Palliative Care by The Surgeon: How To Do It

Dunn, Geoffrey P.; Milch, Robert Austin; Mosenthal, Anne C.; Lee, K.Francis; Easson, Alexandra; Huffman, Joan L.

doi:10.1016/s1072-7515(02)01125-0

Cited by 23 publications

(19 citation statements)

References 5 publications

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“…Whether resection of the primary tumor should be done in patients with synchronous metastases has been discussed extensively [20][21][22][23]. In some recent articles, it has been suggested that patients who do not have any related symptoms should not undergo resection of the primary tumor [20,23], and increased use of chemotherapy or stent techniques may support this trend [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…In some recent articles, it has been suggested that patients who do not have any related symptoms should not undergo resection of the primary tumor [20,23], and increased use of chemotherapy or stent techniques may support this trend [21,22]. However, a randomized controlled trial would be required to decide this issue.…”

Section: Discussionmentioning

confidence: 99%

“…Whether or not resection of the primary tumor should be performed prior to starting palliative therapy is controversial [20][21][22][23]. However, patients with metastatic disease who have symptoms related to their primary tumor, such as anemia due to bleeding or obstruction, have undergone resection at our institution.…”

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confidence: 99%

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Laparoscopic surgery for stage IV colorectal cancer

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic surgery for stage IV colorectal cancer

et al. 2009

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“…33 Moreover, each of the above scenarios presumes that the surgeon, intensivist, and/or SICU nurse have the desire and skill set to adequately conduct palliative care related meetingsa presumption that some experts question. 20,22 There are multiple limitations to this study. First, we studied staff from surgical ICUs in one academic medical center; our findings may not be representative of the views of nurses working in other settings.…”

Section: Cultural Barriersmentioning

confidence: 98%

“…[17][18][19][20][21] The time frame of surgical illness is often compressed, which requires patients, families, and clinicians to make difficult decisions in haste, without either clear information on patient prognosis or adequate emotional adjustment. 21 SICUs are more likely to use ''open'' or ''semiclosed'' administrative models 18 in which coordination of multiple care teams can be difficult.…”

Section: Introductionmentioning

confidence: 99%

Nurse-Perceived Barriers to Effective Communication Regarding Prognosis and Optimal End-of-Life Care for Surgical ICU Patients: A Qualitative Exploration (314-A)

Aslakson

Wyskiel²,

Thornton³

et al. 2011

Journal of Pain and Symptom Management

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Background: Integration of palliative care for intensive care unit (ICU) patients is important but often challenging, especially in surgical ICUs (SICUs), in part because many surgeons equate palliative care with terminal care and failure of restorative care. SICU nurses, who are key front-line clinicians, can provide insights into barriers for delivery of optimal palliative care in their setting. Methods: We developed a focus group guide to identify barriers to two key components of palliative careoptimal communication regarding prognosis and optimal end-of-life care-and used the tool to conduct focus groups of nurses providing bedside care in three SICUs at a tertiary care, academic, inner city hospital. Using content analysis technique, responses were organized into thematic domains that were validated by independent observers and a subset of participating nurses. Results: Four focus groups included a total of 32 SICU nurses. They identified 34 barriers to optimal communication regarding prognosis, which were summarized into four domains: logistics, clinician discomfort with discussing prognosis, inadequate skill and training, and fear of conflict. For optimal end-of-life care, the groups identified 24 barriers in four domains: logistics, inability to acknowledge an end-of-life situation, inadequate skill and training, and cultural differences relating to end-of-life care. Conclusions: Nurses providing bedside care in SICUs identify barriers in several domains that may impede optimal discussions of prognoses and end-of-life care for patients with surgical critical illness. Consideration of these perceived barriers and the underlying SICU culture is relevant for designing interventions to improve palliative care in this setting.

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La sédation en fin de vie en réanimation

Ferrand

2010

Analgésie Et Sédation en Réanimation

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Palliative Care by The Surgeon: How To Do It

Cited by 23 publications

References 5 publications

Laparoscopic surgery for stage IV colorectal cancer

Laparoscopic surgery for stage IV colorectal cancer

Nurse-Perceived Barriers to Effective Communication Regarding Prognosis and Optimal End-of-Life Care for Surgical ICU Patients: A Qualitative Exploration (314-A)

La sédation en fin de vie en réanimation

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