Top Ten Tips Palliative Care Clinicians Should Know About Medical Decision-Making Capacity Assessment

Ehrman, Sarah; Norton, Kavitha; Karol, David E.; Weaver, Meaghann S.; Lockwood, Bethany; Latimer, Abigail; Scott, Erin; Jones, Christopher A.; Macauley, Robert

doi:10.1089/jpm.2021.0022

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Assessment in palliative care may include formal assessment, such as capacity assessments (Ehrman et al, 2021) or cognitive testing (e.g. Hjermstad et al, 2004).…”

Section: The Role Of Psychologistsmentioning

confidence: 99%

Psychosocial intervention in palliative care: What do psychologists need to know

Feldstain

2024

J Health Psychol

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Emotional and existential suffering is prevalent in advanced diseases and psychologists have valuable skills to support people in this time of life. Yet, psychologists are rarely integrated in palliative care and relevant training is sparse. Being integrated in other areas of health, it is likely that we will be supporting these patients, whether integrated in a specialized team or not. This article is meant to serve psychologists, already skilled in the art and science of psychosocial intervention, who may find themselves supporting patients with advanced disease. Relevant history of palliative care is provided to elucidate palliative philosophy and approach. Evidence-based existential interventions will be reviewed. Integration of psychological models and both palliative theory and practice is provided to support palliative-appropriate case conceptualizations. Finally, case examples are provided throughout to help readers reconcile their existing practice in this domain of care.

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“…Assessment in palliative care may include formal assessment, such as capacity assessments (Ehrman et al, 2021) or cognitive testing (e.g. Hjermstad et al, 2004).…”

Section: The Role Of Psychologistsmentioning

confidence: 99%

Psychosocial intervention in palliative care: What do psychologists need to know

Feldstain

2024

J Health Psychol

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“…Prior studies have shown discordance between patients and their surrogate decision-makers on preferences for medical care [38,39]. This highlights that surrogates must be prepared for the responsibility of making medical decisions that best reflect the patients' values and preferences, as opposed to their own, by practicing substituted judgment [40]. Hepatologists must engage both patients and their surrogate decision-makers in a series of conversations to assess their medical knowledge, prognostic awareness, personal values, and goals and preferences for care.…”

Section: Recommended Strategies To Improve Acp In Advanced Liver Diseasementioning

confidence: 99%

Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease

Ufere

2021

Curr Hepatology Rep

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Purpose of Review Advance care planning (ACP) has been shown to improve multiple outcomes in patients with serious illnesses; however, patients with advanced liver disease, or cirrhosis, rarely receive timely ACP. The purpose of this review is to evaluate the current state of ACP for patients with advanced liver disease and to provide practical guidance for integrating early ACP into routine outpatient hepatology care. Recent Findings Due to multiple patient-, physician-, and systems-level barriers, patients with advanced liver disease have low rates of timely ACP engagement. Early identification and preparation of a surrogate decision-maker, enhancing clinician ACP communication skills, use of patient-centered educational tools, optimizing outpatient processes for ACP documentation, and early referral to specialty palliative care may help to improve current deficits in ACP for this population. Summary Provision of early ACP to patients with advanced liver disease may better ensure that patients receive medical care that is consistent with their goals and values.

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Ethical dilemmas for palliative care nurses: systematic review

Geng,

Zhang,

Zhang

et al. 2024

BMJ Support Palliat Care

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BackgroundNurses play a unique and critical role in palliative care, and it is noteworthy that nurses often encounter ethical dilemmas in this field.ObjectiveThis review aims to conduct a summarised synthesis of the latest research on the ethical considerations nurses faced in palliative care.MethodsWe conducted a rigorous systematic review of relevant existing studies published in high-quality English peer-reviewed journals from January 2017 to July 2023. We identified a total of 4492 articles (1029 in Web of Science, 1570 in PubMed and 1893 in Science Direct). Out of these, only 13 studies met the inclusion criteria.ResultsFollowing the thematic analysis, the ethical considerations reported in these 13 studies were grouped into three main themes and four subthemes: ethical issues in communication (ethical issues in communication with patients, ethical issues in communication with families), ethical issues in decision-making (autonomy, dignity) and moral distress in palliative care.ConclusionThis study elaborated on the ethical challenges faced by nurses in their communication with patients and families as well as decision-making and analysed the causes and effects of ethical distress, hoping to give a hand to ethical issues for nurses’ work in palliative care.

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Top Ten Tips Palliative Care Clinicians Should Know About Medical Decision-Making Capacity Assessment

Cited by 3 publications

References 24 publications

Psychosocial intervention in palliative care: What do psychologists need to know

Psychosocial intervention in palliative care: What do psychologists need to know

Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease

Ethical dilemmas for palliative care nurses: systematic review

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