Patient participation in discussing palliative radiotherapy

Timmermans, L; Maazen, R.W.M. van der; Verhaak, C.M.; Roosmalen, Mariëlle S. van; Daal, W.A.J. van; Kraaimaat, Floris W.

doi:10.1016/j.pec.2004.03.016

Cited by 31 publications

(38 citation statements)

References 48 publications

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“…Their influence could be poorly documented or they may simply not be involved. We know that involving patients' families and patients in decisions can place burdens, [22][23][24][25][26][27][28] but wellfacilitated involvement can ease patients' transitions to EOL care. 29 Future studies should be focused on understanding how these LOMTs are made in an acute/critical care situation, outlining how these processes occur and why.…”

Section: Discussionmentioning

confidence: 99%

Negotiating Transitions: Involvement of Critical Care Outreach Teams in End-of-Life Decision Making

Pattison

O’Gara

Wigmore

2015

American Journal of Critical Care

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Background Little research has examined the involvement of critical care outreach teams in end-of-life decision making. Objective To establish how much time critical care outreach teams spend with patients who are subsequently subject to limitation of medical treatment and end-of-life decisions and how much influence the teams have on those decisions. Methods A single-center retrospective review, with qualitative analysis, in a large cancer center. Data from all patients referred emergently for critical care outreach from October 2010 to October 2011 who later had limitation of medical treatment or end-of-life care were retrieved. Findings were analyzed by using SPSS 19 and qualitative free-text analysis. Results Of 890 patients referred for critical care outreach from October 2010 to October 2011, 377 were referred as an emergency; 108 of those had limitation of medical treatment and were included in the review. Thirty-five patients (32.4%) died while hospitalized. As a result of outreach intervention and a decision to limit medical treatment, 56 (51.9%) of the 108 patients received a formal end-of-life care plan (including care pathways, referral to palliative care team, hospice). About a fifth (21.5%) of clinical contact time is being spent on patients who subsequently are subject to limitation of medical treatment. Qualitative document analysis showed 5 emerging themes: difficulty of discussions about not attempting cardiopulmonary resuscitation, complexities in coordinating multiple teams, delays in referral and decision making, decision reversals and opaque decision making, and technical versus ethical imperatives. Conclusion A considerable amount of time is being spent on these emergency referrals, and decisions to limit medical treatment are common. The appropriateness of escalation of levels of care is often not questioned until patients become critically or acutely unwell, and outreach teams subsequently intervene.

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Section: Discussionmentioning

confidence: 99%

Negotiating Transitions: Involvement of Critical Care Outreach Teams in End-of-Life Decision Making

Pattison

O’Gara

Wigmore

2015

American Journal of Critical Care

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“…However, the Lifestyle code was not reported in Timmerman and colleagues' studies 35,36 ; it is likely that these topics were infrequent in the radiotherapy appointments, as families may be more comfortable discussing lifestyle issues in the comfort of their homes with nurses and in the context of an ongoing relationship with a clinician, compared to an initial consult visit with a physician. There was variability in communication patterns across visits.…”

Section: Description Of Home Hospice Visit Dialoguementioning

confidence: 99%

“…[32][33][34] It is difficult to compare how hospice nurse communication compares to other end-of-life encounters, because little research has been conducted in this area. Timmerman and colleagues 35,36 applied RIAS to initial palliative care consultation sessions with radiation oncologists. Although there is less verbal exchange in the consultations 36 (median = 811 versus median = 1159 total utterances for visits), there are some similarities.…”

Section: Description Of Home Hospice Visit Dialoguementioning

confidence: 99%

“…Timmerman and colleagues 35,36 applied RIAS to initial palliative care consultation sessions with radiation oncologists. Although there is less verbal exchange in the consultations 36 (median = 811 versus median = 1159 total utterances for visits), there are some similarities. In both hospice nurse communication and physician consultations, the clinicians talk more than the patients and caregivers and they tend to lead with the provision of physical care information, followed by partnership-type statements.…”

Section: Description Of Home Hospice Visit Dialoguementioning

confidence: 99%

“…Previously, RIAS has been successfully applied to patientphysician dialogue related to end-of-life [38][39][40] and nurse communication. [41][42][43][44][45] We found that RIAS was suited to capture the general content and process of hospice encounters.…”

Section: Rias Application To Hospice Encountersmentioning

confidence: 99%

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Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

Ellington

Reblin

Clayton

et al. 2012

Journal of Palliative Medicine

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Background: Effective communication by hospice nurses enhances symptom management for the patient, reduces family caregiver burden and distress, and potentially improves bereavement adjustment. However, research has not kept pace with the rising use of hospice by patients with cancer and thus we know little about how hospice nurses communicate. Methods: The overriding objective of this pilot study was to provide insight into these in-home visits. Hospice nurses audiorecorded their interactions over time with family caregivers and patients with cancer. The communication within these tapes was coded using Roter Interaction Analysis System (RIAS) and analyzed. Results: We found that tape recording home hospice nurse visits was feasible. RIAS was suited to capture the general content and process of the home hospice encounter and the coded interactions show the range of topics and emotions that are evident in the dialogue. Implications and future directions for research are discussed.

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Palliative or curative treatment intent affects communication in radiation therapy consultations

et al. 2005

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Patient participation in discussing palliative radiotherapy

Cited by 31 publications

References 48 publications

Negotiating Transitions: Involvement of Critical Care Outreach Teams in End-of-Life Decision Making

Negotiating Transitions: Involvement of Critical Care Outreach Teams in End-of-Life Decision Making

Hospice Nurse Communication with Patients with Cancer and their Family Caregivers

Palliative or curative treatment intent affects communication in radiation therapy consultations

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