Exploring the psychological impact of life-limiting illness using the Attitude to Health Change scales : A qualitative focus group study in a hospice palliative care setting

Dunleavy, Lesley and Walshe, Catherine and Machin, Linda (2020) Exploring the psychological impact of life-limiting illness using the Attitude to Health Change scales : A qualitative focus group study in a hospice palliative care setting. European Journal of Cancer Care, 29 (6): e13302. ISSN 0961-5423

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Abstract

Objective Practitioners are often reluctant to engage in conversations that acknowledge patient's health concerns. This can affect patient and family carer psychological well‐being. The Attitude to Health Change scales, adapted from the validated Adult Attitude to Grief scale, may have potential to address the psychological impact of illness and facilitate conversations in palliative care. To explore how health and social care professionals experience using the Attitude to Health Change Scales within hospice settings. Methods Qualitative focus groups with practitioners currently using the Attitude to Health Change scales in three UK hospices. Two researchers conducted the interviews, developed the thematic framework and independently coded the transcripts using a framework analysis approach. Results Three focus groups (n = 21 practitioners). The scale was used to assess and reassess levels of vulnerability and resilience to identify the need for support and to facilitate structured in‐depth conversations. Factors that influenced scale implementation included the following: practitioner personal comfort and training; patient and family carer willingness to engage with the scales and having a practitioner “champion” within the organisation. Conclusion This exploratory work has identified the potential value of the scales for assessment and to facilitate conversations. Further research needs to incorporate the views of patients and family carers.