Timothy Quill
- Published in print:
- 2001
- Published Online:
- November 2011
- ISBN:
- 9780195139402
- eISBN:
- 9780199999859
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195139402.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
In this book, the author uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section One ...
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In this book, the author uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section One utilizes the near-death experiences of two patients to explore values underlying medical humanism, and then presents the case of “Diane” to explore the fundamental clinical commitments of partnership and non-abandonment. Section Two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In Section Three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In the final chapter, the author discusses the tragic death of his brother, which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives. The author exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision making, ensuring medical and palliative care expertise, and committing to see the dying process through to the patient's death, is vividly illustrated.Less
In this book, the author uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section One utilizes the near-death experiences of two patients to explore values underlying medical humanism, and then presents the case of “Diane” to explore the fundamental clinical commitments of partnership and non-abandonment. Section Two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In Section Three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In the final chapter, the author discusses the tragic death of his brother, which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives. The author exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision making, ensuring medical and palliative care expertise, and committing to see the dying process through to the patient's death, is vividly illustrated.
James L. Hallenbeck
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195165784
- eISBN:
- 9780199999897
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195165784.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview ...
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Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.Less
Drawing from his extensive clinical experience and many years of teaching, the author of this book has written a guide to palliative care for clinicians. The topics addressed range from an overview of death and dying to specific approaches to symptom management. As an introduction to both the art and science of palliative care, the book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. It links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.
Betty R. Ferrell and Nessa Coyle
- Published in print:
- 2008
- Published Online:
- November 2011
- ISBN:
- 9780195333121
- eISBN:
- 9780199999910
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195333121.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This book attempts to give ...
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The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This book attempts to give voice to the suffering that nurses witness in patients, families, colleagues, and themselves. By making this suffering visible, the book aims both to honor and help solve the problem. The book offers nurses' colleagues in other professions — social workers, psychologists, chaplains, ethicists, and physicians — a window onto what it means to practice nursing.Less
The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This book attempts to give voice to the suffering that nurses witness in patients, families, colleagues, and themselves. By making this suffering visible, the book aims both to honor and help solve the problem. The book offers nurses' colleagues in other professions — social workers, psychologists, chaplains, ethicists, and physicians — a window onto what it means to practice nursing.
Sara Booth and Andrew Davies (eds)
- Published in print:
- 2006
- Published Online:
- November 2011
- ISBN:
- 9780198530749
- eISBN:
- 9780191730467
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530749.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, ...
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This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, the editors bring together palliative care and oncological treatment for patients with head and neck cancer. Head and neck cancer is one of the most frightening and distressing cancers for patients and their families as it affects appearance, the ability to speak, and the ability to eat. Pain, which is difficult to treat, infection, and disfiguring surgery with wounds that often do not heal, are common accompaniments of advanced disease. In addition, psychological distress, loneliness, and isolation are often experienced by patients. Head and neck cancer is not that common but, when it does occur, it very often needs specialist help from palliative care and hospice clinicians. There is little written on this subject and this book provides a practical guide that draws together all the information in an easily accessible format. The Palliative Care Consultations series is primarily aimed at those individuals working in an acute hospital cancer centre and/or tertiary referral centre. The books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common but difficult.Less
This is the fifth book in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, the editors bring together palliative care and oncological treatment for patients with head and neck cancer. Head and neck cancer is one of the most frightening and distressing cancers for patients and their families as it affects appearance, the ability to speak, and the ability to eat. Pain, which is difficult to treat, infection, and disfiguring surgery with wounds that often do not heal, are common accompaniments of advanced disease. In addition, psychological distress, loneliness, and isolation are often experienced by patients. Head and neck cancer is not that common but, when it does occur, it very often needs specialist help from palliative care and hospice clinicians. There is little written on this subject and this book provides a practical guide that draws together all the information in an easily accessible format. The Palliative Care Consultations series is primarily aimed at those individuals working in an acute hospital cancer centre and/or tertiary referral centre. The books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common but difficult.
Adriana Petryna
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691151663
- eISBN:
- 9781400845095
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691151663.003.0006
- Subject:
- Anthropology, Social and Cultural Anthropology
This chapter examines the ethical positions of local scientists and clinicians from the perspective of Soviet and post-Soviet scientific trajectories as well as in relation to international ...
