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Angelos P, Taylor LJ, Roggin K, Schwarze ML, Vaughan LM, Wightman SC, Sade RM. Decision-Making in Surgery. Ann Thorac Surg 2024; 117:1087-1094. [PMID: 38242340 DOI: 10.1016/j.athoracsur.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
Surgeons face unique challenges in perioperative decision-making and communication with patients and families. In cardiothoracic surgery, the stakes are high, life and death decisions must be made quickly, and surgeons often lack a longstanding relationship with patients and families prior to intervention. This review considers specific challenges in the preoperative period followed by those faced postoperatively. While preoperative deliberation and informed consent focus on reaching a decision between 2 or more alternative approaches, the most vexing postoperative decisions often involve the patient's discontent with the best-case outcome or how to ensure goal-concordant care when complications arise. This review explores the preoperative ethical and legal requirement for informed consent by describing the contemporary preferred method, shared decision-making. We also present a framework to optimize surgeon communication and promote patient and family engagement in the setting of high-risk surgery for older patients with serious illness. In the postoperative period the family is often tasked with deciding what to do about major complications when the patient has lost decision-making capacity. We discuss several examples and offer strategies for surgeons to navigate these challenging situations. We also explore the concepts of clinical heroism and futility in relation to communicating with patients and families about the outcomes of surgery. Persistent ethical challenges in decision-making suggest that surgeons should improve their skills in communicating with patients to better engage with them, both before and after surgery.
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Affiliation(s)
- Peter Angelos
- Department of Surgery, The University of Chicago, Chicago, Illinois; MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois
| | - Lauren J Taylor
- Division of Cardiothoracic Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia; Department of Surgery, Central Virginia VA Healthcare System, Richmond, Virginia
| | - Kevin Roggin
- Division of Surgical Oncology, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Margaret L Schwarze
- Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Leigh M Vaughan
- Division of General Medicine, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Sean C Wightman
- Division of Thoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, California
| | - Robert M Sade
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
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2
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Cowling WR. Mystery and Miracle in Nursing: A Preliminary Unitary Appreciative Inquiry. ANS Adv Nurs Sci 2024; 47:218-230. [PMID: 38713141 DOI: 10.1097/ans.0000000000000531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
This study of mystery and miracles in nursing offers a unique perspective in examning and understanding these phenomena grounded in a unitary science framework and guided by unitary appreciative inquiry. It examined 6 years of postings from an online course that gave nurses globally the opportunity to describe and elaborate upon experiences of mystery and miracles in their professional and personal lives. The analysis and synopsis processes used revealed the diversity and uniqueness of mystery and miracle phenomena and acceptance by nurses of their reality without need for scientific explanation despite the tendency to dismiss them by colleagues.
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Affiliation(s)
- William Richard Cowling
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina
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3
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Simpson C, Lee-Ameduri K, Hartwick M, Shaul RZ, Kanji A, Healey A, Murphy NB, Pope TM. Navigating disagreement and conflict in the context of a brain-based definition of death. Can J Anaesth 2023; 70:724-735. [PMID: 37131031 PMCID: PMC10202992 DOI: 10.1007/s12630-023-02417-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/03/2022] [Accepted: 09/20/2022] [Indexed: 05/04/2023] Open
Abstract
In this paper, we discuss situations in which disagreement or conflict arises in the critical care setting in relation to the determination of death by neurologic criteria, including the removal of ventilation and other somatic support. Given the significance of declaring a person dead for all involved, an overarching goal is to resolve disagreement or conflict in ways that are respectful and, if possible, relationship preserving. We describe four different categories of reasons for these disagreements or conflicts: 1) grief, unexpected events, and needing time to process these events; 2) misunderstanding; 3) loss of trust; and 4) religious, spiritual, or philosophical differences. Relevant aspects of the critical care setting are also identified and discussed. We propose several strategies for navigating these situations, appreciating that these may be tailored for a given care context and that multiple strategies may be helpfully used. We recommend that health institutions develop policies that outline the process and steps involved in addressing situations where there is ongoing or escalating conflict. These policies should include input from a broad range of stakeholders, including patients and families, as part of their development and review.
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Affiliation(s)
- Christy Simpson
- Department of Bioethics, Dalhousie University, Halifax, NS, Canada.
