Can clinical interventions change care at the end of life?
Article Abstract:
It appears that efforts to change end of life health care should be targeted at educating doctors. Published research on ways to change end of life health care were summarized and categorized according to whether the aim was giving patients more choice or reducing cost, pain, or use of extraordinary life-sustaining measures. Results were further analyzed according to the target for change. Some studies showed that significant improvement in doctor education improved the likelihood of adherence to patient wishes. No strategy improved health care costs or pain at the end of life.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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Opening the black box: how do physicians communicate about advance directives?
Article Abstract:
Many primary care physicians do not adequately discuss advance directives with their patients. Advance directives are documents specifying how patients want to be treated if they become incapable of making these decisions in the future. Researchers studied transcripts of actual conversations about advance directives between 56 physicians and one of their patients. The conversation lasted an average of five minutes and the physician did most of talking. In most cases, the patient's values were not considered and the discussion included vague terminology.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1998
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Remembering the real questions
Article Abstract:
Internists should do a better job of answering the three basic questions most patients ask. Most want to know what's happening to them, what will happen in the future, and how the doctor can improve their outcome. Patients are turning more and more to alternative health care practitioners to answer these questions. Doctors must learn to communicate and to listen to their patients. They must take continuing education courses so they can learn to predict the course of a disease. And they must take the lead in defending the patient's best interests.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1998
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