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This chapter examines the ethical positions of local scientists and clinicians from the perspective of Soviet and post-Soviet scientific trajectories as well as in relation to international scientific influences. More specifically, it considers how the radiation research process makes connections between ailments and the Chernobyl disaster real—that is, organic. It also explores how scientific and political pressures at the international level restrict local discourses on the health effects of radiation from the Chernobyl disaster and influence the processes through which the biology of such effects becomes an object of contested scientific understanding and research. Finally, it shows how patients become captives of a new sociality in Ukraine and describes the changing doctor–patient relations, along with the in utero research carried out, at the Radiation Research Center.Less
This chapter examines the ethical positions of local scientists and clinicians from the perspective of Soviet and post-Soviet scientific trajectories as well as in relation to international scientific influences. More specifically, it considers how the radiation research process makes connections between ailments and the Chernobyl disaster real—that is, organic. It also explores how scientific and political pressures at the international level restrict local discourses on the health effects of radiation from the Chernobyl disaster and influence the processes through which the biology of such effects becomes an object of contested scientific understanding and research. Finally, it shows how patients become captives of a new sociality in Ukraine and describes the changing doctor–patient relations, along with the in utero research carried out, at the Radiation Research Center.
Michael A. West
- Published in print:
- 1990
- Published Online:
- March 2012
- ISBN:
- 9780198521945
- eISBN:
- 9780191688478
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198521945.003.0001
- Subject:
- Psychology, Developmental Psychology
This chapter describes meditation as an historical and cross-cultural phenomenon, demonstrating its ubiquity in secular and religious domains. Instructions for a simple ...
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This chapter describes meditation as an historical and cross-cultural phenomenon, demonstrating its ubiquity in secular and religious domains. Instructions for a simple and relatively permissive type of meditation are presented so that the reader with no previous experience of meditation can, to a limited extent, explore meditation in a practical way. The chapter goes on to discuss why people meditate, examining this question from a wide variety of viewpoints, before concluding that stress management is a peculiarly Western orientation and that meditation is more widely used for spiritual purposes. Psychological approaches to understanding meditation are presented via a history of psychological research in this area. The discussion explores the causes and consequences of the particular research orientations which have developed, arguing that there has been slow progress in understanding. Finally some of the problems of conducting meditation research are described.Less
This chapter describes meditation as an historical and cross-cultural phenomenon, demonstrating its ubiquity in secular and religious domains. Instructions for a simple and relatively permissive type of meditation are presented so that the reader with no previous experience of meditation can, to a limited extent, explore meditation in a practical way. The chapter goes on to discuss why people meditate, examining this question from a wide variety of viewpoints, before concluding that stress management is a peculiarly Western orientation and that meditation is more widely used for spiritual purposes. Psychological approaches to understanding meditation are presented via a history of psychological research in this area. The discussion explores the causes and consequences of the particular research orientations which have developed, arguing that there has been slow progress in understanding. Finally some of the problems of conducting meditation research are described.
Jonathan C. Smith
- Published in print:
- 1990
- Published Online:
- March 2012
- ISBN:
- 9780198521945
- eISBN:
- 9780191688478
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198521945.003.0008
- Subject:
- Psychology, Developmental Psychology
This chapter reviews traditional evidence and describes the difficulties of interpeting the results before arguing for a skills-based approach to understanding meditation. ...
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This chapter reviews traditional evidence and describes the difficulties of interpeting the results before arguing for a skills-based approach to understanding meditation. The chapter separates out what it states are the three principal skills involved in meditation practice and urges that we focus on these rather than on the generic notion of meditation. Using this strategy the chapter shows how clinicians can effectively use meditation to help others and how new and possibly more effective research can be conducted.Less
This chapter reviews traditional evidence and describes the difficulties of interpeting the results before arguing for a skills-based approach to understanding meditation. The chapter separates out what it states are the three principal skills involved in meditation practice and urges that we focus on these rather than on the generic notion of meditation. Using this strategy the chapter shows how clinicians can effectively use meditation to help others and how new and possibly more effective research can be conducted.
