The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills. Export

@article{citeulike:819418, abstract = {Physician competence in end-of-life care requires skill in communication, decision making, and building relationships, yet these skills were not taught to the majority of physicians during their training. This article presents a 7-step approach for physicians for structuring communication regarding care at the end of life. Physicians should prepare for discussions by confirming medical facts and establishing an appropriate environment; establish what the patient (and family) knows by using open-ended questions; determine how information is to be handled at the beginning of the patient-physician relationship; deliver the information in a sensitive but straightforward manner; respond to emotions of the patients, parents, and families; establish goals for care and treatment priorities when possible; and establish an overall plan. These 7 steps can be used in situations such as breaking bad news, setting treatment goals, advance care planning, withholding or withdrawing therapy, making decisions in sudden life-threatening illness, resolving conflict around medical futility, responding to a request for physician-assisted suicide, and guiding patients and families through the last hours of living and early stages after death. Effective application as part of core end-of-life care competencies is likely to improve patients' and families' experiences of care. It may also enhance physicians' professional fulfillment from satisfactory relationships with their patients and patients' families.}, address = {Interdisciplinary Program on Professionalism and Human Rights, 750 N Lake Shore Dr, Suite 601, Chicago, IL 60611-2611, USA.}, author = {von Gunten, C. F. and Ferris, F. D. and Emanuel, L. L.}, citeulike-article-id = {819418}, citeulike-linkout-0 = {http://www.biomedexperts.com/Abstract.bme/11122596}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/11122596}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=11122596}, day = {20}, issn = {0098-7484}, journal = {JAMA : the journal of the American Medical Association}, keywords = {communication, end-of-life, skills, terminal}, month = {December}, number = {23}, pages = {3051--3057}, posted-at = {2009-01-29 23:14:40}, priority = {3}, title = {The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills.}, url = {http://www.biomedexperts.com/Abstract.bme/11122596}, volume = {284}, year = {2000} }

TY - JOUR ID - citeulike:819418 L3 - citeulike-article-id:819418 N2 - Physician competence in end-of-life care requires skill in communication, decision making, and building relationships, yet these skills were not taught to the majority of physicians during their training. This article presents a 7-step approach for physicians for structuring communication regarding care at the end of life. Physicians should prepare for discussions by confirming medical facts and establishing an appropriate environment; establish what the patient (and family) knows by using open-ended questions; determine how information is to be handled at the beginning of the patient-physician relationship; deliver the information in a sensitive but straightforward manner; respond to emotions of the patients, parents, and families; establish goals for care and treatment priorities when possible; and establish an overall plan. These 7 steps can be used in situations such as breaking bad news, setting treatment goals, advance care planning, withholding or withdrawing therapy, making decisions in sudden life-threatening illness, resolving conflict around medical futility, responding to a request for physician-assisted suicide, and guiding patients and families through the last hours of living and early stages after death. Effective application as part of core end-of-life care competencies is likely to improve patients' and families' experiences of care. It may also enhance physicians' professional fulfillment from satisfactory relationships with their patients and patients' families. IS - 23 JF - JAMA : the journal of the American Medical Association SN - 0098-7484 AD - Interdisciplinary Program on Professionalism and Human Rights, 750 N Lake Shore Dr, Suite 601, Chicago, IL 60611-2611, USA. EP - 3057 TI - The patient-physician relationship. Ensuring competency in end-of-life care: communication and relational skills. VL - 284 SP - 3051 KW - communication KW - end-of-life KW - skills KW - terminal AU - von Gunten, CF AU - Ferris, FD AU - Emanuel, LL PY - 2000/12/20/ UR - http://www.biomedexperts.com/Abstract.bme/11122596 ER -