Abstract
Background Communication and shared decision-making (SDM) are essential to patient-centered care. Hospital-based palliative care with patients with limited health literacy (LHL) poses particular demands on communication. In this context, patients’ emotions and vulnerable condition impact their skills to obtain, understand, process and apply information about health and healthcare even more. If healthcare providers (HCPs) meet these demands, it could enhance communication. In this study, HCPs were interviewed and asked for their strategies, barriers and suggestions for improvement regarding communication and SDM with LHL patients in hospital-based palliative care. Methods A qualitative interview study was conducted in 2018 in four Dutch hospitals with 17 HCPs— 11 physicians and 6 nurses. Transcripts were analyzed using thematic analysis. Results In general HCPs recognized limited literacy as a concept, however, they did not recognize limited health literacy. Regarding SDM some HCPs were strong advocates, others did not believe in SDM as a concept and perceived it as unfeasible. Furthermore, five themes, acting as either strategies, barriers or suggestions for improvement emerged from the interviews: 1) time management; 2) HCPs’ communication skills; 3) information tailoring; 4) characteristics of patients and significant others; 5) the content of the medical information. PLOS ONE PLOS ONE | June 19, 2020 1 / 20 OPEN ACCESS Citation: Roodbeen R, Vreke A, Boland G, Rademakers J, van den Muijsenbergh M, Noordman J, et al. (2020) Communication and shared decision-making with patients with limited health literacy; helpful strategies, barriers and suggestions for improvement reported by hospitalbased palliative care providers. PLoS ONE 15(6): e0234926. pone.0234926 Editor: Katie MacLure, Independent Researcher, UNITED KINGDOM Received: January 31, 2020 Accepted: June 4, 2020 Published: June 19, 2020 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: Copyright: © 2020 Roodbeen et al. – munication and SDM. Additionally, more aw