May McCreaddie
- Published in print:
- 2011
- Published Online:
- January 2012
- ISBN:
- 9780199599295
- eISBN:
- 9780191731532
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199599295.003.0021
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter takes a constructivist approach to the topic of communication, information, and support. This view recognizes that individuals actively generate their own understanding and ‘rules’ are ...
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This chapter takes a constructivist approach to the topic of communication, information, and support. This view recognizes that individuals actively generate their own understanding and ‘rules’ are then used to make sense of their experiences, rather than accepting that communication, information, and support are passive things that health and social care workers do to, and for, others. It begins with a discussion of the key issues and what patients want. It then considers changes in the patient-clinician relationship, relevant information and services policy context and initiatives in the UK, and the rise of computer-mediated communications, such as blogs.Less
This chapter takes a constructivist approach to the topic of communication, information, and support. This view recognizes that individuals actively generate their own understanding and ‘rules’ are then used to make sense of their experiences, rather than accepting that communication, information, and support are passive things that health and social care workers do to, and for, others. It begins with a discussion of the key issues and what patients want. It then considers changes in the patient-clinician relationship, relevant information and services policy context and initiatives in the UK, and the rise of computer-mediated communications, such as blogs.
JEFF GIDDINGS, ROGER BURRIDGE, SHELLEY A. M. GAVIGAN, and CATHERINE F. KLEIN
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195381146
- eISBN:
- 9780199869305
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195381146.003.0001
- Subject:
- Law, Public International Law
This chapter considers the early development of clinical legal education in a group of countries that have proven influential in the spread of clinical methods across the globe: the United States, ...
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This chapter considers the early development of clinical legal education in a group of countries that have proven influential in the spread of clinical methods across the globe: the United States, Britain, Canada, and Australia. There are both similarities and differences in the stories of how clinics emerged during the 1960s and 1970s with volunteer-based student services developing into academic programs that pursued both social justice and student learning objectives while emphasizing ethics and professional responsibility. The points of contrast relate to the academic-professional divide in British and Australian legal education, accreditation requirements, funding arrangements, and the treatment of clinicians in the legal academy. The chapter also considers the lasting legacy of these early programs, suggesting that the distinctiveness of clinical legal education is a source of both strength and vulnerability.Less
This chapter considers the early development of clinical legal education in a group of countries that have proven influential in the spread of clinical methods across the globe: the United States, Britain, Canada, and Australia. There are both similarities and differences in the stories of how clinics emerged during the 1960s and 1970s with volunteer-based student services developing into academic programs that pursued both social justice and student learning objectives while emphasizing ethics and professional responsibility. The points of contrast relate to the academic-professional divide in British and Australian legal education, accreditation requirements, funding arrangements, and the treatment of clinicians in the legal academy. The chapter also considers the lasting legacy of these early programs, suggesting that the distinctiveness of clinical legal education is a source of both strength and vulnerability.
Terry McNulty and Ewan Ferlie
- Published in print:
- 2004
- Published Online:
- October 2011
- ISBN:
- 9780199269075
- eISBN:
- 9780191699351
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199269075.003.0001
- Subject:
- Business and Management, Public Management, Organization Studies
Business Process Reengineering (BPR) was used to implement transformatory change in the Leicester Royal Infirmary, a large National Health Service (NHS) teaching hospital in the UK. This NHS Trust ...
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Business Process Reengineering (BPR) was used to implement transformatory change in the Leicester Royal Infirmary, a large National Health Service (NHS) teaching hospital in the UK. This NHS Trust was under pressure to improve performance but at the same time it needed to retain the support of doctors and other health care professionals in achieving these improvements. This programme received support from stable top-level leadership and ‘hybrid’ help from both doctors and managers. This change, however, produced uneven outcomes and required managers to form partnerships with clinicians. This chapter introduces how BPR works and relates this with the limits of organizational transformation. Also, BPR here is presented as an example of process organization and not merely a managerial fad. This chapter generally looks at health care and hospitals from a management perspective.Less
Business Process Reengineering (BPR) was used to implement transformatory change in the Leicester Royal Infirmary, a large National Health Service (NHS) teaching hospital in the UK. This NHS Trust was under pressure to improve performance but at the same time it needed to retain the support of doctors and other health care professionals in achieving these improvements. This programme received support from stable top-level leadership and ‘hybrid’ help from both doctors and managers. This change, however, produced uneven outcomes and required managers to form partnerships with clinicians. This chapter introduces how BPR works and relates this with the limits of organizational transformation. Also, BPR here is presented as an example of process organization and not merely a managerial fad. This chapter generally looks at health care and hospitals from a management perspective.
