LEVERAGING FEELINGS: A CARE TEAM'S STRATEGIC USE OF EMOTIONS IN THE TRANSITION TO PALLIATION.

The transition to palliative care is intensely emotional for patients, their caregivers, and healthcare providers because accepting palliation means ceasing curative treatment in favor of pain management for the remainder of life. This paper draws from the emotion management perspective to understand how a palliative care team can use emotions in consultations about end-of-life care. The study used ethnographic observations of a palliative care team's consultations with patients and semi-structured interviews with the care team. The study found that healthcare providers strategically leverage emotions to help patients transition to palliative care. Strategies include leveraging anger through the specter of physical pain, leveraging guilt through navigating moral dilemmas, and distancing from anger to build trust. Providers use situational clues and information from the patients' backgrounds to determine which strategy to deploy. If one strategy fails, team members often cycle through other strategies to help persuade patients and their families that palliative care is the best option. This paper argues that leveraging emotions is an integral part of transitioning to palliative care. The strategies outlined here could be useful for studying professional healthcare delivery in other settings. The cultural, organizational, and professional pressures affecting the emotional work of healthcare providers are discussed. [ABSTRACT FROM AUTHOR]