On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

Abstract:

OBJECTIVES:This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. METHODS:Thirty-three semi-structured individual interviews were analysed using thematic analysis. RESULTS:One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. CONCLUSIONS:Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

authors

Zambrano SC,Chur-Hansen A,Crawford GB

doi

10.1136/bmjspcare-2012-000208

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

270-5

issue

3

eissn

2045-435X

issn

2045-4368

pii

bmjspcare-2012-000208

journal_volume

2

pub_type

杂志文章
  • Purple urine bag syndrome in palliative care.

    abstract::Purple urine bag syndrome (PUBS) is a rare condition characterised by urine discolouration. The management of PUBS remains controversial. Four females (mean age 84.5±9.7 years) with palliative conditions (two cancer and two non-cancer cases) presenting PUBS were identified. Urine bags were changed in all cases. Urinar...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001601

    authors: Wattanapisit S,Wattanapisit A,Meepuakmak A,Rakkapan P

    更新日期:2019-06-01 00:00:00

  • Management of venous thromboembolism in far-advanced cancer: current practice.

    abstract:OBJECTIVES:Venous thromboembolism (VTE) is common in advanced cancer. Guidelines suggest that indefinite anticoagulation be considered for patients with ongoing active cancer. There are no data on the management of cancer-associated thrombosis (CAT) at the end of life or when to stop anticoagulation as death approaches...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2019-001804

    authors: Noble S,Banerjee S,Pease NJ

    更新日期:2019-06-25 00:00:00

  • Bereaved caregivers of patients with high-grade glioma: a systematic review.

    abstract:OBJECTIVE:Caregivers to patients with primary malignant brain tumours neglect their own physical and emotional needs during the disease trajectory. The aim of the systematic review was to explore how informal caregivers of patients with primary malignant brain tumour (high-grade glioma (HGG)) experience and manage thei...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2017-001386

    authors: Piil K,Nordentoft S,Larsen A,Jarden M

    更新日期:2019-03-01 00:00:00

  • International variations in clinical practice guidelines for palliative sedation: a systematic review.

    abstract:OBJECTIVES:Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation aga...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2016-001159

    authors: Abarshi E,Rietjens J,Robijn L,Caraceni A,Payne S,Deliens L,Van den Block L,EURO IMPACT.

    更新日期:2017-09-01 00:00:00

  • Rose geranium in sesame oil nasal spray: a treatment for nasal vestibulitis?

    abstract:OBJECTIVES:As a rose geranium in sesame oil spray product has been anecdotally noted to improve nasal vestibulitis symptoms, this study was designed to assess whether patients with nasal vestibulitis associated with cancer-directed therapy experienced symptomatic improvements from it. METHODS:Patients with breast canc...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001569

    authors: Cathcart-Rake EJ,Smith D,Zahrieh D,Loprinzi CL

    更新日期:2020-12-01 00:00:00

  • Quality versus risk of bias assessment of palliative care trials: comparison of two tools.

    abstract:BACKGROUND:Randomised controlled trials (RCTs) of palliative care interventions are challenging to conduct and evaluate. Tools used to judge the quality of RCTs do not account for the complexities of conducting research in seriously ill populations and may artificially downgrade confidence in palliative care research. ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002539

    authors: Isenberg SR,Kavalieratos D,Chow R,Le L,Wegier P,Zimmermann C

    更新日期:2020-11-18 00:00:00

  • Radiation therapy in malignant spinal cord compression: what is the current knowledge on fractionation schedules? A systematic literature review.

    abstract::Malignant spinal cord compression (MSCC) in patients with short life expectancy is most frequently treated with radiotherapy and/or corticosteroids. Hypofractionation has been proven to be efficient in metastatic bone pain, but the level of evidence for hypofractionation in MSCC is limited. Searches were performed in ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2011-000154

    authors: Løhre ET,Lund JÅ,Kaasa S

    更新日期:2012-03-01 00:00:00

  • Resistance training in advanced cancer: a phase II safety and feasibility trial-home versus hospital.

