In this article, we develop an exploratory analysis of some of the interactional strategies developed by palliative care (PC) professionals in order to prepare end-of-life (EoL) talks with patients and their families, namely in the frame of specifically social problem-solving work which they develop on a daily basis. In this sense, our object of analysis is not EoL talks in themselves, but the broader social processes that tend to precede them in PC, that is, all the work both of approaching the patient and his or her family and of coordination within the teams that PC professionals routinely do in order to propitiate EoL talk. In this way, we don’t envisage EoL talks as a conversation between two parties, with a patient on one side and a doctor on the other side, but as a wider social process which relies upon strong and previous professional engagement. The analysis conducted herein was carried out on data collected under the projects ETIC – Managing EoL trajectories in palliative care: a study on the work of healthcare professionals (Ref. PTDC/SOC-SOC/30092/2017) and Building paths towards death: an analysis of everyday work in palliative care (Ref. PTDC/CS-SOC/119621/2010), both financed by the Portuguese Science and Technology Foundation (FCT); in particular the data obtained through 17 months (12 in the first project and 5 in the second one, still in progress) of ethnographic observation carried out at two hospital internment units providing PC in Mainland Portugal and 42 (37 in the first project and 5 in the second one, still in progress) in-depth interviews to professionals in PC – physicians, nurses, and social workers. As main results, we present several theoretical and empirical elements relevant to the analysis of the field of EoL communication in the context of interactions between healthcare professionals, patients and their families. Following earlier studies on the same theme, we show how the work of preparing EoL conversations refers to a broader social process preceding those conversations. We believe that our findings may contribute to elucidating this dimension of the intervention of PC professionals, thus being instrumental for the future definition of systematised guidelines and recommendations in the framework of PC.

在本文中，我们对姑息治疗（PC）专业人员开发的一些互动策略进行了探索性分析，以准备与患者及其家人进行临终（EoL）对话，即在特定的社会问题框架内-解决他们每天开展的工作。从这个意义上讲，我们的分析对象不是自身的EoL谈话，而是PC之前出现的更广泛的社会过程，即与患者及其家人联系以及团队内部协调的所有工作。 PC专业人士通常会这样做，以促进EoL对话。这样，我们就不会将EoL对话设想为两方之间的对话，一侧是患者，另一侧是医生，但作为一个更广泛的社会过程，它需要强大的和先前的专业参与。本文进行的分析是根据ETIC项目-姑息治疗中的EoL轨迹管理：卫生保健专业人员的工作研究（参考PTDC / SOC-SOC / 30092/2017）和构建通往死亡的道路：姑息治疗中的日常工作分析（参考PTDC / CS-SOC / 119621/2010），均由葡萄牙科学技术基金会（FCT）资助；特别是在葡萄牙内陆的两个提供PC的医院拘留所进行的17个月（第一个项目中的12个，第二个项目中的5个，仍在进行中）获得的民族志观察数据，以及在42个月（第一个项目中的37个和5个在第二阶段（仍在进行中）对PC专业人员-医师的深入访谈，护士和社会工作者。作为主要结果，我们提出了与医疗专业人员，患者及其家人之间的互动中的EoL交流领域分析相关的几个理论和经验要素。在针对同一主题进行了较早的研究之后，我们展示了准备EoL对话的工作是如何指代这些对话之前的更广泛的社会过程的。我们认为，我们的发现可能有助于阐明PC专业人员干预的这一方面，从而有助于PC框架中系统化指南和建议的未来定义。在医疗保健专业人员，患者及其家人之间的互动中，我们提出了一些与EoL交流领域分析相关的理论和经验要素。在针对同一主题进行了较早的研究之后，我们展示了准备EoL对话的工作是如何指代这些对话之前的更广泛的社会过程的。我们认为，我们的发现可能有助于阐明PC专业人员干预的这一方面，从而有助于PC框架中系统化指南和建议的未来定义。在医疗保健专业人员，患者及其家人之间的互动中，我们提出了一些与EoL交流领域分析相关的理论和经验要素。在针对同一主题进行了较早的研究之后，我们展示了准备EoL对话的工作是如何指代这些对话之前的更广泛的社会过程的。我们认为，我们的发现可能有助于阐明PC专业人员干预的这一方面，从而有助于PC框架中系统化指南和建议的未来定义。