Anita Lightburn and Phebe Sessions (eds)
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195159226
- eISBN:
- 9780199893843
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159226.001.0001
- Subject:
- Social Work, Health and Mental Health, Communities and Organizations
This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making ...
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This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making the transition to community-based work. This is the first handbook to address this gap and provide guidance for today's community practitioners. Its overarching goal is to support the ongoing development of community-based mental health care, drawing on practical examples. This collection outlines the history and philosophy of community practice, and also illustrates the state of the art, with examples from early intervention and development programs, school-based practice, and community mental health services for children, families, and adults.Less
This volume builds the bridge between books on community practice and on clinical practice, including 33 chapters written by social workers, psychologists, and psychiatrists, for clinicians making the transition to community-based work. This is the first handbook to address this gap and provide guidance for today's community practitioners. Its overarching goal is to support the ongoing development of community-based mental health care, drawing on practical examples. This collection outlines the history and philosophy of community practice, and also illustrates the state of the art, with examples from early intervention and development programs, school-based practice, and community mental health services for children, families, and adults.
Virginia Berridge
- Published in print:
- 1996
- Published Online:
- October 2011
- ISBN:
- 9780198204725
- eISBN:
- 9780191676376
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198204725.003.0004
- Subject:
- History, British and Irish Modern History
AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late ...
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AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late 1984 and into 1985, AIDS began to impinge on the public consciousness to a much greater extent than it had done before. The number of AIDS deaths hit the press headlines. Professional groups, nurses, and laboratory workers showed concern, and politicians began to press for a response based on exclusion and isolation. Both the media and public opinion in general supported such a line, and significant pressure groups close to the government wanted a response based on the assertion of family values. The economics of AIDS also had a part to play, as did the question of health-care worker infection.Less
AIDS had been an issue for gay men, for clinicians and scientists, since 1982. AIDS assumed the dimensions of a serious public, departmental, and political issue during the course of 1985. From late 1984 and into 1985, AIDS began to impinge on the public consciousness to a much greater extent than it had done before. The number of AIDS deaths hit the press headlines. Professional groups, nurses, and laboratory workers showed concern, and politicians began to press for a response based on exclusion and isolation. Both the media and public opinion in general supported such a line, and significant pressure groups close to the government wanted a response based on the assertion of family values. The economics of AIDS also had a part to play, as did the question of health-care worker infection.
Eric J. Cassell
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780195156164
- eISBN:
- 9780199999880
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195156164.003.0011
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
This chapter discusses three kinds of information, namely: empirical facts, value-laden terms, and aesthetic. It shows that these kinds of information about sick persons are necessary to the work of ...
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This chapter discusses three kinds of information, namely: empirical facts, value-laden terms, and aesthetic. It shows that these kinds of information about sick persons are necessary to the work of clinicians, and also attempts to show that clinicians treat particular patients in particular circumstances at particular moments in time, thus requiring information that particularizes the individual and the moment.Less
This chapter discusses three kinds of information, namely: empirical facts, value-laden terms, and aesthetic. It shows that these kinds of information about sick persons are necessary to the work of clinicians, and also attempts to show that clinicians treat particular patients in particular circumstances at particular moments in time, thus requiring information that particularizes the individual and the moment.
Eric J. Cassell
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780195156164
- eISBN:
- 9780199999880
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195156164.003.0012
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
This chapter discusses the experience of the clinician, beginning with the science and art of the practice of medicine. It then moves on to the importance of the clinician's experience, the relation ...
