Abstract:
OBJECTIVE:It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated with better patient ratings of their physicians' communication skills. DESIGN:Cross-sectional observational study of audio-recorded conversations between patients and physicians. SETTING:Three outpatient oncology practices. PATIENTS:Ninety-four patients with advanced cancer and 52 physicians. INTERVENTION:None. MAIN OUTCOME MEASURES:Conversations were reviewed and coded for the presence of metaphors and analogies. Patients also completed a 6-item rating of their physician's ability to communicate. RESULTS:In a sample of 101 conversations, coders identified 193 metaphors and 75 analogies. Metaphors appeared in approximately twice as many conversations as analogies did (65/101, 64% versus 31/101, 31%; sign test p < 0.001). Conversations also contained more metaphors than analogies (mean 1.6, range 0-11 versus mean 0.6, range 0-5; sign rank test p < 0.001). Physicians who used more metaphors elicited better patient ratings of communication (rho = 0.27; p = 0.006), as did physicians who used more analogies (Spearman rho = 0.34; p < 0.001). CONCLUSIONS:The use of metaphors and analogies may enhance physicians' ability to communicate.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Casarett D,Pickard A,Fishman JM,Alexander SC,Arnold RM,Pollak KI,Tulsky JAdoi
10.1089/jpm.2009.0221subject
Has Abstractpub_date
2010-03-01 00:00:00pages
255-60issue
3eissn
1096-6218issn
1557-7740journal_volume
13pub_type
杂志文章abstract:OBJECTIVE:To describe the growth and outcomes of the Palliative Care Research Cooperative Group (PCRC). BACKGROUND:Despite advances, significant gaps remain in the evidence base to inform care for people with serious illness. To generate this needed evidence and bolster research capacity, the Palliative Care Research ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0138
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:Rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors and negatively impacts quality of life. This single-institution study sought to explore how rash is currently managed outside a clinical trial setting and to further characterize general clinical aspects of this rash. MET...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0258
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The provision of complementary therapy in palliative care is rare in Canadian hospitals. An Ontario hospital's palliative care unit developed a complementary therapy pilot project within the interdisciplinary team to explore potential benefits. Massage, aromatherapy, Reiki, and Therapeutic Touch™ were provid...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0295
更新日期:2013-10-01 00:00:00
abstract:: Background: Systematic measurement of conversational features in the natural clinical setting is essential to better understand, disseminate, and incentivize high quality serious illness communication. Advances in machine-learning (ML) classification of human speech offer ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0270
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals. OBJECTIVE:To identify factors associated with 30-day readmission among older adults newly discharged to hospice. DESIGN/SUBJECTS:Medical record review of 59 patients, 19 readmitted within 30 days and 40 ran...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0224
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to describe the perceptions of community residence (CR) staff who have cared for older adults with developmental disabilities (ADDs) that are at the end of life. DESIGN:This exploratory, descriptive study utilized qualitative methods that involved semistructured interviews with C...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0408
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To compare residents in hospice care at admission to the nursing facility to end stage residents not in hospice at admission. DESIGN AND METHODS:We analyzed 18,211 admission assessments recorded in the Minimum Data Set (MDS) during the year 2000 throughout the United States for residents classified as having...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662104773709341
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:End-stage renal disease (ESRD) affects nearly 1400 new children each year in the United States. Morbidity and mortality rates remain high for pediatric patients with ESRD, including those that have received a renal transplant. OBJECTIVE:To better understand ESRD patients referred to palliative care, includi...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0353
更新日期:2017-08-01 00:00:00
abstract:: Background: Community-dwelling adults with serious illness benefit from conversations about their goals for care. Objective: We undertook a project to increase the number of serious illness conversations occurring in an account...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0110
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2017.0097
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Inpatient palliative consultation are generally provided to seriously ill hospitalized patients with the intent to alleviate pain and suffering and develop a plan of care for the patient. Although numerous benefits of this service have been documented, little is known about hospital readmission rates and fac...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0259
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:To continuously assess overall quality of life (QOL) and disease progression in patients with amyotrophic lateral sclerosis (ALS) at different stages of the disease and compare the results between these two variables. DESIGN/SUBJECTS:Twenty-six patients with ALS were interviewed with a questionnaire to asse...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.304
更新日期:2006-04-01 00:00:00
abstract:: Background: Growing evidence suggests that pediatric palliative care (PPC) teams influence the care received by children and young adults with chronic, life-limiting illnesses. Little is known about how PPC involvement affects advance care planning (ACP) and circumstances ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0111
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:This case report describes a patient whose persistent hiccups significantly improved with the use of vinegar. CASE PRESENTATION:A patient with an adenocarcinoma of the colon and hepatic metastases developed hiccups the day following chemotherapy with FOL-FOX (folinic acid (leucovorin), 5-fluorouracil, oxali...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0391
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Pain, dyspnea, and depression are highly troubling near the end of life. OBJECTIVE:To characterize factors associated with clinically significant pain and the presence of dyspnea and depression during the last year of life in a nationally representative sample. DESIGN:Retrospective cohort study. SETTING:H...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0391
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Regardless of the payer and the period studied the prevalence of potentially inappropriate medication use in the elderly ranged from 21% to 40%. OBJECTIVE:To look at potentially inappropriate prescribing in a group of Medicare+Choice beneficiaries in their last year of life (LYOL) in a large national manage...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.0215
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0167
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among...
