TY - JOUR
T1 - Dancing around death
T2 - Hospitalist-patient communication about serious illness
AU - Anderson, Wendy G.
AU - Kools, Susan
AU - Lyndon, Audrey
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Anderson was funded by the National Palliative Care Research Center. Drs. Anderson and Lyndon were funded by the University of California, San Francisco, Clinical and Translational Science Institute Career Development Program, supported by National Institutes of Health grant number 5 KL2 RR024130-04.
PY - 2013/1
Y1 - 2013/1
N2 - Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues.
AB - Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues.
KW - communication, medical
KW - death and dying
KW - dimensional analysis
KW - end-of-life issues
KW - health care, acute / critical
KW - illness and disease, life-threatening / terminal
KW - medicine
UR - http://www.scopus.com/inward/record.url?scp=84870003424&partnerID=8YFLogxK
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U2 - 10.1177/1049732312461728
DO - 10.1177/1049732312461728
M3 - Article
C2 - 23034778
AN - SCOPUS:84870003424
SN - 1049-7323
VL - 23
SP - 3
EP - 13
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 1
ER -