- Canadian Blood Services, Ottawa, ON, Canada.
| | - Katarina Lee-Ameduri
- St. Boniface Hospital, Reseau Compassion Network, Winnipeg, MB, Canada
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Michael Hartwick
- Department of Medicine, Divisions of Critical Care and Palliative Medicine, University of Ottawa, Ottawa, ON, Canada
- Trillium Gift of Life, Ottawa, ON, Canada
| | - Randi Zlotnik Shaul
- Bioethics Department, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Aly Kanji
- McGill University, Montreal, QC, Canada
| | - Andrew Healey
- Trillium Gift of Life Network, Hamilton, ON, Canada
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nicholas B Murphy
- Departments of Medicine and Philosophy, Western University, London, ON, Canada
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4
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Coyne HL, Arp R, Kumar LT, Smith GT, Mims L. Top Ten Tips Palliative Care Clinicians Should Know About Caring for Pentecostal Patients. J Palliat Med 2022; 26:559-563. [PMID: 36327106 DOI: 10.1089/jpm.2022.0488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
People of the Pentecostal faith are a grouping of Protestant Christians. Pentecostals are a growing group not only in the United States, but also worldwide. This article focuses on the Pentecostal beliefs and spiritual practices in North America and their implications in the clinical environment. As the population of this faith group continues to grow, palliative care clinicians will need a basic understanding of the values and practices of Pentecostal spirituality and its potential impact on goals-of-care discussions. This article offers 10 recommendations for clinicians to better understand and support Pentecostal patients and families. These overarching concepts of Pentecostal faith and practices are presented as a point of initiation for further exploration of the support that may be needed, and not as a comprehensive guide.
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Affiliation(s)
- Hannah L. Coyne
- Palliative Care Department, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Rob Arp
- Pastoral Care Department, Roper St. Francis Healthcare, Charleston, South Carolina, USA
| | - Lephen T. Kumar
- International Pastor, Refuge Church, Walterboro, South Carolina, USA
| | - Gordon T. Smith
- President, Ambrose University and Seminary, Calgary, Alberta, Canada
| | - Lauren Mims
- Department of Internal Medicine-Palliative Care Department, Medical University of South Carolina, Charleston, South Carolina, USA
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5
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Gauznabi S. Managing the hope for a miracle: a reflection. J Prim Health Care 2022; 14:280-282. [PMID: 36178846 DOI: 10.1071/hc22070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/26/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Shomel Gauznabi
- Faculty of Medicine and Health Sciences, University of Auckland, New Zealand
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6
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Byrne-Martelli S, Rosenberg LB. Communication Strategies When Patients Utilize Spiritual Language to Hope for a Miracle #433. J Palliat Med 2022; 25:506-507. [PMID: 35230904 DOI: 10.1089/jpm.2021.0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kestenbaum A, Fitchett G, Galchutt P, Labuschagne D, Varner-Perez SE, Torke AM, Kamal AH. Top Ten Tips Palliative Care Clinicians Should Know About Spirituality in Serious Illness. J Palliat Med 2021; 25:312-318. [PMID: 34871044 DOI: 10.1089/jpm.2021.0522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Assessment of spiritual suffering and provision of spiritual care are a central component of palliative care (PC). Unfortunately, many PC clinicians, like most medical providers, have received limited or superficial training in spirituality and spiritual distress. This article, written by a group of spiritual care providers, and other PC and hospice clinicians, offers a more in-depth look at religion and spirituality to help to enhance readers' current skills while offering a practical roadmap for screening for spiritual distress and an overview of partnering with colleagues to ensure patients receive values-aligned spiritual care provision.
