Discussion of death and dying in surgical textbooks

Easson, Alexandra; Crosby, Jacqueline A.; Librach, S. Lawrence

doi:10.1016/s0002-9610(01)00646-8

Cited by 38 publications

(12 citation statements)

References 21 publications

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“…Evidence suggests that clinicians working in surgical ICUs find this type of communication to be particularly challenging. Surgical textbooks contain scant content related to communication of distressing news or goal setting [16]. The "rescue culture" that dominates many surgical ICUs may also further impede such discussions [17-20].…”

Section: Introductionmentioning

confidence: 99%

Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis

et al. 2010

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IntroductionIntensive care unit (ICU) patients and family members repeatedly note accurate and timely communication from health care providers to be crucial to high-quality ICU care. Practice guidelines recommend improving communication. However, few data, particularly in surgical ICUs, exist on health care provider opinions regarding whether communication is effective.MethodsTo evaluate ICU clinician perceptions regarding adequacy of communication regarding prognosis, we developed a survey and administered it to a cross section of surgical ICU nurses, surgical ICU physicians, nurse practitioners (NPs), and surgeons.ResultsSurgeons had a high satisfaction with communication regarding prognosis for themselves (90%), ICU nurses (85%), and ICU physicians and NPs (85%). ICU nurses noted high satisfaction with personal (82%) and ICU physician and NP (71%) communication, but low (2%) satisfaction with that provided by surgeons. ICU physicians and NPs noted high satisfaction with personal (74%) and ICU nurse (88%) communication, but lower (23%) satisfaction with that provided by surgeons. ICU nurses were the most likely (75%) to report speaking to patients and patient families regarding prognosis, followed by surgeons (40%), and then ICU physicians and NPs (33%). Surgeons noted many opportunities to speak to ICU nurses and ICU physicians and NPs about patient prognosis and noted that comments were often valued. ICU physicians and NPs and ICU nurses noted many opportunities to speak to each other but fewer opportunities to communicate with surgeons. ICU physicians and NPs thought that their comments were valued by ICU nurses but less valued by surgeons. ICU nurses thought that their comments were less valued by ICU physicians and NPs and surgeons.ConclusionsICU nurses, surgeons, and ICU intensivists and NPs varied widely in their satisfaction with communication relating to prognosis. Clinician groups also varied in whether they thought that they had opportunities to communicate prognosis and whether their concerns were valued by other provider groups. These results hint at the nuanced and complicated relationships present in surgical ICUs. Further validation studies and further evaluations of patient and family member perspectives are needed.

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Section: Introductionmentioning

confidence: 99%

Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis

et al. 2010

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“…However, palliative care guidelines, specifically as they pertain to surgical options, remain less well defined. Ideally, the surgeon should be able to counsel patients and their families regarding the risks of surgical procedures or, more importantly, prognosticate based on data rather than speculations or anecdotal experience [1].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Outcomes Analysis of Palliative Procedures Performed for Malignant Intestinal Obstruction Due to Recurrent Ovarian Cancer

et al. 2009

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Objective. To obtain prospective outcomes data on patients (pts) undergoing palliative operative or endoscopic procedures for malignant bowel obstruction due to recurrent ovarian cancer.Methods. An institutional study was conducted from July 2002 to July 2003 to prospectively identify pts who underwent an operative or endoscopic procedure to palliate the symptoms of advanced cancer. This report focuses on pts with malignant bowel obstruction due to recurrent ovarian cancer. Procedures performed with an upper or lower gastrointestinal (GI) endoscope were considered "endoscopic." All other cases were classified as "operative." Following the procedure, the presence or absence of symptoms was determined and followed over time. All pts were followed until death.Results. Palliative interventions were performed on 74 gynecologic oncology pts during the study period, of which 26 (35%) were for malignant GI obstruction due to recurrent ovarian cancer. The site of obstruction was small bowel in 14 (54%) cases and large bowel in 12 (

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“…Published guidelines recommend that physicians should restrain from saying that they have nothing to provide for patients. [10] It has also been shown that prognostic disclosure of definite survival periods without probability and ranges caused high emotional distress. Moreover, in a large survey from Japan, the percentages of respondents who wanted to know the estimated prognosis was not very high (63%) and it was recommended that estimated prognosis be conveyed within the context of statistical uncertainty for each patient.…”

Section: Transition and Communication Issuesmentioning

confidence: 99%

Curative to palliative care-transition and communication issues: Surgeons perspective

Deo¹,

Thejus²

2013

Indian J Palliat Care

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Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.

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Discussion of death and dying in surgical textbooks

Cited by 38 publications

References 21 publications

Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis

Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis

A Prospective Outcomes Analysis of Palliative Procedures Performed for Malignant Intestinal Obstruction Due to Recurrent Ovarian Cancer

Curative to palliative care-transition and communication issues: Surgeons perspective

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