Perceptions of trained laypersons in end-of-life or advance care planning conversations: A qualitative meta-synthesis

Elizabeth Somes, Joanna Dukes, Adreanne Brungardt, Sarah Jordan, Kristen Desanto, Christine D. Jones, Urvi Jhaveri Sanghvi, Khadijah Breathett, Jacqueline Jones, Hillary D. Lum

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Laypersons including volunteers, community health navigators, or peer educators provide important support to individuals with serious illnesses in community or healthcare settings. The experiences of laypersons in communication with seriously ill peers is unknown. Methods: We performed an ENTREQ-guided qualitative meta-synthesis. We conducted a systematic search of MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED to include qualitative studies with data regarding communication and laypersons in advance care planning, palliative care, or end-of-life settings. Study quality was appraised using a standardized tool. The analysis identified key domains and associated themes relating specifically to laypersons' perspectives on communication. Results: Of 877 articles, nine studies provided layperson quotations related to layperson-to-peer communication associated with advance care planning (n = 4) or end-of-life conversations (n = 5). The studies were conducted in United Kingdom (n = 4) or United States settings (n = 5). The synthesis of layperson perspectives yielded five main domains: 1) layperson-to-peer communication, focusing on the experience of talking with peers, 2) layperson-to-peer interpersonal interactions, focusing on the entire interaction between the layperson and peers, excluding communication-related issues, 3) personal impact on the layperson, 4) layperson contributions, and 5) layperson training. Laypersons described using specific communication skills including the ability to build rapport, discuss sensitive issues, listen and allow silence, and respond to emotions. Conclusions: Published studies described experiences of trained laypersons in conversations with peers related to advance care planning or end-of-life situations. Based on these layperson perspectives related to communication, programs should next evaluate the potential impact of laypersons in meaningful conversations.

Original languageEnglish (US)
Article number98
JournalBMC Palliative Care
Issue number1
StatePublished - Aug 6 2018
Externally publishedYes


  • Advance care planning
  • Communication
  • Hospice care
  • Lay health navigators
  • Palliative care
  • Peer educators
  • Terminal care
  • Volunteers

ASJC Scopus subject areas

  • Medicine(all)


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