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Affiliation(s)
- Allison Kestenbaum
- Spiritual Care Services, UC San Diego Health, San Diego, California, USA
| | - George Fitchett
- Department of Religion, Health & Human Values, Rush University Medical Center, Chicago, Illinois, USA
| | - Paul Galchutt
- Spiritual Health Services, M Health Fairview, Minneapolis, Minnesota, USA
| | - Dirk Labuschagne
- Supportive Oncology, Rush University Medical Center, Chicago, Illinois, USA
| | - Shelley E Varner-Perez
- Indiana University (IU) Health, Indianapolis, Indiana, USA.,IU Center for Aging Research, Regenstrief Institute, Inc., Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, Indiana, USA
| | - Alexia M Torke
- Indiana University School of Medicine, Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, Indiana, USA
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Guedes A, Carvalho MS, Laranjeira C, Querido A, Charepe Z. Hope in palliative care nursing: concept analysis. Int J Palliat Nurs 2021; 27:176-187. [PMID: 34169743 DOI: 10.12968/ijpn.2021.27.4.176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hope has long been considered essential to humans in several disciplines, nursing included. At the end-of-life, hope is a complex and dynamic emotion, and there have been different interpretations and conceptions of hope. AIM To develop hope in palliative care as an evidenced-based nursing concept: analyse its attributes, antecedents and consequences. METHOD This study follows Walker and Avant's concept analysis: (a) select a concept; (b) determine the aims or purposes of analysis; (c) identify as many uses of the concept as possible; (d) determine the defining attributes; (e) identify a model case; (f) identify borderline and contrary cases; (g) identify antecedents and consequences; and finally (h) define the empirical referents. FINDINGS Antecedents included symptom control, existential suffering, interpersonal relationships and the establishment of realistic goals. The synthetic attributes were a positive outcome expectancy and a process oriented towards the present and future. The concept's consequences were quality of life, survival, acceptance and a peaceful death. CONCLUSION This study revealed a strong history of publications on the subject. The analysis of attributes, antecedents and consequences of the concept of hope contributed to understanding its relevance to palliative care nursing and provided suggestions for effective interventions and future research.
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Affiliation(s)
- Ana Guedes
- PhD student in Nursing, Catholic University of Portugal, Institute of Health Sciences, Lisbon, Portugal
| | - Matilde Silva Carvalho
- PhD student in Nursing, Catholic University of Portugal, Institute of Health Sciences, Lisbon, Portugal
| | - Carlos Laranjeira
- Associate Professor, Center for Innovative Care and Health Technology (ciTechCare); School of Health Sciences of Polytechnic of Leiria
| | - Ana Querido
- Associate Professor, Center for Innovative Care and Health Technology (ciTechCare); School of Health Sciences of Polytechnic of Leiria
| | - Zaida Charepe
- Associate Professor, Catholic University of Portugal, Institute of Health Sciences, Center for Interdisciplinary Research in Health (CIIS), Lisbon, Portugal
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Choudhuri AH, Duggal S, Ahuja B, Uppal R. An Observational Study on the Effects of Delayed Initiation of End-of-Life Care in Terminally ill Young Adults in the Intensive Care Unit. Indian J Palliat Care 2021; 27:31-34. [PMID: 34035614 PMCID: PMC8121244 DOI: 10.4103/ijpc.ijpc_61_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/14/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction The early initiation of end-of-life (EOL) care in terminally ill patients in the intensive care unit (ICU) offers distinct advantages but requires the consent and cooperation of the patients or their relatives. The terminally ill young adults pose distinct set of challenges. The present study was conducted to measure the prevalence and identify and compare the risk factors for the delayed initiation of EOL in terminally ill young adults. Methods The retrospective study was conducted in a mixed medical-surgical 7-bedded ICU after extracting the medical records of all terminally ill young adults in the age group of 20-40 years admitted between June 2014 and November 2018. Only "treatment futile" patients were eligible for inclusion. The patients already on EOL care or with unproven diagnosis were excluded from the study. The commencement of EOL care was divided into (a) normal group (N) and (b) late group (L). The two groups were compared with respect to the demographic factors, outcome, and patient satisfaction level. The factors responsible for the delay were investigated. All statistical analyses were performed using software SPSS 21.0 (SPSS, Inc., Chicago, IL, USA). Results Out of 66 terminally ill young adults with treatment futility, 23 (38.9%) were in the N group and 36 (61.1%) were in the L group (0.8 ± 0.4 days vs. 3.1 ± 1.6 days; P = 0.01). The education level and social and family support of the relatives of the N group were higher (P = 0.03; P - 0.04). The N group had lesser drug consumption of ICU resource usage (14.7% vs. 36.1%, P = 0.01; 18.5% vs. 24.7%, P = 0.04). There was no difference in the duration of mechanical ventilation, ICU stay, and satisfaction level at the time of discharge (or death) from the ICU. Conclusions Our study found a high prevalence of delayed initiation of EOL care in terminally ill young adults and identified the factors responsible for them. The normal initiation of EOL care reduced the usage of medications and resources without affecting the level of patient satisfaction.
