often, difficult questions like, 'Why me?' are asked. When the relatives or the patient ask such questions one has to recognize why some questions are difficult and develop skills to understand the concerns behind the questions and handle the emotional issues that arise from them.
Collusion is a universal phenomenon very often observed in Indian families with cancer patients. It implies that information about diagnosis, prognosis and medical details is being withheld by some persons and not shared with other significant persons. Problems associated with collusion and ways of overcoming them are discussed. Other challenging situations in palliative care include handling a withdrawn and depressed patient and communicating with an angry patient. Case vignettes teach how to skillfully handle some of the issues. One misses the nuances in communication that need to be made with levels of literacy, socio-economic and rural/urban factors. In some instances open questions may evoke fear and dependence on the physician may be high. In such cases making decisions has to be more directive and paternalistic.
Palliative care being multi-disciplinary, collaborative care that is smooth and seamless is called for healthy functioning of the team as well as in making the patient and caregiver satisfied and secure.
The bibliography brings home the truth of the paucity of Indian experience in this field. The book makes an excellent guide for volunteers, social workers, nurses and other health professionals. The contents, though satisfactory, could be repetitive at times. The utility could have gained by the authors presenting more essential data in the current evidence-based era of medicine.
The best tribute that a book on communicative skills could pay to itself is to communicate these ideas effectively, which this book does.
Correspondence Address:
B R Ravi Shankar Rao
MS Ramaiah Medical College, Bangalore
India
 Source of Support: None, Conflict of Interest: None  | Check |
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