Chapter 6 132 4.2 Future perspectives Various studies have explored alternative approaches to care decision conversations, such as those conducted by social workers or nurses.33,34 These studies indicated that such conversations need not be exclusively conducted by physicians, with high patient satisfaction observed. The emotional proximity that social workers and nurses establish with patients may render them particularly well-suited for initiating these conversations. Additionally, nurses may face fewer time constraints, increasing the likelihood of these discussions, particularly during challenging periods such as the COVID-19 pandemic. An ongoing study by Prachanukool investigates the impact of a priming conversation by a nurse in the emergency room on subsequent care decisions.35 Another approach involves a brief negotiated interview conducted by a different physician, which has proven effective in increasing the number of care decision conversations and subsequent self-reported care decisions.36 However, this method is time-consuming and may not be feasible in an emergency department setting. Further research could explore the most suitable individuals for conducting care decision conversations. Although our data suggests the physicians’ training probably contributed most to the effectiveness of the interventions, we recognize the potential of patient education materials. Further research could explore optimal approaches to patient education and increasing the distribution of the patient educational materials., the most suitable individuals for conducting care decision conversations, and the organization of professional training. These areas warrant further investigation to enhance our understanding and inform best practices in healthcare communication. We based part of our hand-on training on our prior study, in which we used conversation analysis of authentic care decision conversations in our hospital.23 The examples that we use in our training might be generalizable to other settings, especially in the Netherlands and countries comparable to the Netherlands in communication strategies. However, to adjust the training to another setting, especially were communication strategies are quite different from the Netherlands, we would suggest to video-tape several care decision conversations in that setting and discuss the interactional implication of
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