    abstract:BACKGROUND:Resistance training (RT) is an effective way to increase muscle mass but little is known about its role to prevent sarcopenia in advanced cancer. Furthermore, the preferred setting for this training is not known. Considering home is frequently the place of care and death preferred by cancer patients, it is i...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002230

    authors: Ribeiro C,Santos R,Correia P,Maddocks M,Gomes B

    更新日期:2020-08-13 00:00:00

  • Psychological concerns of Indian women with breast cancer in different national contexts: a systematic review and mixed-methods synthesis.

    abstract:BACKGROUND:Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population. AIM:To improve understanding of psychological symptoms among Indian women with breast cancer. DESIGN:This is a syste...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2019-002076

    authors: Daniel S,Clark J,Gnanapragasam S,Venkateswaran C,Johnson MJ

    更新日期:2020-05-11 00:00:00

  • What is the patient experience in advanced liver disease? A scoping review of the literature.

    abstract:BACKGROUND:There has been a dramatic increase in liver disease over recent decades, with morbidity and mortality rates predicted to rise significantly. In order to effectively support this growing patient population we need to understand the experiences, key issues and priorities of people living and dying with advance...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2012-000435

    authors: Kimbell B,Murray SA

    更新日期:2015-12-01 00:00:00

  • Meaning in life and quality of life: palliative care patients versus the general population.

    abstract:BACKGROUND AND OBJECTIVES:Meaning in life (MIL) represent a key topic in palliative care. The aims of this study were to explore (1) the differences in perceived MIL and in the meaning-relevant life areas between a representative sample of the Swiss population and palliative care patients, and (2) to what extent MIL ca...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002211

    authors: Bernard M,Berchtold A,Strasser F,Gamondi C,Borasio GD

    更新日期:2020-07-06 00:00:00

  • Methodological considerations for researching the financial costs of family caregiving within a palliative care context.

    abstract:BACKGROUND:The financial impact of family caregiving in a palliative care context has been identified as an issue which requires further research. However, little is known about how research should be conducted in this area. OBJECTIVE:The aim of this study was to explore the opinions of family caregivers in New Zealan...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-001046

    authors: Gardiner C,Allen R,Moeke-Maxwell T,Robinson J,Gott M

    更新日期:2016-12-01 00:00:00

  • Does place of death vary by deprivation for patients known to specialist palliative care services?

    abstract:OBJECTIVES:Referral to, and usage of, specialist palliative care (SPC) services are not equitable and social deprivation may be a contributory factor in this. Deprivation may also affect the place of death of patients with cancer. No study, however, has investigated whether inequalities persist following referral to SP...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2016-001099

    authors: Macfarlane M,Carduff E

    更新日期:2018-12-01 00:00:00

  • End-of-life care for older first-generation migrants: a scoping review.

    abstract:BACKGROUND:The unprecedented scale of contemporary migration across countries over the last decade means that ageing and dying occur in a more globalised, multicultural context. It is therefore essential to explore the end-of-life experiences of older people from migrant backgrounds. METHODS:A scoping review of peer-r...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2020-002617

    authors: Gerber K,Maharaj E,Brijnath B,Antoniades J

    更新日期:2020-12-09 00:00:00

  • OA28 At the clinical shores - palliative care volunteers and population health in new south wales (NSW).

    abstract:BACKGROUND:In October 2014 a detailed mapping study of volunteers in palliative care services in NSW was undertaken for the first time. This presentation will provide a thematic analysis of the initial findings. AIMS:The aim of this study was to provide a thematic analysis of the occupational terrain of palliative car...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-000906.28

    authors: Hansen L,Huntir A

    更新日期:2015-04-01 00:00:00

  • Enzyme replacement in advanced pancreatic cancer: patient perceptions.

