A Case for Increased Medical Student and Psychiatric Resident Education in Palliative Care

Balon, Richard; Motlová, Lucie Bankovská; Beresin, Eugene V.; Coverdale, John; Louie, Alan K.; Roberts, Laura Weiss

doi:10.1007/s40596-015-0479-6

Cited by 11 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Balon et al have gone further in raising the possibility of characterizing psychiatry itself as a form of palliative care: "in many aspects, psychiatry itself is a form of palliative care because psychiatric treatments are frequently not curative." 4 Other proponents of palliative psychiatry, however, have recognized that this suggestion is too expansive 2 because it blurs the distinctive ways in which palliative care prioritizes quality of life and harm reduction strategies over other clinical goals in the management of chronic, serious, or life-threatening conditions and have proposed that the term palliative psychiatry be used to describe care of those only with severe and persistent mental illness (SPMI). Rather than characterize psychiatry itself as a form of palliative care, Westermair et al have elaborated on narrow and broad notions of palliative psychiatry: "palliative psychiatry in a narrow sense refers to the provision of end-of-life care for persons dying from a mental illness.…”

Section: Introductionmentioning

confidence: 99%

What Should Clinicians Know About Palliative Psychopharmacology?

2023

AMA Journal of Ethics

View full text Add to dashboard Cite

The nature and scope of palliative psychiatry and associated ethical implications are debated in the literature. This article examines conceptual limitations of extant accounts of palliative psychiatry, with a focus on psychopharmacological practice, and suggests that modifiable and unmodifiable psychiatric illnesses exist on a spectrum along which broader or narrower palliative psychiatric care approaches can be outlined. The article also discusses how these approaches intersect with questions about whether and to what extent psychiatric medications have symptom-reducing or disease-modifying effects. The discussion leads to the conclusion that clinicians are ethically obliged to distinguish among and clearly formulate goals of care in a dynamic and ongoing process of shared decision making with patients.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

show abstract

Section: Introductionmentioning

confidence: 99%

What Should Clinicians Know About Palliative Psychopharmacology?

2023

AMA Journal of Ethics

View full text Add to dashboard Cite

show abstract

“…8 This includes countries that have established PC services [9][10][11] since most health-care practitioners wish they had received more education on it. [12][13][14][15] In Mexico, despite the fact that PC has been present for more than 2 decades, its impact is still negligible. 16 It was not until 2009 that the General Health Law was modified, and Article 166 entitled ''On palliative care in people with a terminal disease'' was introduced, generating the first law on PC in the country's history.…”

Section: Introductionmentioning

confidence: 99%

“…8 This includes countries that have established PC services 9 -11 since most health-care practitioners wish they had received more education on it. 12 -15…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Knowledge and Comfort Providing Palliative Care: A Survey of Pediatricians in Mexico

2019

View full text Add to dashboard Cite

Background: Lack of education and training in palliative care has been described to be one of the most important barriers to pediatric palliative care implementation. Objective: To examine what factors determine the degree of knowledge and level of comfort Mexican pediatricians have providing pediatric palliative care. Methods: A questionnaire that assessed palliative care concepts was developed and applied online to Mexican pediatricians, both generalists and specialists. Results: A total of 242 pediatricians responded. The majority had not received palliative care education (92.6%) and felt uncomfortable discussing palliative needs with patients and families (92.1%). The mean score of the questionnaire was 6.8 (+1.4) of 10 correct answers. Knowledge in palliative care was associated with exposure to oncologic patients (P ¼ .01) and previous palliative care education (P ¼ .02) but inversely related to the pediatrician's age (P ¼ .01). Comfort addressing patient's palliative care needs was associated with knowledge in palliative care (P < .01), exposure to oncologic patients (P ¼ .03), and previous education in palliative care (P ¼ .02). Conclusions: Although Mexican pediatricians have basic knowledge of palliative care concepts, they do not feel comfortable addressing palliative care needs, suggesting that the main barrier for implementing palliative care is not the lack of knowledge but rather feeling uncomfortable when addressing these issues with patients and families. Educational programs should incorporate strategies that could help physicians develop comfort in approaching palliative care patients.

show abstract

“…Future research may include evaluation of an education intervention among psychiatry trainees targeting one or multiple aspects of these findings—for example, a workshop on communication skills training with patients who have a life-limiting illness or an online teaching module about issues faced by patients with a life-limiting illness and the evidence around therapies in this setting. Provision of opportunities for psychiatry trainees to spend time in a palliative care rotation has already been suggested to enhance knowledge in this area (Balon et al, 2016; Irwin et al, 2011; Winer, 2013). Developing formal links between training bodies in these disciplines may enable trainees to undertake accredited rotations in palliative care rather than being an “add-on” to training.…”

Section: Limitations and Future Researchmentioning

confidence: 99%