{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:14:18Z","timestamp":1788275658264,"version":"build-2803163510"},"reference-count":26,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Do Not Intubate\/Do Not Resuscitate (DNI\/DNR) decisions are made when a patient has declined resuscitation, has a poor prognosis or if the patient will not survive intubation with sufficient quality of life. The DNI\/DNR discussion is always a complex communication process. The primary objective of the study was to describe the reflections on the experience during conversations on DNI\/DNR with the family members of the patients referred for palliative care and conversations through a focus group discussion (FGD) with other medical specialty trainees to improve learning through self-reflection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This is a qualitative study. A qualitative reflective study of DNI\/DNR conversations was made. Reflections on various experiences during the conversation were carried out using the Gibbs reflective tool. FGD with six other speciality post-graduate trainee doctors was audio recorded after informed consent, transcribed verbatim and thematically analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Reflections on self-experience during DNI\/DNR conversations were summarised under the following: (i) Difficult conversation, (ii) lack of communication and denial, (iii) influence of financial background and (iv) emotional burden on healthcare workers. Themes identified included factors influencing DNI\/DNR conversations (patient demographics and disease onset, early initiation of discussions, empathic communication, and rapport building), emotional burden on healthcare workers, and the need for multiple discussion sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The analysis revealed that every conversation differs depending on the patient and his or her family members\u2019 perspectives. Reflections on various conversations help to identify flaws and improve one\u2019s communication skills. Communication skills might improve by practising self-reflection, attending communication skill classes and observing seniors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijpc_262_2025","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:57:13Z","timestamp":1785578233000},"page":"274-281","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reflective Learning from Do Not Intubate\/Do Not Resuscitate Conversations: A Qualitative Study Using Gibbs Reflective Methodology and Focus Group Discussion"],"prefix":"10.25259","volume":"32","author":[{"given":"Betty Mary","family":"Abraham","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Geo","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajashree Kattil","family":"Chittazhathu","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoba","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Amrita Institute of Medical Sciences and Research, Kochi, Kerala, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"10.25259\/IJPC_262_2025\/ref-2","author":"World Health Organization","year":"2020"},{"key":"10.25259\/IJPC_262_2025\/ref-3","author":"World Hospice and Palliative Care Alliance","year":"2014"},{"key":"10.25259\/IJPC_262_2025\/ref-4","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1080\/15265160903469328","article-title":"Reviving the conversation around CPR\/DNR","volume":"10","author":"Bishop","year":"2010","journal-title":"Am J Bioeth"},{"key":"10.25259\/IJPC_262_2025\/ref-5","article-title":"Cardiac Arrest in Hospital -Treatment and Education","author":"Swedish Society of Medicine, Swedish Society of Nursing, Swedish Resuscitation Council","year":"2017"},{"key":"10.25259\/IJPC_262_2025\/ref-6","volume-title":"Health Statistics and Information Systems","author":"WHO","year":"2018"},{"key":"10.25259\/IJPC_262_2025\/ref-8","doi-asserted-by":"publisher","first-page":"S676","DOI":"10.1161\/CIRCULATIONAHA.110.970913","article-title":"Part 4: CPR overview: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"122","author":"Travers","year":"2010","journal-title":"Circulation"},{"key":"10.25259\/IJPC_262_2025\/ref-9","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1097\/CCM.0B013E3181659096","article-title":"Recommendations for end-of-life care in the intensive care unit: A consensus statement by the american college of critical care medicine","volume":"36","author":"Truog","year":"2008","journal-title":"Crit Care Med"},{"key":"10.25259\/IJPC_262_2025\/ref-10","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1111\/j.1525-1497.2006.00302.x","article-title":"Relationship-centered care research network, Relationship-centered care. 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