Ruth Helen Parry

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Verified

Ruth verified their affiliation via an institutional email.

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• PhD Sociology, Master of Medical Science, MCSP
• Professor (Emeritus) at Loughborough University

Background Choosing to have dialysis or conservative kidney management is often challenging for older people with advanced kidney disease. While we know that clinical communication has a major impact on patients’ treatment decision-making, little is known about how this occurs in practice. The OSCAR study (Optimising Staff-Patient Communication in...

Background and Aims For older people with kidney failure, especially those with comorbidities or poor performance status, the survival benefits of dialysis are uncertain and its quality of life impact greatest. Conservative kidney management (CKM) can be a beneficial alternative. However, there is significant variation in treatment rates among olde...

Training to enhance healthcare practitioners’ capabilities in engaging people in sensitive and end-of life-related conversations is in demand. However, evaluations have either not measured, or found very limited impact on actual practice and patient experience. Training effectiveness is improved when it is based on in-depth evidence, reflects the c...

Background There is growing recognition that a diverse range of healthcare professionals need competence in palliative approaches to care. Effective communication is a core component of such practice. This article informs evidence-based communication about illness progression and end of life through a rapid review of studies that directly observe h...

BACKGROUND Communication skills training for professionals caring for people with life-limiting conditions is in demand. Evidence shows that transfer of skills into practice is limited. Training can be improved by building on in-depth evidence and reflecting the complexity of actual interactions. Scientific advances from direct observational ‘conve...

Objective Assessing pain intensity is an important palliative care task. Self-report pain intensity scales are frequently used within assessment. In contrast to formal studies of validity and reliability, we examine administration of, and responses to these scales in everyday palliative care. Methods We searched episodes of pain scale use in a dat...

As the main symptom in palliative care, pain requires careful assessment. Repeating patient answers is one recommended communication technique for helping convey to patients that they have been heard, and to encourage them to say more. We examined 23 episodes where experienced doctors repeat patients' answers with mirrored rhythm and downward-final...

The presence of companions adds complexity to healthcare interactions. Few studies have characterised challenges arising when interactions involve healthcare professionals (HCPs), patients, and companions, or how those challenges are managed. Using conversation analysis, we examined recorded episodes where patients and companions adopt divergent po...

Background: Pandemics pose significant challenges for healthcare systems, including an increase in difficult discussions about future illness progression and end of life. Objectives: To synthesise existing evidence about communication practices used to discuss difficult matters, including prognosis and end of life, and to use this evidence to make...

Background Assessing pain is a key palliative care task. Structured tools to assess pain intensity are commonly used, but patients report challenges in responding to these. Aims The study aimed to analyse real-life episodes of pain scale use within hospice care, and develop communication training resources based on the findings. Methods Pain scal...

Drawing on insights from conversation analysis, discursive psychology and social psychology, this article describes some interactional features of two celebrity TV confessionals and the resources used by the TV interviewers and celebrity guests to attribute, accept or deny responsibility for their transgressions. The analytic interest lies in how c...

Background Gaps in practice knowledge exist in initiating and navigating through difficult conversations; these new resources provide impactful, evidenced based learning opportunities in developing competence/confidence in engaging patients in end of life talk. Analysis of filmed data of patient consultations at a UK hospice provides the materials...

Objective: To break new ground by directly examining how patients seek life-expectancy estimates, and how doctors support them in doing so. Methods: Conversation analytic examination of 10 recorded UK hospice consultations involving 3 palliative specialists. Results: Life-expectancy estimate episodes frequently begin after a doctor has given a...

Empathy is an important way for doctors to demonstrate their understanding of patients’ subjective experiences. This research considers the role of empathy in 37 doctor–patient palliative or end-of-life care consultations recorded in a hospice. Specifically, it focuses on four contexts in which there is a disparity between patients’ displayed exper...

outcome data

Background Twenty-five per cent of hospital beds are occupied by a person living with dementia. Dementia affects expressive communication and understanding. Health-care professionals report a lack of communication skills training. Objectives To identify teachable, effective strategies for communication between health-care professionals and people...

Objective Giving terminally ill people opportunities to participate in advance care planning involves tensions between: endorsing and supporting patients’ expectations, plans and decisions, and addressing how realistic these are. The latter risks exerting undue pressure to change plans; undermining autonomy; jeopardising therapeutic relationships....

Background 25% of hospital beds are occupied by a person living with dementia. Dementia affects expressive communication and understanding. Healthcare professionals report lack of communication skills training. Objectives To identify teachable effective strategies for communication between healthcare professionals and people living with dementia, a...

Introduction Despite clear compatibilities between the tenets of occupational therapy and re-ablement, there is limited research on occupational therapy in homecare reablement services. This article describes an occupational therapy intervention that was delivered as part of a feasibility randomised controlled trial (Occupational Therapy interventi...

