Abstract
BackgroundLaypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings. The experiences of laypersons in communication with seriously ill peers is unknown.MethodsWe performed an ENTREQ-guided qualitative meta-synthesis. We conducted a systematic search of MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED to include qualitative studies with data regarding communication and laypersons in advance care planning, palliative care, or end-of-life settings. Study quality was appraised using a standardized tool. The analysis identified key domains and associated themes relating specifically to laypersons’ perspectives on communication.ResultsOf 877 articles, nine studies provided layperson quotations related to layperson-to-peer communication associated with advance care planning (n = 4) or end-of-life conversations (n = 5). The studies were conducted in United Kingdom (n = 4) or United States settings (n = 5). The synthesis of layperson perspectives yielded five main domains: 1) layperson-to-peer communication, focusing on the experience of talking with peers, 2) layperson-to-peer interpersonal interactions, focusing on the entire interaction between the layperson and peers, excluding communication-related issues, 3) personal impact on the layperson, 4) layperson contributions, and 5) layperson training. Laypersons described using specific communication skills including the ability to build rapport, discuss sensitive issues, listen and allow silence, and respond to emotions.ConclusionsPublished studies described experiences of trained laypersons in conversations with peers related to advance care planning or end-of-life situations. Based on these layperson perspectives related to communication, programs should next evaluate the potential impact of laypersons in meaningful conversations.
Highlights
Laypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings
We performed a meta-synthesis of qualitative studies to address the study question: “What are the perspectives of laypersons on communication with individuals with serious illness or advance care planning?” The intention of this study is to provide a rich description of how trained non-medical laypersons engage in layperson-to-peer conversations related to advance care planning or end of life situations, including palliative care and hospice care
Main findings of the study This meta-synthesis addresses the study question: “What are the perspectives of laypersons on communication with individuals with serious illness or advance care planning?” We provide an integrated synthesis of the thoughts and experiences of non-medical laypersons as they communicate with peers experiencing serious illnesses, end-of-life care, or related to advance care planning conversations
Summary
Laypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings. Trained laypersons have been involved in supporting advance care planning among general older adult populations and specific populations such as ethnic minorities with multiple comorbidities, patients with end-stage renal disease, and patients with cancer [9,10,11]. These layperson-based programs suggest that individuals value the opportunity to exchange stories with peers who belong to their community group, are a similar age, or share similar experiences [12]. The involvement of volunteers in advance care planning conversations is a natural extension of the long-standing role volunteers have played in interdisciplinary hospice and palliative care teams [13,14,15]
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