    abstract:PURPOSE:Advanced pancreatic cancer has a universally poor survival rate. Patients frequently develop malabsorption that requires pancreatic enzyme replacement therapy (PERT). This study explores the experience of patient engagement with PERT and how the medication is taken and tolerated. METHODS:Participants with adva...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2019-002153

    authors: Landers A,McKenzie C,Pitama SG,Brown H

    更新日期:2020-03-22 00:00:00

  • Medical specialists' motivations for referral to specialist palliative care: a qualitative study.

    abstract:OBJECTIVES:The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists' motivations and triggers underpinning decision-making around referral to palliative care in order to facilitate improvements in referral practice...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2012-000376

    authors: Kirby E,Broom A,Good P,Wootton J,Adams J

    更新日期:2014-09-01 00:00:00

  • Effect of creative writing on mood in patients with cancer.

    abstract:OBJECTIVE:To determine the feasibility of conducting creative writing workshops (CWW) for patients with cancer to promote improvement in mood. METHOD:We piloted a prospective study to determine the feasibility of conducting CWW over a 4-week period. Patients were randomised 2:1 to either an intervention arm (IA) or to...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmjspcare-2018-001710

    authors: Zhu J,Hussain M,Joshi A,Truica CI,Nesterova D,Collins J,Saunders EFH,Hayes M,Drabick JJ,Joshi M

    更新日期:2020-03-01 00:00:00

  • OA2 Chinese migrant peasant workers and the contradictory demands of filial piety in neo-liberal chinese society: a case study of filial end-of-life care in langzhong city.

    abstract:BACKGROUND:Many scholars claim that recent changes to Chinese society since economic reform have challenged longstanding forms of informal social care, such as filial piety. For instance there is a societal tension at work in contemporary Chinese society today. On the one hand decreasing co-residence in multi-generatio...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-000906.2

    authors: He L

    更新日期:2015-04-01 00:00:00

  • OA48 Engaging communities: the impact of a decade of health promoting palliative care policy in victoria.

    abstract:BACKGROUND:Health promoting palliative care began in Victoria, Australia and has been included in Victorian palliative care policy for over a decade. AIM:To review the way Victorian palliative care services have responded to government policies and strategic directions that are based upon health promoting palliative c...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-000906.48

    authors: Rumbold B,Grindrod A

    更新日期:2015-04-01 00:00:00

  • Global prevalence of depression in HIV/AIDS: a systematic review and meta-analysis.

    abstract:INTRODUCTION:The incidence of some fatal diseases, including HIV/AIDS, accompanied by depression has become a significant concern in developed, developing and underdeveloped countries. A great deal of time and money are spent on controlling and reducing the complications of this infection across the world. Accordingly,...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmjspcare-2019-001952

    authors: Rezaei S,Ahmadi S,Rahmati J,Hosseinifard H,Dehnad A,Aryankhesal A,Shabaninejad H,Ghasemyani S,Alihosseini S,Bragazzi NL,Raoofi S,Kiaee ZM,Ghashghaee A

    更新日期:2019-12-01 00:00:00

  • Body composition and dietary intake in patients with head and neck cancer during radiotherapy: a longitudinal study.

    abstract:OBJECTIVES:To investigate the body composition and dietary intake in the patients with head and neck cancer (HNC) during radiotherapy (RT), and explore the relationship between them. METHODS:This was a prospective, longitudinal observational study. Adult patients with HNC undergoing RT between March 2017 and August 20...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2020-002359

    authors: Zhuang B,Zhang L,Wang Y,Cao Y,Shih Y,Jin S,Li H,Gong L,Wang Y,Jin S,Lu Q

    更新日期:2020-09-11 00:00:00

  • Systematic mixed-method review of barriers to end-of-life communication in the family context.

