Patient education and counseling
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Communication about medical errors with patients and families demonstrates respect, compassion, and commitment by providing information, acknowledging harm, and maintaining trust through a process of dialogue that involves multiple conversations. This communication requires knowledge, skills, and attitudes that allow healthcare professionals to discuss facts transparently, take responsibility for what happened, and express regret and (as appropriate) apologize; these abilities also allow professionals to describe what will happen next for the patient and explain what will be done to prevent the error from happening to others in the future. ⋯ Healthcare organizations should promote a systems approach to patient safety and cultivate a culture of transparency and learning in which healthcare professionals are supported as they cope with the distress they experience after an error. Communication about errors should be incorporated into all healthcare practice settings (medical, surgical, in-patient, out-patient), and can be taught to medical students and residents using didactic, role-playing, or simulation methodologies.
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To examine transitions out of prognostic talk in interactions between clinicians and the relatives and friends of imminently dying hospice patients. ⋯ In a context in which there is a great deal of uncertainty, transitioning towards talk on comfort care can emphasise action and the continued care of the patient and their family.
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This study sought to develop a decision aid with cartoon pictures and evaluate its effectiveness in increasing consistency between elderly individuals and their surrogates regarding end-of-life care. ⋯ A decision aid with cartoon pictures may support the discussion of end-of-life care in older Asian populations.
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Randomized Controlled Trial
Efficacy of a dyadic intervention to improve communication between patients with cancer and their caregivers: A randomized pilot trial.
Cancer-related communication is critical for patients' and caregivers' adaptation to illness. This randomized pilot study was conducted to test the feasibility, acceptability, and efficacy of a specific dyadic intervention to improve communication. ⋯ Encouraging patients and caregivers to discuss personal cancer-related concerns may improve their ability to cope with the illness together.
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Shared decision making (SDM) is recommended to improve healthcare quality. Physicians who use a rational decision-making style and patient-centric approach are more likely to incorporate SDM into clinical practice. This paper explores how certain physician characteristics such as gender, age, race, experience, and specialty explain patient participation. ⋯ A patient-centric approach, rational decision-making and certain physician characteristics help explain patient participation in clinical decisions. Practice Implications Future SDM research and policy initiatives should focus on physician adoption of patient-centric approaches to chronic care diseases and the potential bias associated with physician characteristics and decision-making style.