Advanced communication: A critical component of high quality gynecologic cancer care: A Society of Gynecologic Oncology evidence based review and guide

被引:19
|
作者
Littell, Ramey D. [1 ]
Kumar, Amanika [2 ]
Einstein, M. Heather [3 ]
Karam, Amer [4 ]
Bevis, Kerri [5 ]
机构
[1] Kaiser Permanente Northern Calif Gynecol Canc Pro, San Francisco, CA USA
[2] Mayo Clin, Rochester, MN USA
[3] Univ Connecticut, Sch Med, Hlth Ctr, Hartford, CT 06112 USA
[4] Stanford Univ, Palo Alto, CA 94304 USA
[5] Univ Alabama Birmingham, Birmingham, AL 35294 USA
关键词
Advanced communication; Communication skills; Serious illness; Palliative care; Delivering bad news; Goals of care; Empathy; END-OF-LIFE; TERMINALLY-ILL PATIENTS; DISCUSSING PROGNOSIS; OVARIAN-CANCER; MENTAL-HEALTH; MEDICAL-CARE; NEAR-DEATH; BAD-NEWS; STRESS; PHYSICIANS;
D O I
10.1016/j.ygyno.2019.07.026
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Effective communication between gynecologic oncology providers and patients is vital to patient-centered care. Skilled communication improves the patient's knowledge retention, builds trust in providers, enhances shared decision-making, and alleviates anxiety of both patients and caregivers. Effective communication is also associated with reduced provider burnout due to improved comfort from possessing the skills to handle emotionally charged situations. Therefore, training in serious illness communication skills is critically important to gynecologic oncology practice and benefits patients, providers, and the healthcare system. Like surgical skills, communication skills can be learned and improved upon, particularly by making use of communication skills courses and other resources. While the purpose of each conversation will vary based on the medical setting, most communication roadmaps incorporate four basic components: 1) Assess patient knowledge and understanding, 2) inform patient in accordance with her communication preferences, 3) recognize and respond to emotion 4) elicit patient values, and create a plan that aligns with those values. Improved patient outcomes associated with addressing patient emotions underscore a critical need to recognize and address emotional cues during difficult conversations. We present strategies for delivering serious news, and for discussing prognosis and goals of care. In each strategy, we highlight skills for recognizing and responding to patient and family emotional cues. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码:161 / 169
页数:9
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