Abstract：
:Despite believing end-of-life (EOL) discussions with patients are important, doctors often do not have them. Multiple factors contribute to this shortfall, which interventions including reimbursement changes and communication skills training have not significantly improved to date. One commonly cited but under-researched reason for physician avoidance of EOL discussion is emotional difficulty. High occupational demand for frequent difficult discussions may overload physicians' normal emotional functioning, leading to avoidance or failure. We propose that cognitive, behavioral, and neuroscience evidence from affective science may offer helpful insights into this problem. Data from other populations show that strong emotion impairs cognitive performance and multiple demands can overload cognitive resources. We discuss several affective processes that may apply to physicians attempting EOL discussions. We then discuss selected interventions that have been shown to modify some of these processes and associated behavioral outcomes. Evidence for change in behavioral outcomes of interest includes performance and mood enhancement in healthy populations. We suggest that such mechanistically-targeted interventions may be hypothesized to help decrease physician avoidance of EOL discussion. Physicians may be motivated to adopt such interventions in order to enhance normal emotional functioning to meet supra-normal occupational demand. We propose this as a promising area of future study.
journal_name
Patient Educ Counsjournal_title
Patient education and counselingauthors
Soodalter JA,Siegle GJ,Klein-Fedyshin M,Arnold R,Schenker Ydoi
10.1016/j.pec.2017.12.008subject
Has Abstractpub_date
2018-05-01 00:00:00pages
960-967issue
5eissn
0738-3991issn
1873-5134pii
S0738-3991(17)30654-7journal_volume
101pub_type
杂志文章abstract：:The patient role as discussed in popular and professional literature is in a transitional period, but actual patient behaviors remain predominantly traditional. This article summarizes advice to the public concerning patient-physician communication from the past 25 years of popular periodicals and recent self-help lit...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/0738-3991(88)90042-0
更新日期：1988-04-01 00:00:00
abstract：OBJECTIVE:New pharmacological measures assessing medication adherence, including longitudinal drug levels in hair, are emerging. Little is known, however, about how best to present results from such measures to patients and clinicians in comprehensive, easy-to-understand, acceptable formats. We, therefore, developed th...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2018.12.029
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:To identify and describe the extent to which theory or theoretical frameworks informed the development and evaluation of decision support technologies (DSTs). METHODS:The analysis was based on the decision technologies used in studies included in the Cochrane systematic review of patient decision aids for pe...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/j.pec.2007.12.004
更新日期：2008-04-01 00:00:00
abstract：OBJECTIVE:The VR-CoDES has been previously applied in the dental context. However, we know little about how dental patients with intellectual disabilities (ID) and complex communication needs express their emotional distress during dental visits. This is the first study explored the applicability of the VR-CoDES to a d...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2014.07.023
更新日期：2014-11-01 00:00:00
abstract：:An analysis of 11 physicians' speech content regarding medications was conducted on 267 encounters with hypertensive patients. Scored were categories for questions, instructions, directions to take and justifications for taking medications. The median inter-auditor agreement was 83%. The results indicate that the phys...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/0738-3991(85)90003-5
更新日期：1985-06-01 00:00:00
abstract：:Physician counseling on physical activities for sedentary people is usually based on anamneses. The aim of the present study was to investigate the accuracy of self-perception of participation in physical activities, and the correlation of physical activity with background factors. A random sample of 276 individuals a...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/S0738-3991(03)00119-8
更新日期：2004-04-01 00:00:00
abstract：:In 2015, at the International Conference on Communication in Healthcare in New Orleans, USA, we formed a symposium panel to discuss and debate how interdisciplinary research can inform interpreter-mediated medical consultation training. In all our work, a recurring theme is not just the strengths but also the shortcom...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2017.04.021
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities. METHODS:Selective critical review of research regarding IMCPs tailored to psychological mediator...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/j.pec.2010.11.012
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:Develop a system of practice tools and procedures to prompt shared decision making in primary care. SDM-GRIP (Shared Decision Making Guidance Reminders in Practice) was developed for suspected stable coronary artery disease (CAD), prior to the percutaneous coronary intervention (PCI) decision. METHODS:Progra...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2010.12.028
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:The average age at diagnosis for type 2 diabetes is decreasing. However, because age is most often controlled for in clinical research, little is known regarding how adult age is associated with diabetes disease-related variables. METHODS:In a community based study with type 2 diabetes patients (N=506), afte...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2010.10.030
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:To determine the association between self-efficacy and health-related quality of life (HRQoL) in people with Chronic Obstructive Pulmonary Disease (COPD) and the moderating effect of self-efficacy type (exercise task, exercise barrier, COPD symptom, general) and HRQoL type (generic, COPD specific). METHODS:D...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/j.pec.2019.12.003
更新日期：2020-04-01 00:00:00
abstract：OBJECTIVE:To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. METHODS:We performed a systematic literature search to identify issues important t...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2014.07.004
更新日期：2014-11-01 00:00:00
abstract：OBJECTIVE:To investigate parents' experiences and views of clinician communication during primary care consultations for respiratory tract infections (RTIs) in children under 12. METHODS:Semi-structured interviews with 30 parents who had recently consulted for RTI in their child. Purposive sampling was used to intervi...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2014.01.010
更新日期：2014-05-01 00:00:00
abstract：OBJECTIVE:To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-rel...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/j.pec.2015.05.020
更新日期：2015-06-10 00:00:00
abstract：:Amongst all the long-term complications of diabetes it is believed that foot ulceration and amputation are the most preventable: small studies have suggested that more than 50% of amputations should be avoidable by screening and appropriate education. There is ample evidence that simple non-invasive screening tests ar...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/0738-3991(95)00746-m
更新日期：1995-09-01 00:00:00
abstract：:This paper presents part of a survey which investigated people's response to different approaches to health education campaigns. The main objective of the original study was to find out whether the respondents preferred a fear-inducing campaign or a positive image advertising. Two anti-smoking advertisement produced b...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/s0738-3991(96)00958-5
更新日期：1997-01-01 00:00:00
abstract：OBJECTIVE:(1) To investigate the impact of education on patients' knowledge; (2) to determine if educational interventions are related to health behavior change in cardiac patients; and (3) to describe the nature of educational interventions. METHODS:A literature search of several electronic databases was conducted fo...
