Recognizing the Dying Patient, When Less Could be More: A Diagnostic Framework for Shared Decision-Making at the End of Life
| Autor: | Dilraj Kalsi BMBCh, Joel Ward BMBCh, Regent Lee MBBS, Bee Wee MBBS, Kenneth WM Fulford MBBS, Ashok Handa MBBS |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Journal of Patient Experience, Vol 7 (2020) |
| Druh dokumentu: | article |
| ISSN: | 2374-3735 2374-3743 23743735 |
| DOI: | 10.1177/2374373519869153 |
| Popis: | Background: Recognizing dying patients is crucial to produce outcomes that are satisfactory to patients, their families, and clinicians. Aim: Earlier discussion of and shared decision-making around dying to improve these outcomes. Design: In this study, we interviewed 16 senior clinicians to develop summaries of palliative care in 4 key specialties: Cardiology, Vascular Surgery, Emergency General Surgery, and Intensive Care. Setting: Oxford University Hospitals. Results: Based on themes common to our 4 clinical areas, we developed a novel diagnostic framework to support shared palliative decision-making that can be summarized as follows: 1) Is the acute pathology reversible? 2) What is the patient’s physiological reserve? 3) What is important to the patient? Will they be fit enough for discharge for a reasonable length of time? Conclusions: We believe that education using this framework in the medical school and postgraduate curricula would significantly improve recognition of dying patients. This would serve to stimulate earlier conversations, more shared decision-making, and ultimately better outcomes in palliative care and patient experience. |
| Databáze: | Directory of Open Access Journals |
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