Background Much palliative care communication training draws on sparse evidence about practice. Yet training’s effectiveness depends on the strength of its underpinning evidence. An empirical, observational science of language and social interaction – ‘Conversation Analysis’ holds great promise because: • it is generating copious evidence on commu...

Introduction Family members of patients near the end-of-life value accurate prognostic information that is communicated sensitively by experienced healthcare professionals. This provides opportunities to say goodbye and make decisions about care. Current research is limited and has mostly focused on discussions early in the illness trajectory and w...

This chapter examines how agency, and thus flexibility and accountability, can be distributed across body—or body parts—and self. It shows that people can construct three broad configurations: (1) body and self as disaggregated agents; (2) self as possessing body—with associated control and accountability for bodily actions; (3) self and body as on...

Proceedings of SRR The Society of Research in Rehabilitation (SRR) is the major multidisciplinary rehabilitation research society in the UK (www.srr.org.uk). Its aim is to advance education and research into all aspects of rehabilitation medicine and to disseminate the useful results of such research for the public benefit. The SRR runs two confer...

Background Shared decision making (SDM) is generally treated as good practice in health‐care interactions. Conversation analytic research has yielded detailed findings about decision making in health‐care encounters. Objective To map decision making communication practices relevant to health‐care outcomes in face‐to‐face interactions yielded by pr...

Objectives: To develop, test and validate a versatile questionnaire, the East Midlands Evaluation Tool (EMET), for measuring effects of end of life care training events on trainees' self-reported confidence and competence. Methods: A paper-based questionnaire was designed on the basis of the English Department of Health's core competences for en...

Background Research using video recordings can advance understanding of healthcare communication and improve care, but making and using video recordings carries risks. Aim To explore views of hospice patients, carers and clinical staff about whether videoing patient–doctor consultations is acceptable for research and training purposes. Design We...

Objectives The objective of this study was to test the feasibility of conducting a randomised controlled trial (RCT) of an intervention targeted at activities of daily living (ADL), delivered by an occupational therapist, in homecare reablement. Design Feasibility parallel group RCT. Setting Single-site local authority homecare reablement service...

Objective: To examine how palliative medicine doctors engage patients in end-of-life (hereon, EoL) talk. To examine whether the practice of “eliciting and responding to cues”, which has been widely advocated in the EoL care literature, promotes EoL talk. Design: Conversation analysis of video- and audio-recorded consultations. Participants: Un...

A poster presented at the 11th Palliative Care Congress.

Objectives: To contribute to understandings about acceptability and risks entailed in video-based research on healthcare communication. To generate recommendations for non-covert video-based research on healthcare communication - with a focus on maximising its acceptability to participants, and managing and reducing its risks. Methods: A literat...

Objectives To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. Data sources The Cochrane Central Register of Controlled Tria...

Conversation and discourse analytic research has yielded important evidence about skills needed for effective, sensitive communication with patients about illness progression and end of life. OBJECTIVES: To: ▸ Locate and synthesise observational evidence about how people communicate about sensitive future matters; ▸ Inform practice and policy on ho...

Homecare re-ablement services have been developed by local authorities in England in response to the government agenda for health and social care. These services aim to optimize users' independence and ability to cope at home, and reduce the need for ongoing health and social care services. However, there is currently limited evidence and guidance...

Background Conversation and discourse analytic research has yielded important evidence about skills needed for effective, sensitive communication with patients about illness progression and end of life. Objectives To: ▸ Locate and synthesise observational evidence about how people communicate about sensitive future matters; ▸ Inform practice and po...

Optimal practices for recruiting, consenting, and randomizing patients, and delivering treatment in out-of-hospital ultra-acute stroke trials, remain unclear. We aim to identify key barriers and facilitators relevant to the design and conduct of ambulance-based stroke trials and to formulate preliminary recommendations for the design of future tria...

Research using video-recordings of actual consultations is increasingly providing better understandings of healthcare communication, and grounding new and effective interventions. Video-recordings provide details inaccessible through interviews and ethnographic observations. Initial work in a Health Association funded study involved consulting stak...

Purpose: Health care practice guidelines require physiotherapists to include patients in goal-setting. However, not much is known about how this process is accomplished in practice. The purpose of this study is to analyse patient-physiotherapist consultations and to identify how physiotherapists enquire about goals and how patients respond to thes...

Citation: Parry R, Land V, Seymour J (2012) Communicating with Patients about their Feelings and Preferences for the Future in Palliative Care: A Systematic Review of Evidence from Social Science and Linguistics Poster Abstract 7th World Research Congress of the European Association for Palliative Care, Trondheim. Palliative Medicine, 26(4) pp539...

