The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills.
نویسندگان
چکیده
Physician competence in end-of-life care requires skill in communication, decision making, and building relationships, yet these skills were not taught to the majority of physicians during their training. This article presents a 7-step approach for physicians for structuring communication regarding care at the end of life. Physicians should prepare for discussions by confirming medical facts and establishing an appropriate environment; establish what the patient (and family) knows by using open-ended questions; determine how information is to be handled at the beginning of the patient-physician relationship; deliver the information in a sensitive but straightforward manner; respond to emotions of the patients, parents, and families; establish goals for care and treatment priorities when possible; and establish an overall plan. These 7 steps can be used in situations such as breaking bad news, setting treatment goals, advance care planning, withholding or withdrawing therapy, making decisions in sudden life-threatening illness, resolving conflict around medical futility, responding to a request for physician-assisted suicide, and guiding patients and families through the last hours of living and early stages after death. Effective application as part of core end-of-life care competencies is likely to improve patients' and families' experiences of care. It may also enhance physicians' professional fulfillment from satisfactory relationships with their patients and patients' families.
منابع مشابه
Investigating Medical Ethics in the Medicine-Based Tales of Mathnawi
In human communication, the relationship between the patient and the physician is one of the most challenging issues. This relationship is of critical importance in the medical ethics and forms the base of medical measures. Relationship between the physician and the patient brings about mutual trust between them to the extent that it overshadows physician’s skills. A physician needs to have the...
متن کاملThe effectiveness of communication skills training on medical students’ self-efficiency and social well-being based on the Calgary- Cambridge model
Background and aim: communication is a clinical skill in the field of medical education that it have key role in understanding of the patient and providing appropriate treatment. The main components of any effective interviews including: medical knowledge, communication skills, physical examination and problem solving ability. Communication skills cause patient satisfaction and the patient...
متن کاملDignity in Medicine: Emphasis on Dignity of End Stage Patients
Medicine is the most scientific way of humanity, and the most humanistic science. Its Professional communications are important due to its sensitivity and responsibility. One the most emphasized relation is patient’s dignity. Evidence has shown that the correct relationship rarely will establish between physician and end stage patient and this communication is always associated with many shortc...
متن کاملنگاهی به مدل های ارتباطی پزشک - بیمار و چالش های مرتبط با آن
Medicine is known as a combination of science and art. Besides knowledge, a good physician should be equipped with the art of establishing communication with patients. The keystone of any efficient relationship like a therapeutic one is trust, and its deterioration makes the relationship deficient and based on mere need. Therefore, establishing an efficient relationship brings about positive re...
متن کاملAn Investigation of Processes Linking Patient-Centered Communication Approaches to Favorable Impressions of Vietnamese Physicians and Hospital Services
Strong doctor-patient relationships generate greater patient satisfaction and compliance with physician recommendations. Although prior research has explored distinct factors driving favorable patient outcomes, investigations have yet to comprehensively address the efficacy of different communication styles. Furthermore, it is critical to explore the full impact communication approaches have on...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- JAMA
دوره 284 23 شماره
صفحات -
تاریخ انتشار 2000