Not Just Little Adults: Palliative Care Physician Attitudes Toward Pediatric Patients

2013 ◽  
Vol 16 (6) ◽  
pp. 675-679 ◽  
Author(s):  
Adam Rapoport ◽  
Christopher Obwanga ◽  
Giovanna Sirianni ◽  
S. Lawrence Librach ◽  
Amna Husain
Keyword(s):  
Palliative Care ◽  
Pediatric Patients ◽  
Care Physician ◽  
Physician Attitudes ◽  
Palliative Care Physician

scholarly journals Burn Surgeon and Palliative Care Physician Attitudes Regarding Goals of Care Delineation for Burned Geriatric Patients

2018 ◽  
Vol 39 (6) ◽  
pp. 1000-1005 ◽  
Author(s):  
Holly B Cunningham ◽  
Shannon A Scielzo ◽  
Paul A Nakonezny ◽  
Brandon R Bruns ◽  
Karen J Brasel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Geriatric Patients ◽  
Care Physician ◽  
Physician Attitudes ◽  
Goals Of Care ◽  
Palliative Care Physician

scholarly journals On Being a Palliative Care Physician: What Is Our Role in a Changing System?

2018 ◽  
Vol 56 (6) ◽  
pp. e90
Author(s):  
Alexandra Farag ◽  
Joshua Shadd ◽  
Cait O'Donnell ◽  
Joseph Pellizzari ◽  
Marilyn Swinton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Physician ◽  
Palliative Care Physician

Untaming Grief ? For Palliative Care Physicians

2011 ◽  
Vol 28 (8) ◽  
pp. 569-572 ◽  
Author(s):  
Paul J. Moon
Keyword(s):  
Palliative Care ◽  
Care Physician ◽  
Psychosocial Issues ◽  
Self Knowledge ◽  
Palliative Care Physician

Little doubt (if any) remains as to the assured importance of physicians possessing praxis regarding psychosocial issues, including grief dynamics, in order to tend to dying and sorrowing people. It stands to reason then that palliative care physicians become knowledgeable enough about the phenomenon of grief. But imperative nuances must also be considered: what sort of knowledge on grief, as well as how much of such knowledge, is enough? This article poses topical queries on the importance of the palliative care physician exercising a deliberate agenda to persistently refine one’s personal framework or beliefs regarding grief. In doing so, it is proposed physicians will engender improved self-knowledge, which will serve to better poise themselves toward being with and purposefully encountering aggrieved others.

Oncologists’ perceptions of rounding alongside palliative care physicians: Results of a post-intervention survey study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20674-e20674 ◽  
Author(s):  
Thomas William LeBlanc ◽  
James A Tulsky ◽  
Amy Pickar Abernethy ◽  
Christopher A Jones ◽  
Anthony N Galanos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Solid Tumor ◽  
Hospice Care ◽  
Care Physician ◽  
Lessons Learned ◽  
Survey Study ◽  
Post Intervention ◽  
New Model ◽  
Oncology Service ◽  
Palliative Care Physician

e20674 Background: In August 2011, a new rounding model was instituted on the inpatient solid tumor oncology service at Duke. This model incorporated a palliative care physician as a second attending on service, alongside the rounding solid tumor oncologist. We sought to assess the oncologists’ perceptions of this model, and of palliative care, 1 year later. Methods: We developed a 15-item survey assessing 3 domains: (1) perceptions about palliative care in general, (2) lessons learned from palliative care colleagues, if any, and (3) changes in the experience of rounding on the solid tumor oncology service. Faculty were invited to participate by e-mail, via an anonymous web link. All oncology faculty who rounded at least 2 weeks since August 2011 were included. Results: Response rate was 73% (8 of 11). 75% (N=6) of respondents had rounded both before and after the new model was instituted. 75% reported a more positive perception of palliative care (N=6), 88% (N=7) reported learning new ways to manage cancer patients’ symptoms, and 100% agreed that the palliative care physician brings a valuable skill set to the team. Only 1 respondent felt that palliative care physicians detract from oncologic issues, and none thought the palliative care physicians discuss hospice too early. 88% (N=7) reported greater willingness to round on the service under the new model, and 100% agreed that rounding was more enjoyable since the addition of the palliative care attending to the team. 100% agreed that palliative care is a necessary component of comprehensive cancer care, and that palliative care should have a presence in the outpatient cancer clinics; 88% (N=7) reported feeling comfortable doing palliative care in their own clinical practice. All agreed that “palliative care” is different from “hospice care.” Conclusions: Rounding alongside palliative care physicians on an inpatient oncology service may improve oncologists’ perceptions of palliative care, teach them new symptom management skills, and improve their willingness to do inpatient rounding. Fears about palliative care physicians inappropriately introducing hospice too early for patients with solid tumors may be unfounded.

Trauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients

2019 ◽  
Vol 36 (8) ◽  
pp. 669-674 ◽  
Author(s):  
Holly B. Cunningham ◽  
Shannon A. Scielzo ◽  
Paul A. Nakonezny ◽  
Brandon R. Bruns ◽  
Karen J. Brasel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Geriatric Patients ◽  
Care Physician ◽  
Physician Attitudes ◽  
The Other ◽  
Goals Of Care ◽  
Care Community ◽  
Trauma Surgeons ◽  
Better Than ◽  
Do So

Background: The value of defining goals of care (GoC) for geriatric patients is well known to the palliative care community but is a newer concept for many trauma surgeons. Palliative care specialists and trauma surgeons were surveyed to elicit the specialties’ attitudes regarding (1) importance of GoC conversations for injured seniors; (2) confidence in their own specialty’s ability to conduct these conversations; and (3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multicenter, palliative care-focused consortium and beta-tested by trauma surgeons and palliative care specialists unaffiliated with the consortium. The finalized instrument was electronically circulated to active physician members of the American Association for the Surgery of Trauma and American Academy for Hospice and Palliative Medicine. Results: Respondents included 118 trauma surgeons (8.8%) and 244 palliative care specialists (5.7%). Palliative physicians rated being more familiar with GoC, were more likely to report high-quality training in performing conversations, believed more palliative specialists were needed in intensive care units, and had more interest in conducting conversations relative to trauma surgeons. Both groups believed themselves to perform GoC discussions better than the other specialty perceived them to do so and favored their own specialty leading team discussions. Conclusions: Both groups believe themselves to conduct GoC discussions for injured seniors better than the other specialty perceived them to do so, which led to disparate views on the optimal leadership of these discussions.

scholarly journals Do Canadian and Japanese palliative care physicians perceive the concept of resilience differently?

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Shizuma Tsuchiya ◽  
Yusuke Takamiya ◽  
Alenoush Saroyan ◽  
Linda Snell
Keyword(s):  
Palliative Care ◽  
North American ◽  
Healthcare Professionals ◽  
Care Physician ◽  
Theory Approach ◽  
North American Society ◽  
Structured Interviews ◽  
American Society ◽  
Grounded Theory Approach ◽  
Palliative Care Physician

Teaching about resilience is one of the biggest challenges in medical education. One of the problems of currently accepted definitions is that they attribute individualistic notions mainly originating in North American society, such as “endure ongoing hardship,” “thrive on challenges,” “be healthy,” and “be stronger.” In response to this situation, Tsuchiya et al (2017) proposed a description of a broader model of a resilient physician in healthcare that incorporates concepts of self-definition as described in both North American and the East Asian societies; that is, “a person’s capacity to be aware of the aspects of the self differently identified in each context, and to consciously value oneself and others in the context”. However, the concept is still theoretical, and more empirical understanding is needed.This presentation will examine the findings from our exploratory study on physician resilience using semi-structured interviews with 20 palliative care physicians (10 each in Canada and Japan) to answer the following questions:(1) Are there any differences in the way Canadian and Japanese palliative care physician perceive resilience? (2) What factors might affect the similarities or differences of their perceptions of resilience? (3) Are these findings consistent with Tsuchiya’s description? Following qualitative analysis using a grounded theory approach, a schematic representation of resilience in physicians will be offered, to inform a coherent educational program for resilient healthcare professionals. 

Integrating outpatient palliative care into a metastatic breast oncology clinic.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 154-154 ◽  
Author(s):  
Rebecca Small ◽  
Jeffrey Belkora ◽  
Alexander Jow ◽  
Michael W. Rabow ◽  
Melanie Catherine Majure ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Palliative Care ◽  
Metastatic Breast ◽  
Quality Criteria ◽  
Care Physician ◽  
Cancer Center ◽  
Eligibility Criteria ◽  
Early Integration ◽  
Early Results ◽  
Palliative Care Physician

154 Background: The Advanced Breast Cancer (ABC) program at UCSF aims to improve metastatic breast cancer outcomes through early integration of palliative and oncologic care. Oncologists now routinely refer stage 4 patients to a palliative care physician and social worker. Thus this initiative translates ASCO policy recommendations into clinical practice. We report early results from our development, implementation, and evaluation of this novel program. Methods: To evaluate ABC, we used the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance), and Rogers’ Diffusion of Innovations theory. Results: Reach: From 10/2014 to 6/2015, 43 women participated out of 64 invited. Decliners’ main reason for refusal was to avoid additional appointments. Effectiveness: 36 patients reported improvements in 13 of 15 quality criteria, including care coordination, emotional support, and propensity to recommend the program. 34 patients responded to ESAS, QUAL-E and Steinhauser Spiritualty Screen questionnaires, with improvement in 10 out of 14 outcomes at 1-2 month follow-up. Improvements included reduction of anxiety, improved quality of life, and decreased nausea. Adoption: Early integration of palliative care is complex and requires additional coordination among busy clinicians. To address this, we embedded a palliative care physician in the oncology clinic two half-days per week; relied on an oncology fellow to facilitate ongoing cross-disciplinary collaboration; and leveraged the program coordinator’s capacity for following up on both project and patient issues. We also instituted a monthly team meeting to review patient cases. Implementation: Overall, our program design succeeded. Challenges included how to best communicate about patient prognosis and reason for referral. We also struggled to determine what patient eligibility criteria should trigger a referral. Maintenance: The program is currently sustained by grants and intramural cancer center funding. We are seeking continued investment. Conclusions: The ABC program demonstrates that early integration of palliative and oncologic care is feasible and associated with the psychosocial benefits previously found in efficacy studies.

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