Waiting for the body to fail: limits to end-of-life communication in Canadian hospitals.
High-quality patient-centred care for hospitalised patients at the end of life requires health care teams to engage patients and families in communication and decision-making about goals of care. In the absence of such engagement, patient preferences may not be reflected in their care, and patients...
| Publicado en: | Mortality Vol. 21; no. 4; pp. 340 - 357 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
| Publicado: |
Taylor & Francis Ltd
Nov2016
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=117878042&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 117878042 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 13576275 MIY jtl: Mortality issn: 13576275 maglogo: Y pubinfo: dt: Nov2016 vid: 21 iid: 4 pid: 377 pub: Taylor & Francis Ltd artinfo: ui: 117878042 10.1080/13576275.2016.1140133 ppf: 340 ppct: 17 formats: fmt: – @attributes: type: T db: hlh ui: 117878042 – @attributes: type: P db: hlh ui: 117878042 tig: atl: Waiting for the body to fail: limits to end-of-life communication in Canadian hospitals. aug: au: Nouvet, Elysée Strachan, Patricia H. Kryworuchko, Jennifer Downar, James You, John J. affil: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada School of Nursing, McMaster University, Hamilton, Canada Departments of Medicine and Clinical Epidemiology and Biostatistics, University of Saskatchewan College of Nursing, Saskatoon, Canada Palliative Care and Critical Care, University Health Network (Toronto), Toronto, Canada Divisions of Critical Care and Palliative Care, University of Toronto, Toronto, Canada Department of Medicine, McMaster University, Hamilton, Canada su: Canada Terminal care & psychology Decision making Interviewing Nurses Physicians Attitudes toward death Communication barriers Patient-centered care Patient-family relations Research funding Judgment sampling Data analysis Thematic analysis Data analysis software Descriptive statistics sug: subj: Terminal care & psychology Decision making Interviewing Nurses Physicians Attitudes toward death Communication barriers Patient-centered care Canada Offices of physicians Offices of Physicians (except Mental Health Specialists) Patient-family relations Research funding Judgment sampling Data analysis Thematic analysis Data analysis software Descriptive statistics keyword: Canadian clinical communication and decision-making death and dying end of life goals of care discussions qualitative research rescue ideology Canadian clinical communication and decision-making death and dying end of life goals of care discussions qualitative research rescue ideology ab: High-quality patient-centred care for hospitalised patients at the end of life requires health care teams to engage patients and families in communication and decision-making about goals of care. In the absence of such engagement, patient preferences may not be reflected in their care, and patients may be subjected to unwanted life-sustaining technologies such as mechanical ventilation and cardiopulmonary resuscitation. The DECIDE (DECIsion-making about goals of care for seriously ill, hospitalised medical patients) study was conducted with the aims of identifying barriers and ideas for improving end-of-life communication and decision-making with seriously ill patients in Canadian hospitals. Its qualitative component involved interviews with 30 physicians and nurses asking them to recall and describe hospital-based goals of care communication and decision-making incidents that had gone ‘well’ or ‘unwell’. This article explores a dominant pattern in participants’ accounts, which is a norm of waiting to initiate end-of-life discussions until seriously ill patients are within days or even hours of death. Attending to clinicians’ explanations of when and why goals of care discussions are routinely delayed provides opportunity to clarify and critically consider important and normally unarticulated rationales underlying end-of-life discussion practices between health care teams and patients/families in Canadian hospitals. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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