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This chapter discusses the experience of the clinician, beginning with the science and art of the practice of medicine. It then moves on to the importance of the clinician's experience, the relation of knowledge to experience, and why experience has a bad name. The chapter then discusses the advantage of experience, the physician as the instrument, and how experience is able to mediate between science and art. It also looks at the experience of uncertainty.Less
This chapter discusses the experience of the clinician, beginning with the science and art of the practice of medicine. It then moves on to the importance of the clinician's experience, the relation of knowledge to experience, and why experience has a bad name. The chapter then discusses the advantage of experience, the physician as the instrument, and how experience is able to mediate between science and art. It also looks at the experience of uncertainty.
Eric J. Cassell
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780195156164
- eISBN:
- 9780199999880
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195156164.003.0006
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
This chapter discusses and addresses the difficult issues that must be faced and solved before shifting the primary concern from diseases to a focus on sick persons. It shows why disease theory has ...
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This chapter discusses and addresses the difficult issues that must be faced and solved before shifting the primary concern from diseases to a focus on sick persons. It shows why disease theory has been so necessary and successful for clinicians, or the doctors who actually take care of the patients. The chapter then looks at three common diseases to show how the ideas contained in classic disease theory are exemplified and used in the practice of medicine. It also illustrates the practical consequences of the changes that have taken place in the axioms of disease theory over the last few decades.Less
This chapter discusses and addresses the difficult issues that must be faced and solved before shifting the primary concern from diseases to a focus on sick persons. It shows why disease theory has been so necessary and successful for clinicians, or the doctors who actually take care of the patients. The chapter then looks at three common diseases to show how the ideas contained in classic disease theory are exemplified and used in the practice of medicine. It also illustrates the practical consequences of the changes that have taken place in the axioms of disease theory over the last few decades.
Sara Booth, Polly Edmonds, and Margaret Kendall
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199238927
- eISBN:
- 9780191730092
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238927.003.0004
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter discusses the importance of being part of the mainstream in an acute hospital for the survival and effective functioning of a hospital palliative care team. However, this may pose ...
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This chapter discusses the importance of being part of the mainstream in an acute hospital for the survival and effective functioning of a hospital palliative care team. However, this may pose specific challenges because most clinicians in palliative care are working in a predominantly advisory role. To address potential problems and become successfully integrated into the mainstream, palliative care should maintain a high profile, take all opportunities for service development, and keep a public image that is flexible, approachable, and responsive.Less
This chapter discusses the importance of being part of the mainstream in an acute hospital for the survival and effective functioning of a hospital palliative care team. However, this may pose specific challenges because most clinicians in palliative care are working in a predominantly advisory role. To address potential problems and become successfully integrated into the mainstream, palliative care should maintain a high profile, take all opportunities for service development, and keep a public image that is flexible, approachable, and responsive.
Albert G. Mulley and John E. Wennberg
- Published in print:
- 2011
- Published Online:
- May 2016
- ISBN:
- 9780262016032
- eISBN:
- 9780262298957
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262016032.003.0003
- Subject:
- Psychology, Health Psychology
Variation in clinical practice in seemingly similar populations of patients has been described for more than seventy years. International collaboration to increase understanding of the sources of ...
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Variation in clinical practice in seemingly similar populations of patients has been described for more than seventy years. International collaboration to increase understanding of the sources of practice variation and respond constructively have spawned efforts to expand and better manage professional knowledge, and to elicit and accommodate the personal knowledge of patients about what matters most to them when they face medical decisions under conditions of uncertainty. The approach, which has come to be known as shared decision making, can move us toward assurance that patients receive the care they need and no less and the care they want and no more. The use of decision aids to support shared decision making can effectively address the limitations in statistical thinking among clinicians as well as patients and thereby help establish informed patient choice as a standard of practice and improve the quality of medical decision making and the efficiency of health care.Less
Variation in clinical practice in seemingly similar populations of patients has been described for more than seventy years. International collaboration to increase understanding of the sources of practice variation and respond constructively have spawned efforts to expand and better manage professional knowledge, and to elicit and accommodate the personal knowledge of patients about what matters most to them when they face medical decisions under conditions of uncertainty. The approach, which has come to be known as shared decision making, can move us toward assurance that patients receive the care they need and no less and the care they want and no more. The use of decision aids to support shared decision making can effectively address the limitations in statistical thinking among clinicians as well as patients and thereby help establish informed patient choice as a standard of practice and improve the quality of medical decision making and the efficiency of health care.
