Abstract:
OBJECTIVE:Explore the impact of existential vulnerability for nursing home doctors' experiences with dying patients and their families. METHODS:We conducted a qualitative study based on three focus group interviews with purposive samples of 17 nursing home doctors. The interviews were audio-recorded, transcribed, and analyzed with systematic text condensation. RESULTS:Nursing home doctors experienced having to balance treatment compromises in order to assist patients' and families' preparation for death, with their sense of professional conduct. This was an arduous process demanding patience and consideration. Existential vulnerability also manifested as powerlessness mastering issues of life and death and families' expectations. Standard phrases could help convey complex messages of uncertainty and graveness. Personal commitment was balanced with protective disengagement on the patient's deathbed, triggering both feelings of wonder and guilt. CONCLUSION:Existential vulnerability is experienced as a burden of powerlessness and guilt in difficult treatment compromises and in the need for protective disengagement, but also as a resource in communication and professional coping. PRACTICE IMPLICATIONS:End-of-life care training for nursing home doctors should include self-reflective practice, in particular addressing treatment compromises and professional conduct in the dialogue with patient and next-of-kin.
journal_name
Patient Educ Counsjournal_title
Patient education and counselingauthors
Jansen K,Ruths S,Malterud K,Schaufel MAdoi
10.1016/j.pec.2016.07.016subject
Has Abstractpub_date
2016-12-01 00:00:00pages
2043-2048issue
12eissn
0738-3991issn
1873-5134pii
S0738-3991(16)30311-1journal_volume
99pub_type
杂志文章abstract::The study was designed to investigate self esteem, modes of coping and interfamilial relationships of asthmatic children and adolescents. Fifty-one asthmatic children (mean age: 12.26 +/- 2.56 years; 57% boys and 43% girls) were questioned about psychological factors of self image, coping with stressful situations and...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/s0738-3991(96)00945-7
更新日期:1997-02-01 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::In order to understand the problems of unwanted infertility in a country--the Gambia--where the desire for children and the fertility is very high, a population-based survey was undertaken. All infertile women in 24 randomly selected enumeration areas were assessed. The study included a review of the problems faced an...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/s0738-3991(97)01006-9
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Patient-provider communication is critical in primary care. Canada's unique health system, population distribution, and cultural context suggest there is value in addressing the topic in the Canadian context. We conducted a scoping review to synthesize recent Canadian literature to inform practice in primary ...
journal_title:Patient education and counseling
pub_type: 杂志文章,评审
doi:10.1016/j.pec.2017.11.008
更新日期:2018-05-01 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::Providing accurate information, in both verbal and written formats, is seen as an important component of patient care. For individuals diagnosed with cancer, acquiring information may be a particularly pertinent issue in terms of coping with the disease. Numerous information booklets are available for people with canc...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/s0738-3991(96)00988-3
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Examine influences of diabetes-specific social support (D-SS) and depressive symptoms on glycemic control over time, among adults randomized to a diabetes self-management education and support (DSME/S) intervention or usual care. METHODS:Data were from 108 African-American and Latino participants in a 6-mont...
journal_title:Patient education and counseling
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.pec.2015.05.019
更新日期:2015-11-01 00:00:00
abstract::The purpose of this study was to evaluate the effectiveness of a diabetes specialty centre in assisting clients with noninsulin-dependent diabetes mellitus to improve their metabolic control and quality of life. A single-subject repeated measures design was used where data was collected on entry to the program, immedi...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/0738-3991(94)00677-e
更新日期:1995-02-01 00:00:00
abstract::With much of the developed world having the increasing sociologic and economic problems of an aging population, there is an increased awareness of educating patients to not only understand and follow the instructions of their medical teams but to have increased responsibility for their own care. Of all the chronic con...
journal_title:Patient education and counseling
pub_type: 历史文章,杂志文章
doi:10.1016/0738-3991(95)00735-i
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To evaluate how limited English proficiency affects treatment outcome in head and neck cancer (HNC) patients treated with curative intent radiation therapy (RT). METHODS:From 2004 to 2010, 131 patients with HNC underwent RT. Patient's self-reported primary language and race/ethnicity were obtained at hospita...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2014.07.031
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:Because quality health care delivery requires effective clinician-patient communication, successful training of health professionals requires communication skill curricula of the highest quality. Two approaches for developing medical communication curricula are a consensus approach and a theory driven approac...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2013.06.012
更新日期:2013-10-01 00:00:00
abstract::We conducted a 4-year randomized study in a community health center that serves primarily low income Blacks in Durham, North Carolina. Patients (1318 at baseline) were assigned randomly to one of three study groups: provider prompting intervention alone, provider prompting and tailored print materials or the previous ...
