Discussing resuscitation preferences with patients: challenges and rewards.
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TLDR
Physician barriers to conducting effective discussions are discussed, a variety of approaches to enhancing these conversations are offered, and important communication techniques are reviewed.Abstract:
Discussing preferences regarding resuscitation is a challenging and important task for any physician. Understanding patients' wishes at the end of life allows physicians to provide the type of care patients want, to avoid unwanted interventions, and to promote patient autonomy and dignity. Hospitalists face an even greater challenge because they are often meeting a patient for the first time in a crisis situation. Despite the frequency with which clinicians have these conversations, they typically fall short when discussing code status with patients. In this evidence-based review, we discuss physician barriers to conducting effective discussions, offer a variety of approaches to enhancing these conversations, and review important communication techniques.read more
Citations
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Can we talk ? Inpatient discussions about advance directives in a community hospital : attending physicians'attitudes, their inpatients'wishes, and reported experience.
Reilly,Magnussen,Ross,Ash +3 more
TL;DR: Most medical inpatients in a community hospital want to, are able to, and meet their own physicians' indications to discuss advance directive discussions, and most patients' preferences for life-sustaining treatments are met.
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Improving residents' code status discussion skills: a randomized trial.
Eytan Szmuilowicz,Kathy Johnson Neely,Rashmi K. Sharma,Elaine R. Cohen,William C. McGaghie,Diane B. Wayne +5 more
TL;DR: A focused, multimodality curriculum can improve resident performance of simulated CSDs and lasted for at least 2 months after the intervention.
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Go Wish: a tool for end-of-life care conversations.
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Awareness of do-not-resuscitate orders: What do patients know and want?
TL;DR: Most respondents were well informed about the meaning of DNR, thought DNR discussions should take place when patients were still healthy, preferred to discuss DNR decisions with family physicians, and did not consider the topic stressful.
References
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