When making high-stakes decisions with their patients, surgeons may have only one opportunity to get a life-changing conversation right. These loaded conversations cover immense ground. Bad news, emotion, prognosis, treatment choices, and patient goals all play a part in coming up with the right plan for each individual patient. Surgeons and patients may overlook important factors when the language and process of informed consent is substituted for decision-making. "Best Case/Worst Case" is a communication tool based in scenario planning that promotes shared decision-making in high-stakes surgical conversations and is discussed at length in this review.
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http://dx.doi.org/10.1016/j.suc.2019.06.011 | DOI Listing |
Kidney Med
January 2025
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.
View Article and Find Full Text PDFEndomyocardial biopsies (EMB) are invasive procedures performed in heart transplant (HTx) patients for surveillance of acute rejection. However, patient preferences for replacing EMBs with noninvasive assays in the context of potential institutional policy changes are unknown. A mixed-methods design was used with 28 semi-structured patient interviews and 123 self-administered online survey questionnaires in English and Spanish between January to June 2023.
View Article and Find Full Text PDFJ Adv Pract Oncol
July 2024
UCSD Comprehensive Breast Health Center, La Jolla, California.
Advanced practice providers in oncology are now likely to encounter real-world data (RWD) studies in addition to data from randomized controlled trials (RCTs) in their practice. Real-world evidence derived from RWD can provide important information about a therapeutic agent's effectiveness outside of the confines of RCTs. It is important to understand how these studies are conducted and how data from these two types of studies can be interpreted and integrated for practical clinical use and shared decision-making.
View Article and Find Full Text PDFHeliyon
January 2025
The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
Introduction: The Person-Centred Care instrument for outpatient care (PCCoc) is a 36-item patient-reported experience measure with 4 ordered response categories, that aims to capture the degree of perceived person-centred care (PCC) from a patient perspective among persons with long-term conditions. The PCCoc is based on a framework that conceptualises outpatient PCC from lower to higher levels of perceived PCC, from personalisation via shared decision-making to empowerment, where 35 of the PCCoc items are a part of the framework's hierarchy.
Aim: To investigate to what extent empirical item responses are consistent with the hierarchical PCCoc conceptual framework among persons with long-term conditions in outpatient care.
Int J Qual Stud Health Well-being
December 2025
Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
Purpose: When serious illness occurs, effective communication is essential but challenged by language barriers. This study explores how patients with limited Danish proficiency and their families experience language barriers during cancer care in two Danish public hospitals.
Method: Adopting a phenomenological-hermeneutic approach, the study stresses narratives in understanding participants' lived experiences.
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