Abstract
Interactions among hospice care providers and caregivers are a promising area of exploration, as we seek to better understand the context of hospice care and how to support those engaged in this complex relationship. This study examines patterns within naturally occurring speech between nurses and family caregivers during hospice visits. Based on previous work, we propose that nurse communication can be more or less facilitative or directive in style and this in turn shapes nurse-family caregiver interactions. We analyzed nurse-caregiver speech interactions recorded during seven hospice encounters. Findings show significant differences in the speech patterns associated with facilitative or directive styles. Directive styles tended to be denser and nurse oriented and offered less opportunity for caregiver self-expression, while facilitative styles were more caregiver oriented and more vivid and responsive and made more space for caregiver expression. There were also significant differences in the amount of cognitive, emotional, or task-oriented speech and how these terms shaped the nature and focus of the interactions. This study provides empirical support for best communication practices and may help us better understand how specific communication patterns facilitate positive outcomes by supporting caregivers' own needs for interaction and self-expression.