Awareness, use and perception of patient versions of clinical practice guidelines - a national cross-sectional survey among patients with a cancer diagnosis and healthcare providers.

Background: To investigate awareness, use, and perceptions of the patient guidelines (PGs) of the German Guideline Program in Oncology (GGPO) and to explore general preferences regarding cancer information among patients and healthcare providers (HCPs).

Methods: Two cross-sectional surveys among patients with cancer (November 2020-May 2021) and among HCPs (April -June 2021) were set up as anonymised, self-administered, semi-structured online surveys, including open-ended questions. Data were analysed with descriptive statistics and qualitative thematic analysis.

Sam Shepard and the dysfunctional American family: therapeutic perspectives.

In depicting dysfunctional families Sam Shepard brought a greater intensity level to family portrayals than had previously been seen in modern American theater. In part, his plays appear to reflect the tumultuous tone of the late 1960s and early 1970s when American society was in flux and when the national uncertainty reached down to the basic unit of society, the family. Yet, despite addressing recently emerging social issues, Shepard's plays also depict universal family conflicts.

The single-session family interview.

Currently, attempts are being made to integrate family systems theory and technique into the practice of family physicians. Although the importance of the family has been demonstrated in a number of medical situations and although several authors have indicated situations in which it is useful for the physician to convene the family, to date no explicit guidelines have been developed for conducting a single-session family interview. This article presents a framework for conducting such an interview, structured in three stages (contracting, exploration, and closure) with clinical examples for each stage.

The shared burden: when physicians and families decide to forego life-sustaining treatment.

Family physicians are being called upon to make decisions regarding whether to forego life-sustaining treatment. These decisions are made based on consultation with the family of the patient but are complicated by problematic family interactions. The family physician can manage difficult family reactions and assist the family in making a decision by understanding that there are common reactions to loss and bereavement on the part of family members such as anger, denial, and feelings of helplessness; assessing whether problems arise from chronic family conflicts (marital, parent-child, or previous unresolved mourning) or are situation related (unexpressed feelings, how to tell others, need to feel they have done everything, overwhelming other stresses); and incorporating several specific techniques into their practices such as family conferences, accepting anger, involving anxious members in treatment planning, referral to self-help family groups, reframing the decision in terms of the patient's wishes, and negotiating mutually acceptable solutions when patient or family members disagree.