journal_title：Patient education and counseling
pub_type： 杂志文章,评审
doi：10.1016/j.pec.2014.01.012
更新日期：2014-05-01 00:00:00
abstract：OBJECTIVES:Internet-based information has potential to impact physician-patient relationships. This study examined medical students' interpretation and response to such information presented during an objective clinical examination. METHOD:Ninety-three medical students who had received training for a patient centered ...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2008.12.014
更新日期：2009-07-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of a lifestyle-related risk factor modification intervention on coronary artery disease (CAD) patients' lifestyle changes. METHOD:A randomized controlled study was conducted in Nepal. A total of 224 CAD patients (112 in each study group) were included at baseline, and 196 patients (...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2020.11.030
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:To determine the association between the format of physicians' opening questions that solicit patients' presenting concerns and patients' post-visit evaluations of (i.e., satisfaction with) the affective-relational dimension of physicians' communication. METHODS:Videotape and questionnaire data were collecte...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2005.11.009
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVE:To assess the impact of a 3-month follow-up of a 6-month quasi-experimental study conducted to evaluate a web-based, tailored-feedback intervention promoting four key components of the Mediterranean diet. METHODS:Fifty-three (intervention) and nineteen (control) healthy females, 25-55 years, employed at two ...
journal_title：Patient education and counseling
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.pec.2008.05.030
更新日期：2008-11-01 00:00:00
abstract：OBJECTIVE:To investigate the applied and conceptual relationship between two measures of shared decision making using the OPTION instrument developed in Wales and the Informed Decision Making instrument developed in Seattle, USA using audio-taped consultation data from a UK general practice population. METHODS:Twelve ...
journal_title：Patient education and counseling
pub_type： 杂志文章,多中心研究
doi：10.1016/j.pec.2007.09.001
更新日期：2008-01-01 00:00:00
abstract：:From the viewpoint of quality of care, doctor-patient communication has become more and more important. Gender is an important factor in communication. Besides, cultural norms and values are likely to influence doctor-patient communication as well. This study examined (1). whether or not communication patterns of gend...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/s0738-3991(02)00178-7
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVE:To determine which formats communicate medication adherence effectively to patients. METHODS:HIV-infected adults on antiretrovirals viewed examples of refill data in 5 formats: (1) percentage of doses, (2) number of days late to refill ("days late"), (3) calendar of days with/without medications, (4) pie cha...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2015.08.002
更新日期：2016-01-01 00:00:00
abstract：OBJECTIVE:To determine the effect of nurse-led program based on Pender's Health Promotion Model on the exercise behaviors of coronary artery patients. METHODS:The two-arm parallel, single-blind, randomized controlled trial was conducted with a total of 62 patients, intervention (n = 32) and control group (n = 30). Int...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2020.10.003
更新日期：2020-10-10 00:00:00
abstract：OBJECTIVE:This paper explores factors that influence the formulation of risk perception among men with a family history of prostate cancer who are currently attending a prostate cancer screening clinic. METHODS:Semi-structured interviews were conducted with fifteen participants. Interview transcripts were analyzed usi...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2010.11.020
更新日期：2011-11-01 00:00:00
abstract：:Information needs, satisfaction with information and information sources of women referred for surgical biopsy in mammography screening were explored. Forty-five Finnish women (23 benign and 22 malignant finding) replied to a mailed questionnaire containing fixed-choice and open-ended questions 10 weeks after biopsy. ...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/s0738-3991(99)00118-4
更新日期：2001-01-01 00:00:00
abstract：OBJECTIVES:To examine the provision of information by health care providers (HCPs) to fertility patients about accessing psychological resources. METHODS:This study utilized data from a cross-sectional survey of 659 male and female patients seeking fertility treatment at clinics in Toronto and Montreal. Regression ana...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2018.06.013
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVE:To explore the accuracy and consistency of standardized patient (SP) performance in the context of routine genetic counseling, focusing on elements beyond scripted case items including general communication style and affective demeanor. METHODS:One hundred seventy-seven genetic counselors were randomly assig...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/j.pec.2010.10.005
更新日期：2011-11-01 00:00:00
abstract：:We evaluated the family-oriented care and counseling provided by the BC Children's Hospital Transport Team paramedies. One hundred families were asked to rate: (1) how they would like paramedies to communicate with them under ideal conditions; and (2) what they actually experienced during their child's transport. Ther...
journal_title：Patient education and counseling
pub_type： 杂志文章
doi：10.1016/s0738-3991(98)00090-1
更新日期：1999-03-01 00:00:00
