Abstract：
OBJECTIVE:To break new ground by directly examining how patients seek life-expectancy estimates, and how doctors support them in doing so. METHODS:Conversation analytic examination of 10 recorded UK hospice consultations involving 3 palliative specialists. RESULTS:Life-expectancy estimate episodes frequently begin after a doctor has given a patient an opportunity to shape the consultation agenda. Rather than posing direct questions, patients cautiously display their interest in receiving an estimate using statements. These often contain preparatory information about: what they already know about their prognosis, their perspective on it, and readiness to hear more. When patients do not provide this information, doctors invite it before giving an estimate. Patients' companions also contribute to this preparatory work. CONCLUSION:Doctors, patients, and companions collaboratively work to prepare a conversational environment wherein emotional states and uncertainties have been addressed prior to delivery of the actual estimate. This helps manage both possible emotional distress, and prognostic uncertainty entailed in seeking and delivering estimates. PRACTICE IMPLICATIONS:Clinicians should be mindful that rather than overtly requesting estimates, patients may seek them more cautiously. Before delivering estimates, doctors can support patients to articulate their existing understanding and perspective regarding prognosis, and their readiness to hear more.
journal_name
Patient Educ Counsjournal_title
Patient education and counselingauthors
Pino M,Parry Rdoi
10.1016/j.pec.2018.03.026subject
Has Abstractpub_date
2019-02-01 00:00:00pages
223-237issue
2eissn
0738-3991issn
1873-5134pii
S0738-3991(18)30151-4journal_volume
102pub_type
杂志文章abstract：OBJECTIVE:Many express concern that modern medicine fails to provide adequate psychosocial and mental health care. Our educational system has not trained the primary care providers who care for most of these patients. Our objective here is to propose a quantum change: prepare residents and students during all years of ...
journal_title：Patient education and counseling
pub_type： 杂志文章
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journal_title：Patient education and counseling
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abstract：OBJECTIVE:To describe the type of care provided by a nationally-representative sample of informal caregivers, the frequency of unmet supportive care needs, and examine characteristics associated with unmet needs. METHODS:Using data from the Health Information National Trends Survey, we identified caregivers of an adul...
journal_title：Patient education and counseling
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journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2009.10.007
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2009.03.032
更新日期：2009-11-01 00:00:00
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
pub_type： 杂志文章
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更新日期：2007-10-01 00:00:00
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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更新日期：2001-04-01 00:00:00
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journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2015.10.006
更新日期：2016-06-01 00:00:00
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journal_title：Patient education and counseling
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更新日期：2006-02-01 00:00:00
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journal_title：Patient education and counseling
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journal_title：Patient education and counseling
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更新日期：2015-08-01 00:00:00
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更新日期：2017-09-01 00:00:00
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journal_title：Patient education and counseling
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abstract：OBJECTIVE:Poor oral contraceptive (OC) knowledge may contribute to premature OC discontinuation and unintended pregnancy. Yet, to understand relationships between OC knowledge and contraceptive behavior, knowledge must be adequately measured. This review evaluates the findings and methodological limitations of research...
journal_title：Patient education and counseling
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