"I Had a Lot More Planned": The Existential Dimensions of Prognosis Communication with Adults with Advanced Cancer.
"I Had a Lot More Planned": The Existential Dimensions of Prognosis Communication with Adults with Advanced Cancer.
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“我有更多计划”：与晚期癌症成人进行预后沟通的存在维度。
DOI：
10.1089/jpm.2020.0696
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发表时间：
2021
影响因子：
2.8
通讯作者：
Meghani,SalimahH
中科院分区：
文献类型：
--
作者：
Tarbi,EliseC;Gramling,Robert;Bradway,Christine;Broden,ElizabethG;Meghani,SalimahH
背景：关于预后的沟通是有效姑息治疗的关键要素。当晚期癌症患者对预后的了解增加时，就有可能发生生存困境。然而，预后沟通的存在维度尚未得到充分探索。目的：描述自然发生的姑息治疗对话中预后沟通的存在维度。方法：本研究是一项解释性序贯混合方法设计。我们分析了来自姑息治疗交流研究计划 (PCCRI) 母研究的随机患者子集（n= 34，参与了 45 次姑息治疗对话）。数据基于晚期癌症成人及其家人和姑息治疗临床医生之间录音和转录的住院姑息治疗对话。我们根据预后沟通的水平对研究样本进行分层，并定性地检查了存在性沟通的模式，比较了水平内和跨水平的强度、频率和内容。结果：在预后沟通水平较高的对话中，存在性沟通更常见，强度也更强。具有更多预后沟通的对话似乎表现出向存在主义的转变，而远离了严重疾病经历的更实际的本质。结论：存在主义和预后沟通在姑息治疗对话中密切相关。结果强调了在考虑死亡率时出现的担忧的多样性和相互性，引起人们对值得未来研究的姑息治疗交流领域的关注。
Background:Communication about prognosis is a key ingredient of effective palliative care. When patients with advanced cancer develop increased prognostic understanding, there is potential for existential distress to occur. However, the existential dimensions of prognosis communication are underexplored.Objective:To describe the existential dimensions of prognosis communication in naturally-occurring palliative care conversations.Methods:This study was an explanatory sequential mixed methods design. We analyzed a random subset of patients from the Palliative Care Communication Research Initiative (PCCRI) parent study (n= 34, contributing to 45 palliative care conversations). Data were based on audio-recorded and transcribed inpatient palliative care conversations between adults with advanced cancer, their families, and palliative care clinicians. We stratified the study sample by levels of prognosis communication, and qualitatively examined patterns of existential communication, comparing the intensity, frequency, and content, within and across levels.Results:Existential communication was more common, and of stronger intensity, within conversations with higher levels of prognosis communication. Conversations with more prognosis communication appeared to exhibit a shift toward the existential and away from the more physical nature of the serious illness experience.Conclusion:Existential and prognosis communication are intimately linked within palliative care conversations. Results highlight the multiplicity and mutuality of concerns that arise when contemplating mortality, drawing attention to areas of palliative care communication that warrant future research.
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影响因子：
2.7
作者：
TOMLINSON, A;READY, DF
通讯作者：
READY, DF
影响因子：
11.4
作者：
BOTAS, J;DELPRADO, JM;GARCIABELLIDO, A
通讯作者：
GARCIABELLIDO, A
DOI：
10.1016/s0022-5320(75)80010-4
发表时间：
1975
期刊：
Journal of ultrastructure research
影响因子：
--
作者：
J. Melamed;O. Trujillo
通讯作者：
O. Trujillo
影响因子：
2.7
作者：
READY, DF;HANSON, TE;BENZER, S
通讯作者：
BENZER, S
影响因子：
10.5
作者：
HART, AC;KRAMER, H;ZIPURSKY, SL
通讯作者：
ZIPURSKY, SL