Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Education

Supervisor

Hibbert, Kathryn M.

Abstract

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. The study engaged 20 healthcare provider participants. Most were interviewed on two separate occasions. Analysis was conducted after each interview. This two-phase semi-structured interview approach enabled ongoing, iterative exploration of the data. The findings revealed that thanatological concepts from these engaged participants came intuitively through experience. This further experience allowed us to gain some novel insights into places where thanatology concepts may support a better educational process for medical students to practicing physicians.

Summary for Lay Audience

Discussing end-of-life care with patients can be difficult for healthcare providers. Many providers lack proper training for such discussions and may not be familiar with goals of care (GOC), advance care planning (ACP), Medical Assistance in Dying (MAiD), or Palliative Care, which makes these end-of-life conversations even more challenging. This study was about understanding how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the scope to which concepts from thanatology inform their understanding.

Twenty healthcare providers participated in semi-structured interviews. A research design that allowed for constant interaction between the research literature, the participants and theories about death and dying allowed for new insights to develop. The research provided some novel insights into places where theories of death and dying may be useful in the training and support of medical students.

Erratum

Correcting spelling error in in-text citations.

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