Hospital Doctors’ Experiences of Caring for Dying Patients

Gray, Denis Pereira; Hood, Henry; Haworth, Gill; Smyth, C; Linklater, Gordon

doi:10.4997/jrcpe.2018.403

Cited by 3 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The reason for this duality may be that shared decision-making between clinicians and patients requires a longer time to establish than the limited clinical time that is usually available [10][11]. In addition, it is especially difficult to communicate with dying patients, and providing a good IC session requires experience [9,29]. In this regard, we believe that by asking both parties questions during medical-mediation, mediators can extract more information from patients such their concerns and anxieties, and they can make it clear that clinicians truly care.…”

Section: Discussionmentioning

confidence: 99%

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Nakanishi¹,

Hayasaka²,

Endo³

et al. 2021

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Nakanishi¹,

Hayasaka²,

Endo³

et al. 2021

View full text Add to dashboard Cite

“…Employee and family satisfaction with the palliative care of the terminally ill has also been examined, without however taking into account the perspectives of physicians [ 3 , 4 ]. When it comes to concrete experiences physicians have had with the terminally ill, these were surveyed in hospitals [ 5 , 6 ], for example, or the focus was more generally on decision-making at the end of life, as in one study that asked general practitioners and medical students about EOL-care [ 7 ]. An exception is a study that explicitly asked about the experiences of hospice staff and volunteers and also includes physicians [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Medical decision-making in hospices from the viewpoint of physicians: results from two qualitative studies

Walker¹,

Breitsameter

2022

BMC Palliat Care

View full text Add to dashboard Cite

Background Physicians who practice in a hospice are responsible for working with patients and nursing staff to develop a medication plan, monitor symptoms and pain, and adjust medication if necessary. In inpatient hospices in Germany, physicians are part of a multi-professional approach, but not part of the hospice team itself. However, there is no, or hardly any, literature on medical practice in a hospice setting. Therefore, we wanted to know how physicians reflect upon their role in hospice within a multi-professional setting, how they communicate with patients, relatives, nursing staff and other physicians, and what the limitations of these communication processes are. Methods By means of two qualitative studies we explored how physicians classify their activities as part of the hospice organization. The study design followed Grounded Theory procedures. Results The physicians named an appropriate interpretation of the patient's wishes as the challenge of everyday practice which can lead to differences of perspective with those involved: with nursing staff, who would prefer an alternative form of medication, with relatives, who do not accept that the patient refuses nutrition, with other physicians, who have a different opinion about appropriate treatment. For physicians, this is all the more challenging as communication with the patient becomes increasingly uncertain due to the patient’s illness. Again and again, medical measures have to be negotiated on several levels. Conclusion Multi-professional organizations that have to deal with differences in perspective handle them by clearly distinguishing areas of responsibility, an aspect that physicians also claim for themselves. For physicians the question arises repeatedly whether they have correctly interpreted the wishes of the patient. They must continuously reassure themselves of the patient's wishes and this presents them with communication challenges not only with the patient, but also with the nursing staff and relatives and, more recently, with their colleagues.

show abstract

“…Det leder således till en personlig mognad och utveckling samt öppnar upp för egen reflektion om livet, vilket även ger möjlighet till professionell utveckling, genom ökad förmåga till beslutsfattande och stolthet över att arbeta med något unikt där varje möte med patient och närstående är ett lärande (100). Att vårda patienter med palliativa vårdbehov har också beskrivits som emotionellt utmanande och kan väcka känslor som medkänsla ledsamhet och hjälplöshet (101), vilket kan leda till arbetsrelaterad stress och utmattning (102,103). Utmattning kan uppstå genom en komplex kombination av emotionell kraftuttömning, avpersonifiering och känsla av minskad personlig prestation (104).…”

Section: Vårdpersonalenatt Vårda Patienter Med Palliativa Vårdbehovunclassified

Samtal vid allvarlig sjukdom - Kronobergsmodellen

Granat

View full text Add to dashboard Cite

Aim: The overall aim of this thesis was to explore clinicians’ perceptions and self-efficacy regarding the use of the ‘Serious illness conversation’ structured workflow, and to explore their self-efficacy in caring for patients with palliative care needs. Methods: This thesis is comprised of four studies: two qualitative studies, one methodological study, and one quantitative study. In studies I and II, observations of clinic meetings and training sessions were undertaken with clinicians. Interviews were performed and a thematic analysis was conducted. In study III, the Self-Efficacy in Palliative Care scale (SEPC) was translated, adapted, and validated. In study IV, the SEPC-SE was completed by nurses and physicians. Factor analysis and Cronbach's alpha were calculated, and the Mann-Whitney U test was used to compare self-efficacy. Multiple linear regression was used to explore associated factors. Results: In study I, clinicians expressed that working with serious illness conversations was vital, but the conversations were also considered in terms of risks. The conversation training sessions created feelings of exposure but were perceived to be rewarding due to an increase in self-awareness. Obstacles in practice were identified as barriers to change. Study II showed that positive experiences and the group’s level of support, consensus, and behaviour was important for self-efficacy. Some clinicians were affected by perceived high demands, failures, anxiety, stress, when working with serious illness conversations. Study III showed that the SEPC-SE needed improvements in understandability and clarity. In study IV, the SEPC-SE reported high reliability. Physicians reported higher self-efficacy than nurses. Education at work and experience in advanced homecare had the strongest associations with self-efficacy. Conclusions: Implementing serious illness conversations can increase clinicians’ awareness about the importance of engaging in serious illness conversations and thus contribute to increased motivation through behavioural and attitudinal changes. However, building a support system for clinicians within the organisation seems essential for improving self-efficacy. The SEPC-SE was found to be valid and reliable. Clinicians’ estimation of their perceived self-efficacy indicates that healthcare organisations should prioritise work-related education and experience to improve self-efficacy in providing palliative care.

show abstract

Hospital Doctors’ Experiences of Caring for Dying Patients

Cited by 3 publications

References 6 publications

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Medical decision-making in hospices from the viewpoint of physicians: results from two qualitative studies

Samtal vid allvarlig sjukdom - Kronobergsmodellen

Contact Info

Product

Resources

About