journal_title:Patient education and counseling
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0738-3991(98)00122-0
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:The study aim was the development of a method to further enhance the educational benefit of medical students' reflective writing. The setting is a Doctoring course at the Warren Alpert Medical School of Brown University, which includes reflective writing assignments, termed "field notes", combining students' ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2009.11.014
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To evaluate patterns of and factors associated with a lack of pharmacotherapy as well as low adherence to treatment of hypothyroidism in pregnancy. METHODS:This multinational, cross-sectional, internet-based study recruited pregnant woman in 18 countries. Data about women's socio-demographic and medical char...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2016.04.006
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:It was hypothesized that parents exposed to a communication skills intervention would participate (e.g., ask questions, express concerns) in a pre-surgical consultation more than parents in the control group. METHODS:Sixty-five parents of prospective pediatric surgery patients were randomly assigned to eithe...
journal_title:Patient education and counseling
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.pec.2013.03.015
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To assess the associated obstetric and sociodemographic risk of vulnerability to postnatal depression in a population-based study. METHODS:All women presenting for postpartum care (n=1656) were surveyed at pregnancy care units of southern-eastern Hungary between January 2004 and May 2006 with an anonymously ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2007.02.004
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To evaluate a web-based self-management training for health professionals. Patients spend 99% of their time outside the healthcare system. Thus self-management support from health professionals is central to optimal care. Our objective was to teach health professionals the skills to provide this support. MET...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2012.09.003
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Poor adherence with prescription medications is a serious problem in health care, especially true for patients with chronic diseases. Previous strategies to promote adherence have generally not resulted in long-term improvements. This research program is designed to improve on past intervention strategies by ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.04.029
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:This study examined the impact of motivational interviewing (MI) counseling time on self-efficacy to practice safer sex for people living with HIV/AIDS (PLWHA). METHODS:In 4 month intervals we followed a cohort of 490 PLWHA for 12 months. We conducted hierarchical linear regression models to examine changes ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.07.021
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:When a child is hospitalized due to an illness or injury, the entire family may experience stress and/or anxiety. According to parents who have been in such a situation, providing adequate information is one of the most valuable ways to help the family deal with such feelings. Most mild head injuries suffered...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2007.10.001
更新日期:2008-02-01 00:00:00
abstract::Previous research has primarily focused on the relationship between providers and expectant mothers as a key element of quality prenatal care. Significantly less attention has been directed toward expectant fathers and the importance of their communication with prenatal care providers and involvement in the prenatal c...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2020.11.005
更新日期:2020-11-06 00:00:00
abstract::The information-seeking behavior of cancer outpatients has been studied with the purpose of collecting data for the development of an educational intervention: stimulating communication between cancer outpatients and their specialists. The intention to seek information, the realization of the intention and the reasons...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/0738-3991(93)90087-d
更新日期:1993-11-01 00:00:00
abstract::Developments in predictive testing for inherited cancers have focused attention on the accurate and sensitive communication of risk information. Although sharing risk information is often equated with genetic testing, it is important to acknowledge that the need for risk information related to familial cancer is also ...
journal_title:Patient education and counseling
pub_type: 杂志文章,评审
doi:10.1016/s0738-3991(97)00047-5
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:We examined the reach and impact of five decision aids (DAs) routinely distributed to breast cancer patients as part of a shared decision making demonstration project. METHODS:From 2005 to 2008, we surveyed patients' change in knowledge and decisional conflict (DC) before and after their review of DAs. Using...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2011.05.011
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:1) to assess patients' descriptions of concerns, and 2) to inform a conceptual framework in which the impact of the nature of concerns on doctor-patient communication is specified. METHODS:Six focus groups were conducted with 39 cancer patients and survivors. In these focus groups participants were asked to ...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2017.02.002
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Assess psychometric characteristics of an instrument to measure patient ratings of treating physicians' compassionate care in a recent hospitalization. METHODS:We used Cronbach's alpha to examine scale reliability, exploratory and confirmatory factor analysis to examine scale structure of two sets of items o...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2015.03.019
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Patient-centered approaches to medicine suggest the need for physicians to become more aware of concerns and needs expressed in patient narratives. However, patients and physicians have different goals and discourse styles during consultations. We attempt to bridge these differences by providing patients with...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2006.03.011
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Patient involvement focused the growth of Shared Decision Making (SDM) in contemporary healthcare practice, research, and education. Whilst important, securing appropriate patient involvement or equipping patients to choose is not necessarily the principal purpose of SDM. The purpose of SDM like all medical d...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2019.07.020
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:Researchers and clinicians acknowledge the complexity of planning for future medical treatment desired in the event of incapacitation. Unfortunately, many attempts to evaluate the quality of such difficult planning have been stymied by the lack of measures that can be shown to have validity. This study examin...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2005.05.003
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Preferences of women who had completed adjuvant chemotherapy for early breast cancer were compared with those of their partners by determining the smallest benefits they judged sufficient to make adjuvant chemotherapy worthwhile. METHODS:Forty-six women and their partners were interviewed separately, 3-34 mo...
journal_title:Patient education and counseling
pub_type: 杂志文章
doi:10.1016/j.pec.2008.02.021
更新日期:2008-08-01 00:00:00