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Affiliation(s)
- Anirban Hom Choudhuri
- Department of Anaesthesiology and Intensive Care, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Sakshi Duggal
- Department of Anaesthesiology and Intensive Care, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Bhuvna Ahuja
- Department of Anaesthesiology and Intensive Care, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Rajeev Uppal
- Department of Anaesthesiology and Intensive Care, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Buchwald D, Brønnum D, Melgaard D, Leutscher PD. Living with a Hope of Survival Is Challenged by a Lack of Clinical Evidence: An Interview Study among Cancer Patients Using Cannabis-Based Medicine. J Palliat Med 2020; 23:1090-1093. [DOI: 10.1089/jpm.2019.0298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Dorte Buchwald
- Palliative Care Team, North Denmark Regional Hospital, Hjørring, Denmark
| | - Dorte Brønnum
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Dorte Melgaard
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Peter D.C. Leutscher
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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11
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Spencer KL, Mrig EH, Talaie AK. Does Palliative Care Utilization Facilitate Conversion to Hospice Care? A Qualitative Study of the "Soft No". Am J Hosp Palliat Care 2020; 37:701-706. [PMID: 31968990 DOI: 10.1177/1049909119900640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Facilitating patient conversion to hospice at end of life is a prominent clinical concern. Enrollment in outpatient palliative care services is often assumed to encourage seamless transition to hospice care, but this has not been demonstrated. Moreover, decisions to convert from palliative care to hospice are generally treated as dichotomous, thus hampering our ability to understand decision processes. OBJECTIVE To examine medical decision-making among patients who are prospectively evaluating whether to convert from palliative care to hospice. DESIGN Qualitative case study, using in-depth interviews and constant comparative method. SETTING/PATIENTS Terminally ill patients currently enrolled in outpatient palliative care services (N = 26) and their caregivers (N = 16), selected purposely for maximum variation in condition and personal background. MEASUREMENTS Themes identified in qualitative in-depth interviews. RESULTS Patients rarely refused hospice outright but more often postponed using a "soft no," in which they neither accepted nor overtly refused hospice. Justifications patients and caregivers offered for why hospice was not needed (yet) appeared in these themes: (1) not seeing the value added of hospice, (2) assuming the timing is premature, and (3) relying on extensive health-related support networks that justify or endorse continuation of active care. CONCLUSIONS Despite assumptions to the contrary, benefits associated with utilization of outpatient palliative care services have the potential to incentivize the delay of hospice in some cases. Clinical interactions with outpatient palliative care patients should consider the influence of these broad social support systems when discussing hospice options.
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Affiliation(s)
- Karen Lutfey Spencer
- Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, USA
| | - Emily Hammad Mrig
- Department of Health Policy and Management, Yale University, New Haven, CO, USA
| | - Ariana Kobra Talaie
- Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, USA
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Marterre B, Clayville K. Navigating the Murky Waters of Hope, Fear, and Spiritual Suffering: An Expert Co-Captain's Guide. Surg Clin North Am 2019; 99:991-1018. [PMID: 31446923 DOI: 10.1016/j.suc.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
How can surgeons deliver compassionate, holistic care to patients who are beyond cure? Interacting emotionally and understanding hope, fear, and spiritual suffering is key. Responsibly reframing hope to underlying meanings, and away from specific outcomes, is critical. Facilitating moves from cure to comfort to a peaceful dying process requires some retooling of the surgical toolbox. Surgeons possess a unique set of skills, including imagination and an undying sense of hope. Surgeons who have the courage to delve into their emotions and sustain realistic hope for their patients, all the way to the end, will reap deep personal and professional rewards.