Martin Härter and Daniela Simon
- Published in print:
- 2011
- Published Online:
- May 2016
- ISBN:
- 9780262016032
- eISBN:
- 9780262298957
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262016032.003.0004
- Subject:
- Psychology, Health Psychology
Shared decision making is an approach where clinicians and patients communicate together using the best available evidence when faced with the task of making decisions. The chapter presents an ...
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Shared decision making is an approach where clinicians and patients communicate together using the best available evidence when faced with the task of making decisions. The chapter presents an overview of current research that focuses on patient participation, the level to which patients want to be involved in medical decisions, and strategies that assess the measurement of these preferences. While most patients (> 80%) want detailed information and physicians often underestimate this need, some patients clearly indicate a strong preference to participate in decision making. Patients’ preferences for participation can vary depending on factors such as age, gender, experience of illness, and relationship with the physician. At present, only a few psychometrically sound instruments are available to measure patients’ preferences for participation.Less
Shared decision making is an approach where clinicians and patients communicate together using the best available evidence when faced with the task of making decisions. The chapter presents an overview of current research that focuses on patient participation, the level to which patients want to be involved in medical decisions, and strategies that assess the measurement of these preferences. While most patients (> 80%) want detailed information and physicians often underestimate this need, some patients clearly indicate a strong preference to participate in decision making. Patients’ preferences for participation can vary depending on factors such as age, gender, experience of illness, and relationship with the physician. At present, only a few psychometrically sound instruments are available to measure patients’ preferences for participation.
Sarah J. Goodlin and James Beattie
- Published in print:
- 2008
- Published Online:
- November 2011
- ISBN:
- 9780198570288
- eISBN:
- 9780191730030
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198570288.003.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter provides an introduction to the concept of supportive care in heart failure (HF). It starts by presenting the concepts of supportive and palliative care. It addresses the delivery of ...
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This chapter provides an introduction to the concept of supportive care in heart failure (HF). It starts by presenting the concepts of supportive and palliative care. It addresses the delivery of supportive care and the framework for supportive care in HF. It is shown that the comprehensive HF care combines evidence-based HF care and supportive care. Further study is important to determine how best to enhance quality of life and reduce the symptoms and burdens associated with HF. While challenges presented by delivery and reimbursement systems may require organized schemes to achieve comprehensive HF care, framing supportive care as integral to comprehensive HF care allows clinicians to better meet the needs of the patient and family now recognized as essential to ‘patient-centered care’.Less
This chapter provides an introduction to the concept of supportive care in heart failure (HF). It starts by presenting the concepts of supportive and palliative care. It addresses the delivery of supportive care and the framework for supportive care in HF. It is shown that the comprehensive HF care combines evidence-based HF care and supportive care. Further study is important to determine how best to enhance quality of life and reduce the symptoms and burdens associated with HF. While challenges presented by delivery and reimbursement systems may require organized schemes to achieve comprehensive HF care, framing supportive care as integral to comprehensive HF care allows clinicians to better meet the needs of the patient and family now recognized as essential to ‘patient-centered care’.
Chris Davies and Ira Byock
- Published in print:
- 2010
- Published Online:
- November 2011
- ISBN:
- 9780199560035
- eISBN:
- 9780191730139
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199560035.003.0011
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter discusses the subject of spiritual care in two distinct and complementary ways and from two different perspectives: Ira Byock views spiritual care from the eyes of an American physician ...
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This chapter discusses the subject of spiritual care in two distinct and complementary ways and from two different perspectives: Ira Byock views spiritual care from the eyes of an American physician and secular academic, while Chris Davies explores spiritual care from the viewpoint of an Anglican priest. Spirituality is one of the inherent characteristics that every human being posesses, and in order to improve spiritual care giving clinicians must aim to have a full understanding of this concept.Less
This chapter discusses the subject of spiritual care in two distinct and complementary ways and from two different perspectives: Ira Byock views spiritual care from the eyes of an American physician and secular academic, while Chris Davies explores spiritual care from the viewpoint of an Anglican priest. Spirituality is one of the inherent characteristics that every human being posesses, and in order to improve spiritual care giving clinicians must aim to have a full understanding of this concept.
