April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Perceptions of a Good Death and Communication Apprehension about Death: Predictors of End-of-Life Preferences
Individual conceptions of what constitutes a good death vary greatly depending on physical, psychological, biomedical, and spiritual beliefs and needs. Communicating and preparing personalized good death experiences promote quality, treatment, and care at the end-of-life (EOL). Yet there is a shortage of research examining how conceptions of a good death relate to EOL communication and preparation. The current study aimed to examine the relationships between individuals' communication apprehension about death (CADS) and conceptions of a good death on EOL decisions. A total of 422 adults aged between 18 to 69 years (M = 25.55, SD = 9.92) completed an online survey. Few individuals reported having an advanced directive (n = 32, 7.5%); most participants either did not have an advanced directive (n = 153, 36.1%) or did not know what an advanced directive was (n = 239, 56.4%). Likewise, less than a third of participants had communicated their preferences (n = 134, 31.6%) while most had not (n = 290, 68.4%). Interestingly, while few individuals had advanced and aftercare documentation or communicated their wishes to loved ones, 70% of participants reported that they have thought about what they want to have happen at the end of their life and to their body after they die (n = 297). Perceptions of a good death was correlated with CADS, r(421)= .291, p < .01, especially with communication anxiety about death, r(421)= .344, p < .01. Good death was also positively correlated with individuals’ likelihood of having an advanced directive, but negatively correlated with having aftercare plans. Further, individuals with high levels of CADS were significantly less likely to have advanced directives and aftercare plans, t(111) = 99.72, p = .000. A multiple linear regression model predicting participants’ advance care plans found that perceptions of a good death and CADS were significant predictors of EOL plans, F(2, 414) = 7.319, p < .001, with an R2of .034. However, the multiple linear regression model for aftercare plans was not significant, F(2, 414) = 1.033, p = .357, with an R2 of .005. In particular, participants placed high importance on having the ability to (1) communicate until time of death, (2) say “good-bye”, (3) complete important tasks, (4) accept their death, (5) have their spiritual needs met, (6) have their loved one’s present/not die alone, (7) die peacefully, and (8) have their family and doctors follow their wishes. Taken together, perceptions of good death are deeply connected to communication. Good communication can serve an important part of the dying process and poor communication can serve as a deterrent to believing someone is able to have a good death. EOL plans were predicted by perceptions of good death and CADS. Additionally, communication apprehension about death, especially communication anxiety, was a significant factor in having EOL documentation. However, there is a discrepancy between thinking about and actually documenting EOL wishes. Communication researchers should develop campaigns and provider trainings to help alleviate communication anxiety when making EOL decisions and plans and help patients document their wishes.