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Affiliation(s)
- Buddy Marterre
- Surgical Palliative Care, Department of General Surgery, Wake Forest Baptist Health, 5th Floor, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
| | - Kristel Clayville
- Zygon Center for Religion and Science, MacLean Center for Clinical Medical Ethics, 1100 East 55th Street, Chicago, IL 60615, USA
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13
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Derry HM, Epstein AS, Lichtenthal WG, Prigerson HG. Emotions in the room: common emotional reactions to discussions of poor prognosis and tools to address them. Expert Rev Anticancer Ther 2019; 19:689-696. [PMID: 31382794 DOI: 10.1080/14737140.2019.1651648] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Introduction: Advanced cancer patients often want prognostic information, and discussions of prognosis have been shown to enhance patient understanding of their illness. Such discussions can lead to high-quality, value-consistent care at the end of life, yet they are also often emotionally challenging. Despite how common and normal it is for patients to experience transient emotional distress when receiving 'bad news' about prognosis, emotional responses have been under-addressed in existing literature on prognostic discussions. Areas covered: Drawing upon psychology research, principles of skilled clinical communication, and published approaches to discussions of serious illness, we summarize patients' common emotional reactions and coping strategies. We then provide suggestions for how to respond to them in clinic. Expert opinion: Ultimately, effective management of emotional reactions to bad news may lead to earlier, more frequent, and more transparent discussions of prognosis, thus promoting cancer patients' understanding of, and adjustment to, their illness and improving the quality of their end-of-life care.
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Affiliation(s)
| | - Andrew S Epstein
- Weill Cornell Medicine , New York , NY , USA.,Memorial Sloan Kettering Cancer Center , New York , NY , USA
| | - Wendy G Lichtenthal
- Weill Cornell Medicine , New York , NY , USA.,Memorial Sloan Kettering Cancer Center , New York , NY , USA
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14
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Thompson K, Tak HJ, El-Din M, Madani S, Brauer SG, Yoon JD. Physicians' Religious Characteristics and Their Perceptions of the Psychological Impact of Patient Prayer and Beliefs at the End of Life: A National Survey. Am J Hosp Palliat Care 2018; 36:116-122. [PMID: 30079746 DOI: 10.1177/1049909118792871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND: Physicians who are more religious or spiritual may report more positive perceptions regarding the link between religious beliefs/practices and patients' psychological well-being. METHODS: We conducted a secondary data analysis of a 2010 national survey of US physicians from various specialties (n = 1156). Respondents answered whether the following patient behaviors had a positive or negative effect on the psychological well-being of patients at the end of life: (1) praying frequently, (2) believing in divine judgment, and (3) expecting a miraculous healing. We also asked respondents how comfortable they are talking with patients about death. RESULTS: Eighty-five percent of physicians believed that patients' prayer has a positive psychological impact, 51% thought that patients' belief in divine judgment has a positive psychological impact, and only 17% of physicians thought the same with patients' expectation of a miraculous healing. Opinions varied based on physicians' religious and spiritual characteristics. Furthermore, 52% of US physicians appear to feel very comfortable discussing death with patients, although end-of-life specialists, Hindu physicians, and spiritual physicians were more likely to report feeling very comfortable discussing death (adjusted odds ratio range: 1.82-3.00). CONCLUSION: US physicians hold divided perceptions of the psychological impact of patients' religious beliefs/practices at the end of life, although they more are likely to believe that frequent prayer has a positive psychological impact for patients. Formal training in spiritual care may significantly improve the number of religion/spirituality conversations with patients at the end of life and help doctors understand and engage patients' religious practices and beliefs.
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Affiliation(s)
- Kathryn Thompson
- 1 Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Hyo Jung Tak
- 2 Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE, USA
| | - Magdy El-Din
- 3 Department of Medicine, Mercy Hospital & Medical Center, Chicago, IL, USA
| | - Syed Madani
- 3 Department of Medicine, Mercy Hospital & Medical Center, Chicago, IL, USA
| | - Simon G Brauer
- 4 Department of Sociology, Duke University, Durham, NC, USA
| | - John D Yoon
- 3 Department of Medicine, Mercy Hospital & Medical Center, Chicago, IL, USA.,5 MacLean Center for Clinical Medical Ethics, Department of Medicine, The University of Chicago, Chicago, IL, USA
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Nierop-van Baalen C, Grypdonck M, van Hecke A, Verhaeghe S. Health professionals’ dealing with hope in palliative patients with cancer, an explorative qualitative research. Eur J Cancer Care (Engl) 2018; 28:e12889. [DOI: 10.1111/ecc.12889] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 04/12/2018] [Accepted: 06/12/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Corine Nierop-van Baalen
- Haaglanden Medical Centre; The Hague The Netherlands
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Mieke Grypdonck
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Ann van Hecke
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Sofie Verhaeghe
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
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