Communication practices in physician decision-making for an unstable critically ill patient with end-stage cancer.

Journal of Palliative Medicine
Deepika MohanAmber E Barnato

Abstract

Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, using the framework of shared decision-making. Analysis of audiotaped encounters between physicians and a standardized patient, in a high-fidelity simulation scenario, to identify best practice communication behaviors. The simulation depicted a 78-year-old man with metastatic gastric cancer, life-threatening hypoxia, and stable preferences to avoid intensive care unit (ICU) admission and intubation. Blinded coders assessed the encounters for verbal communication behaviors associated with handling emotions and discussion of end-of-life goals. We calculated a score for skill at handling emotions (0-6) and at discussing end of life goals (0-16). Twenty-seven hospital-based physicians. Independent variables included physician demographics and communication behaviors. We used treatment decisions (ICU admission and initiation of palliation) as a proxy for accurate ...Continue Reading

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Citations

Aug 25, 2015·Journal of Pain and Symptom Management·Andrea M ElliottAmber E Barnato
Nov 20, 2015·Journal of Palliative Medicine·Cynthia X PanSubroto Paul
Jul 18, 2015·Journal of Palliative Medicine·Annie LuAmber E Barnato
Apr 2, 2019·JAMA Internal Medicine·Leslie P ScheunemannDouglas B White
Sep 26, 2013·Critical Care Medicine·Katerina Rusinova, Jiri Simek
Aug 5, 2018·Journal of Religion and Health·Mustafa AhmedAasim Padela
May 8, 2019·Japanese Journal of Clinical Oncology·Tsui-Hsia HsuChih-Tsun Lin
May 19, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Hanan M AlyamiKaren New
Jan 1, 2021·AJOB Empirical Bioethics·Andre MoralesAmber Barnato

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Software Mentioned

Roter Interaction Assessment System ( RIAS )
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STATA
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