Changing expectations toward end-of-life communication: An experimental investigation.

Objectives: To investigate the effect of a) a brief video intervention and b) end-of-life (EOL) conversations with relatives on EOL communication expectations.

Methods: 272 participants from the general population were randomly assigned to three different video conditions (Intervention group: Persons reporting positive EOL conversation experiences +imagination task, Control group 1: Video unrelated to EOL topics, Control group 2: Persons reporting different attitudes toward EOL conversations +imagination task). Primary outcome was negative expectations. After the videos, participants were invited to have their own conversation with a loved one in the following two months. Data were collected before (pretest) and after watching the videos (posttest) as well as at a two-months follow-up.

Results: Between pre- and posttest, negative expectations decreased significantly more in the IG compared to CG1 (b = 0.15, t = 2.08, p = .020) and CG2 (b = 0.21, t = 2.94, p = .002). Across conditions, participants having had a conversation between posttest and follow-up reported significantly stronger declines of negative expectations (b = 0.35, t = 3.54, p < .001).

Conclusions: In the short term, a brief video intervention can change expectations toward EOL communication. EOL conversations with relatives also have the potential to reduce negative expectations.

Practice Implications: Based on the findings, larger community-based interventions could be developed in order to increase EOL communication.