Care of the Dying Patient

Berkey, Franklin J.; Vithalani, Nicki

doi:10.1007/978-3-030-54441-6_69

Cited by 9 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though not specifically incorporated in this curriculum, there are various models of communication including ask-tell-ask, SPIKES and NURSE, which may help to structure conversation and avoid unintentionally imprecise language; 10 when specifically asked for recommendations of how to set up the conversation, we suggested the SPIKES conversational structure for breaking bad news (Setup, Perception, Invitation, Knowledge, Empathize, and Summarize). 15 Limitations of this study include that it is a single academic center with small cohort of fellows with variable levels and backgrounds of training. Our study includes only one neurocritical care fellow because of the small size of our fellowship program (0 to 2 total fellows per year) skewing this data to represent non-neurology trained fellows.…”

Section: Discussionmentioning

confidence: 99%

Simulation-Based Training Improves Fellows’ Competence in Brain Death Discussion and Declaration

Chen

Trando²,

LaBuzetta³

2021

The Neurologist

View full text Add to dashboard Cite

Background: Despite well-defined American Academy of Neurology guidelines for death by whole brain criteria (brain death), there is marked variability in national practice, which some have attributed to lack of formal education. Further, communication with surrogates and families about brain death is integral to brain death declaration. As such, we developed a targeted brain death curriculum combining didactics and simulation-based education to improve examination and subsequent communication skills with families.Methods: Multidisciplinary critical care fellows participated in (1) didactic and case-based curriculum, (2) brain death simulated examination (SimMan3G mannequin), and (3) a standardized family scenario with delivery of a brain death diagnosis to a surrogate "family member". Fellows completed a precurriculum and postcurriculum multiple choice knowledge test and survey (Likert 1 to 10 scale) evaluating measures regarding diagnosis and communication of brain death. t Test and 2-tailed Wilcoxon signed rank test were used for statistical analysis (P < 0.05).Results: Thirteen critical care fellows participated in the curriculum. Most fellows [80% (N = 12)] had only participated in 0 to 5 brain death declarations before this intervention. There was significant improvement across all measures: self-rated knowledge (P = 0.004), perceived knowledge relative to peers (P = 0.002), confidence (P = 0.001), and comfort (P = 0.001) with performing a brain death exam, and comfort with family discussion (P = 0.01). Objective test scores improved from 56 to 73% after simulation (P = 0.004). All fellows found the curriculum beneficial. Conclusion:Trainees may lack sufficient exposure to brain death education. Didactics with simulation-based education can improve objective knowledge and subjective measures of comfort with brain death declaration and surrogate communication.

show abstract

Section: Discussionmentioning

confidence: 99%

Simulation-Based Training Improves Fellows’ Competence in Brain Death Discussion and Declaration

Chen

Trando²,

LaBuzetta³

2021

The Neurologist

View full text Add to dashboard Cite

show abstract

“…Specific phrases and word choices have been compiled by palliative care teams to support providers when discussing difficult information with family members (Berkey et al, 2018; Kelemen et al, 2020). For example, the family may ask about their loved one's suffering and dying alone.…”

Section: Virtual Bereavement Carementioning

confidence: 99%

Strategies for Virtual Bereavement Care

Carr

2022

Journal of Christian Nursing

View full text Add to dashboard Cite

:The contagiousness of some illnesses (e.g., COVID-19) limits the ways in which families can interact with their dying loved ones who have been admitted to the hospital, especially in the intensive care unit. As a result, nurses have developed culturally relevant strategies for virtual bereavement care for patients and families predeath, perideath, and postdeath. Specific ways nurses can support, communicate, and facilitate meaningful rituals when patients die in isolation are provided in this article.

show abstract

“…In severe cases, they must also share new discouraging findings and unfavorable developments that cannot be avoided through treatment (Alshami et al, 2020). In such situations, physicians often minimize an unpleasant message by lessening the gravity of the bad news-for fear that a patient will feel bereaved of hope and become depressed (Berkey et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Physicians’ Lived Experience of Breaking Bad News in Clinical Practice: Five Essentials of a Relational Process

Tranberg,

Brodin

2023

Qual Health Res

View full text Add to dashboard Cite

The purpose of this study was to develop deeper knowledge about physicians’ lived experiences of breaking bad news by identifying their common meanings and interrelatedness along with their potential alignment with process-oriented and relational aspects. Based on the methodology of descriptive phenomenology, in-depth interviews were conducted with 22 physicians from a wide variety of specialties. The participants were invited to freely reflect upon their experiences of breaking bad news by describing situations that had worked well and less well. Results showed that breaking bad news was fundamentally experienced as a relational process constituted by the five essentials of Becoming the bad messenger, Expecting the unpredictable, Being on stage, Professionally managing hope, and Mindfulness of the emotional relationship. In line with recent research, this study confirms that clinical communication involves much more than just delivering the message. However, it also contributes to existing knowledge by focusing on the phenomenology of physicians’ experiences, which enables deeper understanding of the medical profession and the relational process of breaking bad news. As such, our findings are important to enable broader learning in, for example, medical education and continuing courses for clinical staff.

show abstract

Care of the Dying Patient

Cited by 9 publications

References 28 publications

Simulation-Based Training Improves Fellows’ Competence in Brain Death Discussion and Declaration

Simulation-Based Training Improves Fellows’ Competence in Brain Death Discussion and Declaration

Strategies for Virtual Bereavement Care

Physicians’ Lived Experience of Breaking Bad News in Clinical Practice: Five Essentials of a Relational Process

Contact Info

Product

Resources

About