Finding Hope and Healing When Cure Is Not Possible

Stuart, Brad; Danaher, Tracey S.; Awdish, Rana; Berry, Leonard L.

doi:10.1016/j.mayocp.2019.01.006

Cited by 18 publications

(12 citation statements)

References 27 publications

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“…As pessoas que convivem com essa complicação, apesar de muitos já estarem habituados ao autogerenciamento do diabetes, necessitam de uma narrativa de esperança e de um pensamento positivo para manterem-se engajados com o autocuidado. Estudiosos sugerem que, no atendimento a pessoas com condições que limitam a vida, os profissionais de saúde devem auxiliá -las a encontrar o caminho da esperança que se concentra na cura, proporcionando um alicerce emocional mais realista, com alívio físico, emocional e espiritual 18 .…”

Section: Discussionunclassified

Representações sociais sobre pé diabético: contribuições para Atenção Primária à saúde no Nordeste brasileiro

Lopes¹,

Rolim

Alves

et al. 2021

Ciênc. saúde coletiva

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Resumo A investigação tem por objetivo identificar os elementos estruturantes que orientam a formação das representações sociais do pé diabético entre pessoas com diabetes mellitus. Estudo qualitativo, fundamentado na Teoria das Representações Sociais, seguindo a vertente estrutural complementar, realizado em uma capital do Nordeste brasileiro, de fevereiro a maio de 2019, com a participação de 100 pessoas com pé diabético. Para a coleta dos dados, utilizou-se o teste de associação livre de palavras e o roteiro para caracterização do perfil sociodemográfico e clínico. A análise foi realizada por meio do software openEVOC. Os elementos constituintes da representação social do pé diabético referem-se às evocações são “cura” e “muito ruim”, e revelam que viver com pé diabético é desafiador, mas que há uma esperança de cura que se constitui em mola propulsora na busca cotidiana do cuidado. O elemento prevenção apareceu no campo representacional, o que denota uma visão mais crítica, podendo transformar os elementos nucleares identificados. Constata-se que a estrutura representacional encontra-se ancorada em conteúdos subjetivos, valorativos e atitudinais. Conclui-se que este conhecimento pode contribuir com o desenho de intervenções que auxiliem nas práticas de cuidados e rastreamento do pé diabético nos serviços ofertados na Atenção Primária à Saúde.

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Section: Discussionunclassified

Representações sociais sobre pé diabético: contribuições para Atenção Primária à saúde no Nordeste brasileiro

Lopes¹,

Rolim

Alves

et al. 2021

Ciênc. saúde coletiva

View full text Add to dashboard Cite

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“…Tailoring language to the patient, listening without needless interruption, using nontechnical terminology, allowing for silence after delivering bad news to convey "I am here with you; we are in this together," sitting with patients at eye level during conversation, offering a gentle touch d all convey empathy and lessen fear. 9,[69][70][71][72] One beneficial exercise is to periodically ask clinicians to identify commonly used language that needlessly offends, frightens, or confuses patients, with the goal of banishing their use. 1 Offer "Go-To" Sources for Assistance The need for health-related assistance is often urgent, and sometimes it is perceived by patients as urgent even when it is not.…”

Section: Attend To Languagementioning

confidence: 99%

Trust-Based Partnerships Are Essential — and Achievable — in Health Care Service

Berry

Awdish

Letchuman

et al. 2021

Mayo Clinic Proceedings

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When people think about trust in the context of health care, they typically focus on whether patients trust the competence of doctors and other health professionals. But for health care to reach its full potential as a service, trust must also include the notion of partnership, whereby patients see their clinicians as reliable, caring, shared decision-makers who provide ongoing "healing" in its broadest sense. Four interrelated service-quality concepts are central to fostering trust-based partnerships in health care: empathetic creativity, discretionary effort, seamless service, and fear mitigation. Health systems and institutions that prioritize trust-based partnerships with patients have put these concepts into practice using several concrete approaches: investing in organizational culture; hiring health professionals for their values, not just their skills; promoting continuous learning; attending to the power of language in all care interactions; offering patients "go-to" sources for timely assistance; and creating systems and structures that have trust built into their very design. It is in the real-world implementation of trust-based partnership that health care can reclaim its core mission.

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“…Uncertainty of prognosis can be difficult to communicate and some clinicians may harbor fears that such a conversation would serve to take away hope from their patients. 15 Clinicians may be uncertain of their skills at broaching the topic and may not have spent time cultivating a skillset that allows for emotion-laden, complex conversations. When these conversations are forced to occur, it is too often in urgent situations, and necessarily focused on establishing resuscitation and intubation status.…”

Section: Barriers To Effective Serious Illness Conversationsmentioning

confidence: 99%

Serious illness conversations in pulmonary hypertension

et al. 2021

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Pulmonary arterial hypertension has evolved from a fatal disease with few treatment options to a chronic condition with improved survival. This improvement is possible through development of effective therapies as well as the expansion of risk stratification scores to assist clinical decision making. Despite improved disease control, quality of life, and overall prognosis, many challenges remain. The treatment itself is burdensome, with significant impact on quality of life. Many patients with pulmonary arterial hypertension still present with advanced, often end-stage disease. Increased use of mechanical circulatory support and catheter-based interventions have expanded use of extracorporeal life support and right ventricle assist devices.â¯For these reasons as well as the long-term relationships pulmonary hypertension physicians have with patients and their families, navigating the course of the illness in a considered, proactive way is essential. Understanding individual goals and revisiting them as they change over time requires comfort with the conversation itself. There are many barriers and challenges to having effective, compassionate conversations in the clinical setting with time constraints being the most often cited. Compressed visits are necessarily focused on the clinical aspects, therapy and medication adherence and tolerance. Clinicians are sometimes wary of diminishing hope in the face of ongoing treatment. Having sufficient experience and comfort with these discussions can be empowering. In this paper we discuss the challenges involved and propose a framework to assist in incorporating these discussions into clinical care.

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Finding Hope and Healing When Cure Is Not Possible

Cited by 18 publications

References 27 publications

Representações sociais sobre pé diabético: contribuições para Atenção Primária à saúde no Nordeste brasileiro

Representações sociais sobre pé diabético: contribuições para Atenção Primária à saúde no Nordeste brasileiro

Trust-Based Partnerships Are Essential — and Achievable — in Health Care Service

Serious illness conversations in pulmonary hypertension

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