An Approach to Caring for Patients with Complex Comorbidities for Family Physician: The SBAR4 model

Hock, Lee Kheng; Leng, Low Lian

doi:10.33591/sfp.43.3.u1

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…Previous studies found that open awareness as a medical and ethical mandate was valued in Western countries and showed that patient autonomy was not fully implemented in Eastern cultures 21,37 . Although the gatekeeper role of the family in Eastern countries was confirmed, family members from Western and Eastern countries were both cautious about revealing the truth, especially negative information (risks, compliance, survivorship, and death), although patients preferred to be informed about details of their own cancer 38 .…”

Section: Discussionmentioning

confidence: 99%

“…The awareness context was culturally relevant. Although open awareness was found to be conducive to pain management, psychological well-being, and quality of life, the patient’s autonomy remained challenged because of the emphasis on family determination in many Eastern countries (Iran, Japan, Singapore, and Saudi Arabia) 19–23 . In China, family members tended to be intimately involved in the decision-making process, diagnostic disclosure, and doctor-patient communication 14,24 .…”

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confidence: 99%

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Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China

et al. 2022

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BackgroundLung cancer, as a multistep and multifactorial disease, is among the most fatal cancers worldwide. As new therapies are developed and early screening increases, patients tend to experience progression-free survival (PFS) as a coexistence of living and dying simultaneously.ObjectiveThe aim of this study was to explore the awareness context experienced by Chinese elderly patients and family members.MethodsInterviews were conducted with 20 interviewees, including 13 elderly patients with lung cancer and 7 caregivers that were recruited using purposive sampling. Semistructured, face-to-face, in-depth interviews were conducted using a qualitative descriptive approach.ResultsAmbiguity was commonly experienced by patients with lung cancer with PFS. Three themes emerged from the data analysis: “ambiguity in cancer diagnosis,” “ambiguity in prognostic awareness,” and “ambiguity in identity.” In this case, ambiguity refers to a situation or context in which patients are uncertain about whether there will be a recurrence of their cancer and when it might occur.ConclusionsThe findings highlighted that patients experienced ambiguity in response to unclear diagnoses, uncertain prognoses, and identity crises during PFS.Implications for PracticeHealthcare teams should be equipped with psychosocial knowledge and communication skills to manage ambiguity in diagnosis and prognosis for patients with PFS.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China

et al. 2022

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“…Cultural differences in attitudes towards truth-telling exist; however, these differences should not be used as excuses not to respect individual rights and preferences of cancer patients by making assumptions based on their age, sex, type of cancer, language and/or cultural background [18]. It has been found that physicians from Japan agree upon the concealment of the truth [19] and similar attitudes of patient nondisclosure have been observed in Singapore [20].…”

Section: The Ethical Dilemma Of Communicating Cancer Diagnosismentioning

confidence: 98%

The Rationality of the Evolutionary Synthesis and Its Competing Theories

Wang

2023

IOJASS

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The evolutionary synthesis has stronger empirical coordination force, conceptual coordination force, and background coordination force. It is generally accepted by evolutionary biologists for its stronger comprehensive coordination force. Nowadays, a large amount of new information and new concepts have emerged in evolutionary biology, which goes beyond the traditional framework of evolutionary synthesis and brings many new empirical and conceptual problems to evolutionary synthesis, changing the state of its comprehensive coordination force.

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“…11 ere is also a trend towards delivering this care through forming inter-professional teams or multi-disciplinary teams which has been shown to improve outcomes. 8 e SBAR4 framework, proposed by Lee et al 12 in an earlier publication on complex care combines the elements of the SBAR model of inter-disciplinary communication as well as the tasks of consultations described by Pendleton.…”

Section: Introductionmentioning

confidence: 99%

Using the SBAR4 model for Management of a Patient with Complex Comorbidities in the Primary Care setting – A Case Study

Koong¹

2017

SFP

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Other than the factor of multiple morbidities, literature describes speci c conditions that are often associated with complex patients. ese factors include the diagnosis of heart failure, anxiety, depression, and medication-related factors such as numerous medications and the use of insulin. 3,6 b. Social Factors Common factors include nancial problems, lack of shelter, and lack of caregiver and support, sometimes due to poor family relationships. ese factors are closely intertwined to the patient's access to care and treatment, will in uence the patient's health-seeking behaviour, and will impact his/her mental well-being. c. Behavioral Factors Common presentations of problematic behaviour that interfere with care delivery include non-adherence to medications, follow-ups, and recommended lifestyle changes. Another important problematic behaviour to note is the lack of motivation to participate in self-care. ese behaviours ought to prompt the PCP to explore for underlying ideas, concerns, and expectations of the patient, as well as social and mental health issues that contribute to these behaviours. Addressing these behaviours is essential to improving outcomes. 7 d. Mental Health e presence of depression and anxiety will impact the way care is delivered and needs to be identi ed and addressed. Complex patients have been described as high-cost high-needs patients. Frequent hospital attendance, admissions, multiple visits to various providers, long medication lists, and progression of existing chronic conditions with the development of complications are some reasons contributing to the increased cost in managing this group of patients. eir psychosocial circumstance predisposes them to a reduced capacity for resilience. ey are also more vulnerable to fragmented care as a result of the social dimension. 8 It is important for PCPs to identify a complex case when they see one. ese patients often require more intensive medical services coordinated across multiple providers as well as a wide range of social supports to maintain their health and functioning. However, caring for complex patients can be challenging. Time is often cited as a key challenge to the PCP and it seems almost impossible to understand and address the multiple issues in complex patients. Gaps in information transfer when the patient transfers from the hospital to the community, or between the key stakeholders involved in care, is another challenge. Care is thus

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An Approach to Caring for Patients with Complex Comorbidities for Family Physician: The SBAR4 model

Cited by 4 publications

References 9 publications

Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China

Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China

The Rationality of the Evolutionary Synthesis and Its Competing Theories

Using the SBAR4 model for Management of a Patient with Complex Comorbidities in the Primary Care setting – A Case Study

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