Results suggest that disclosure of a terminal prognosis does not mean loss of patient hope. Instead, hope was redefined on a goal other than cure. Presenting patients with information and increasing their knowledge about care options and resources may facilitate patients in identifying meaningful goals that are better aligned with their prognosis.
Family members report discussion with the inpatient palliative care team results in improved communication and knowledge, which contributes to decision-making ability. However, palliative care consultation may be improved by developing stronger protocols for introducing palliative care and by including the attending physician in the process to preclude conflicting, inconsistent information and recommendations.
The latest advances in medicine and technology are used to care for transplant recipients, yet many patients have psychosocial difficulties that technology alone cannot resolve. Although most healthcare professionals acknowledge the importance of the staff's role in working with patients to resolve psychosocial problems, little research has examined the nature of staff-patient relationships and the proven ability of good relationships to improve outcomes. The purposes of this paper are to profile psychosocial risk and its relationship to outcomes after heart transplantation, explore staff-patient interactions in dealing with psychosocial problems, and present a growth and development model that can be used as a theoretical base to establish a more therapeutic alliance with patients.
Result. Two-thirds of the pre-session PSQI scores were greater than five, associated with poor sleep quality. This was unchanged across the study period. Pre-session BFI scores were below seven, indicating moderately severe fatigue. This was unchanged across the study period. BFI scores showed a significant decrease in fatigue immediately following the art sessions (F 1, 5 ¼ 26.96, p ¼ 0.003).
Conclusion. Expressive art had an immediatesalutary effect on fellows' fatigue.Implications for Research, Policy, or Practice. This is the first study of its kind showing expressive art as a successful treatment for fatigue in physicians training in palliative medicine. This should be of interest to all fatigued clinicians of palliative medicine.
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