Informed public and political debate about end-of-life care, and healthcare in general, requires the recognition that we cannot ensure dignified, compassionate practice unless we make the choices to back it up. We need to choose to: spend enough money to ensure adequate staffing; ensure all staff have more time to provide individual care; help to s...

There is a growing demand for services whereby individuals receive assistance from care workers for personal care within the home. This has led to the development of re-ablement or restorative homecare services that provide time-limited input aimed at reducing dependency in personal activities of daily living, and preventing or delaying the need fo...

Background: Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse a...

Physiotherapists often have to ask their clients to move in a certain way, and they sometimes accompany such instructions with explanations. It turns out that these practitioners have an interesting resource—they can design their explanation to bear either upon the exact movement currently in play or on a more general or future case. I show that th...

This report presents a rapid review of published peer reviewed research about end of life care pathways focused on the dying phase. In particular it examines evidence in relation to use of such pathways in hospitals. Our intention is to provide clear information for stakeholders charged with considering whether any change in current policy and prac...

Communicating with patients about their feelings and preferences for the future is a challenging element of palliative care. Useful evidence exists, but most is embedded in social-scientific rather than clinical research. To collate evidence about communication practices used in addressing sensitive future issues, from studies where patient/profess...

Background. Time from acute stroke to enrolment in clinical trials needs to be reduced to improve the chances of finding effective treatments. No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Meth...

Communicating with Patients about their Feelings and Preferences for the Future in Palliative Care: A Systematic Review of Evidence from Social Science and Linguistics Communicating with patients about their feelings and preferences for the future in the context of uncertainty is a challenging element of palliative care. Useful evidence about how...

To survey practice and opinion regarding school-based teaching of communication skills, to summarise relevant research evidence from physiotherapy and beyond, to reflect on practice in light of evidence, and to propose associated recommendations. Survey using customised questionnaires. Basic descriptive statistical analysis and thematic content ana...

This paper examines healthcare communication between physiotherapists and patients during treatment sessions, using the perspectives and methods of conversation analysis. In particular, it examines communication about reasons and rationale for treatment actions by analysing physiotherapists' accounts (explanations) for these actions during treatmen...

(1) To systematically review direct evidence about effects of interventions to improve communication performance amongst allied health professionals (AHPs). (2) To summarise indirect evidence pertinent to design, delivery, effects, and evaluation of such interventions. (1) Systematic search and narrative review of evaluations of interventions for A...

ObjectivesTo describe and elucidate skilled practices by which physiotherapists communicate with patients about problems of ongoing or recent performance of physical treatment activities; to offer a sociological perspective on this area of practice; to examine relations between actual communication practice and official (Chartered Society of Physio...

This paper explores relations between official written recommendations for physiotherapists and actual practice. It does so by presenting and discussing findings from a conversation analytic study of 74 physiotherapy treatment sessions video-recorded in four English hospitals. Various practices are described by which therapists address troubles of...

Patients’ physical incompetence is a feature of many clinical interactions; the challenges it presents are not only technical but also interactional. This paper examines how interpretations and interactional consequences of physical incompetence are dealt with during stroke physiotherapy. A conversation analytic approach was used to examine video-r...

Objective: To analyse in detail therapists' and patients' communication practices during physiotherapy goal-setting in stroke rehabilitation settings. To deduce explanations for observed practices. To contribute to understanding of the communication challenges entailed in goal-setting. Design: A conversation analytic study of video-recorded treatme...

There are numerous contested issues in qualitative research, and its findings are difficult to condense. Thus, short, qualitative research abstracts are difficult both to compile and evaluate. The Society for Research in Rehabilitation has produced guidelines that aim to illuminate and inform the development and judging of such abstracts. These dra...

Thesis (Ph.D.)-University of Nottingham, Oct 2001.

Evaluations of physiotherapy for stroke patients have been criticised for their lack of description of the content of treatments. The purpose of this paper is to describe in detail the physiotherapy approach employed in a recent trial (Lincoln et al, 1999). The trial evaluated effects of early additional physiotherapy for the arm. The main outcome...

Objective: To investigate effect of initial severity of arm impairment on response to additional physiotherapy for the arm after stroke. Design: In this controlled trial, patients were randomized into one of three groups: routine physiotherapy (RPT) patients received no additional physiotherapy; qualified physiotherapy (QPT) patients received addit...

Many patients have impaired arm function after stroke, for which they receive physiotherapy. The aim of the study was to determine whether increasing the amount of physiotherapy early after stroke improved the recovery of arm function and to compare the effects of this therapy when administered by a qualified therapist or a trained, supervised assi...

This paper discusses some of the issues relevant to the role and training of physiotherapy assistants. It describes the processes of role definition, assessment and training of one particular assistant, developed in the context of a larger research study. A small survey of senior physiotherapists' views on task delegation, training and working with...