journal_title:Journal of palliative medicine
pub_type: 共识发展会议,杂志文章
doi:10.1089/jpm.2012.0205
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Entrustable professional activities (EPAs) are routine tasks considered essential to a professional practice. An EPA can serve as a performance-based outcome that a clinical supervisor would progressively entrust a learner to perform. OBJECTIVE:Our aim was to identify, develop, and validate a set of EPAs fo...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0392
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Little is known about young caregivers of people with advanced life-limiting illness. Better understanding of the needs and characteristics of these young caregivers can inform development of palliative care and other support services. METHODS:A population-based analysis of caregivers was performed from pilote...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2010.0004
更新日期:2010-10-01 00:00:00
abstract:: Background: A major goal of hospice care is to provide individually tailored emotional and spiritual support to caregivers of hospice patients. Objectives: Examine the association between reported emotional support and caregive...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0324
更新日期:2020-10-06 00:00:00
abstract:AIMS:To describe the place of death for patients with cancer in Singapore from 2000 to 2009, and determinants of death at home and in in-patient hospice compared to death in hospital. METHOD:Cross-sectional analysis of all patients registered with the Singapore Cancer Registry who had died in the study period (N=52120...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0092
更新日期:2011-10-01 00:00:00
abstract::Palliating the whole person requires that medicine attend more fully to the phenomenon of existential suffering. The role of social factors, in particular, is often overlooked in attempts to understand why end-of-life suffering does not always respond to physiologic, psychological, and spiritual interventions. Using q...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662104322737223
更新日期:2004-02-01 00:00:00
abstract::Cancer pain assessment and management are integral to palliative medicine. This paper reviews recent publications in the period 1999-2004 in the broad categories of epidemiology, pain assessment, nonpharmacologic approaches to cancer pain (radiation therapy, anesthetic blocks, palliative surgery and chemotherapy, comp...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.9.1414
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2010.0453
更新日期:2011-08-01 00:00:00
abstract::Purpose of report: Understanding the impact of palliative care interventions on intensive care unit (ICU) costs and utilization is critical for demonstrating the value of palliative care. Performing these economic assessments, however, can be challenging. The purpose of this special report is to highlight and discuss ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0548
更新日期:2017-12-01 00:00:00
abstract::The need for palliative care for patients with end-stage renal disease (ESRD) is increasingly recognized. Patients starting renal replacement therapy are now elderly, with a median age of 65 years, and with multiple comorbid conditions. Quality of life is often poor and with advance care planning, patients can be enab...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0033
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Subcutaneous hydration has potential advantages over intravenous. Despite studies supporting the efficacy and safety of subcutaneous hydration it has not been studied extensively to date either with or without hyaluronidase. OBJECTIVES:To compare flow rate, tolerability, and safety of gravity-driven subcuta...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
doi:10.1089/jpm.2007.0126
更新日期:2007-12-01 00:00:00
abstract:: Background: Mobile health (mHealth) is a promising tool for improving health outcomes. However, the benefits of using mHealth in palliative care are under studied. Objective: As a first step to designing meaningful palliative c...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2019.0216
更新日期:2020-02-01 00:00:00
abstract::Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0069
更新日期:2011-09-01 00:00:00