Publications by authors named "Jenica Cimino"
Many patients are unable to identify members of their hospital care team and experience confusion regarding some medical terminology used during hospitalization, including descriptions of the structure of their inpatient care team. This cross-sectional study sought to (1) examine inpatients' understanding of the role of a hospitalist and (2) assess inpatients' familiarity with other medical terminology commonly used in the hospital. We surveyed 172 patients admitted to the hospital medicine service at two academic medical centers.
View Article and Find Full Text PDFBackground: Patient understanding of their care, supported by physician involvement and consistent communication, is key to positive health outcomes. However, patient and care team characteristics can hinder this understanding.
Objective: We aimed to assess inpatients' understanding of their care and their perceived receipt of mixed messages, as well as the associated patient, care team, and hospitalization characteristics.
Context: Clinicians frequently overestimate survival time in serious illness.
Objective: The objective of this study was to understand the frequency of overestimation in palliative care (PC) and the relation with end-of-life (EOL) treatment.
Methods: This is a multisite cohort study of 230 hospitalized patients with advanced cancer who consulted with PC between 2013 and 2016.
Objective: To assess the association between the frequency of empathic physician responses with patient anxiety, ratings of communication, and encounter length during hospital admission encounters.
Design: Analysis of coded audio-recorded hospital admission encounters and pre- and postencounter patient survey data.
Setting: Two academic hospitals.
Background: Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care.
Objective: To implement and evaluate a palliative care professional development program for ICU bedside nurses.
Methods: From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative.
Context: Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses.
Objectives: To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication.
Methods: A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers.
Context: As endorsed by the palliative care "Measuring What Matters" initiative, capturing patients' direct assessment of their care is essential for ongoing quality reporting and improvement. Fostering an environment where seriously ill patients feel heard and understood is of crucial importance to modern health care.
Objectives: To describe the development and performance of a self-report field measure for seriously ill patients to report how well they feel heard and understood in the hospital environment.
Background: Understanding the characteristics of communication that foster patient-centered outcomes amid serious illness are essential for the science of palliative care. However, epidemiological cohort studies that directly observe clinical conversations can be challenging to conduct in the natural setting. We describe the successful enrollment, observation and data collection methods of the ongoing Palliative Care Communication Research Initiative (PCCRI).
View Article and Find Full Text PDFBackground: Integrating palliative care into intensive care requires active involvement of bedside nurses in discussions of patients' prognosis and goals of care.
Objective: To improve critical care nurses' skills and confidence to engage in discussions with patients' families and physicians about prognosis and goals of care by using a focused educational intervention.
Methods: An 8-hour-long workshop was developed for critical care nurses.
Rationale: Surrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit (ICU) clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.
Objective: To determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.
Objective: To describe seriously ill patients' perspectives on expert-endorsed approaches for hospital cardiopulmonary resuscitation (CPR) discussions.
Methods: We created two videos depicting a hospital doctor discussing CPR with a seriously ill patient. One depicted a values-based approach with a doctor's recommendation, and one an information-focused approach without a recommendation.
Objective: To describe hospital-based physicians' responses to patients' verbal expressions of negative emotion and identify patterns of further communication associated with different responses.
Methods: Qualitative analysis of physician-patient admission encounters audio-recorded between August 2008 and March 2009 at two hospitals within a university system. A codebook was iteratively developed to identify patients' verbal expressions of negative emotion.
Objective: To describe experiences of serious illness including concerns, preferences, and perspectives on improving end-of-life (EOL) care in underserved inpatients.
Methods: Qualitative analysis of 1-hour interviews with inpatients at a public hospital whose physician "would not be surprised" by the patient's death or intensive care unit (ICU) admission within a year. Patients who were non-English speaking, lacked mental capacity, or had uncontrolled symptoms were excluded.