    abstract:BACKGROUND:Communication about the end of life is especially important in the family context, as patients and their families are considered as the care unit in palliative care. Open end-of-life communication can positively affect medical, psychological and relational outcomes during the dying process for patient and fa...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2020-002219

    authors: Nagelschmidt K,Leppin N,Seifart C,Rief W,von Blanckenburg P

    更新日期:2020-08-27 00:00:00

  • Acupuncture: a treatment for breakthrough pain in cancer?

    abstract:CONTEXT:Patients with chronic cancer pain frequently suffer severe exacerbations of pain intensity which are difficult to control adequately via pharmaceutical management. Management of these episodes of breakthrough pain (BTP) presents a challenge both to the physician and the patient, and supplemental 'rescue' doses ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审

    doi:10.1136/bmjspcare-2011-000066

    authors: Paley CA,Johnson MI,Bennett MI

    更新日期:2011-12-01 00:00:00

  • Carer experience of end-of-life service provision: a social network analysis.

    abstract:OBJECTIVE:To identify the position of formal service providers in the networks of those providing end-of-life care in the home from the perspective of the informal network. METHODS:Using third-generation social network analysis, this study examined the nature and strength of relationships of informal caring networks w...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2017-001344

    authors: Leonard R,Horsfall D,Rosenberg J,Noonan K

    更新日期:2020-06-01 00:00:00

  • Information transfer to out-of-hours co-operatives: a survey of general practitioners' views in relation to palliative patients.

    abstract:BACKGROUND:In Ireland, weekend and night medical cover for community based patients is largely provided by general practice co-operatives. Doctors working in this service do not have direct access to patients' medical records which challenges continuity of care. OBJECTIVES:This study investigates the opinion of genera...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2012-000281

    authors: Kiely F,Murphy M,O'Brien T

    更新日期:2013-12-01 00:00:00

  • Unusual case of transdermal fentanyl in cachexia.

    abstract::Fentanyl has a low molecular weight and is lipophilic making it suitable for transdermal administration. However, multiple factors appear to lead to interindividual variation in absorption via this route. Here we describe an unusual case where a patient was found to have twelve 100 μg/hour fentanyl patches in situ whi...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001652

    authors: Lam D,Kay S,Pickard J,Harrison S

    更新日期:2019-12-01 00:00:00

  • Gaining an accurate reflection of the reality of palliative care through the use of free-text feedback in questionnaires: the AFTER study.

    abstract:BACKGROUND:In healthcare, many service evaluation questionnaires use free-text boxes without formal mechanisms for analysis. Patients and carers spend time documenting concerns that are often ignored or managed locally in an ad hoc manner. Currently, palliative care experiences of patients and carers in Wales are measu...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2015-000920

    authors: Bowyer AV,Finlay I,Baillie J,Byrne A,McCarthy J,Sampson C,Snow V,Nelson A

    更新日期:2019-03-01 00:00:00

  • Advance directives in European long-term care facilities: a cross-sectional survey.

    abstract:BACKGROUND:End-of-life care practices in long-term care facilities (LTCFs) are the focus of growing attention in Europe, due to rapidly increasing number of older persons living in LTCFs. The knowledge about end-of-life discussions or existence of written advance directives in the European LTCFs is scarce. This study's...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001743

    authors: Andreasen P,Finne-Soveri UH,Deliens L,Van den Block L,Payne S,Gambassi G,Onwuteaka-Philipsen BD,Smets T,Lilja E,Kijowska V,Szczerbińska K,PACE consortium.

    更新日期:2019-05-21 00:00:00

  • Long-term survival in recurrent adrenocortical cancer.

    abstract::Adrenocortical carcinoma (ACC) comprises approximately 0.02% of all malignant tumours, which are a very small fraction of a group of cancers that affect in 0.7 to 2 in 1 000 000 people per year. Recurrence is very common even after complete resection and prognosis is poor. We report a case of a sporadic form of ACC fo...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章

    doi:10.1136/bmjspcare-2018-001568

    authors: Shuayb M,Das A,Uddin MN

    更新日期:2019-03-01 00:00:00