Difficult conversations in medicine:
Gespeichert in:
| Weitere beteiligte Personen: | |
|---|---|
| Format: | Buch |
| Sprache: | Englisch |
| Veröffentlicht: |
Oxford [u.a.]
Oxford Univ. Press
2004
|
| Links: | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=022054811&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| Umfang: | XXII, 231 S. |
| ISBN: | 0198527748 |
Internformat
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| 245 | 1 | 0 | |a Difficult conversations in medicine |c ed. by Elisabeth Macdonald |
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| 300 | |a XXII, 231 S. | ||
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Datensatz im Suchindex
| _version_ | 1819274074203881472 |
|---|---|
| adam_text | Contents
List of Contributors xi
Acknowledgements xiii
Dedications xiv
Preface xv
Introduction xvii
Theo Schofield
1 An introduction to basics 1
Elisabeth Macdonald
Summary I
Why is good communication important? 1
Potential harmful consequences of poor communication 3
References 4
2 Fundamentals of good communication 5
Elisabeth Macdonald
Summary 5
Elements of good communication 5
Conversations in primary care, outpatient clinics and
in hospital 6
Active listening 6
Physical surroundings 8
Linguistics 10
Time management 16
References 19
3 The ethics of communication 20
Michael Parker
Summary 20
Introduction 20
Ethical theory 21
The need for ethical communication 25
Challenges to ethical communication 28
Conclusions 30
References 31
iONTENTS
4 Overall plan of management of difficult conversations 32
Elisabeth Macdonald
Summary 32
Introduction 32
First consultations 32
Subsequent conversations 34
Conclusions 35
5 The patient s perspective 36
Elisabeth Macdonald and Katherine Murphy
Summary 36
Views from the Patient s Association 36
Awareness of the patient s perspective 37
Patient preconceptions 39
Patient preparation for a consultation 41
Barriers to communication 43
References 44
6 The doctor s perspective 46
Elisabeth Macdonald
Summary 46
General perceptions 46
Special circumstances 49
Intensive care: discussions concerning cardiopulmonary
resuscitation 49
Intensive care: withdrawing life support 52
Organ donation 58
Withdrawal of active treatment 6/
The dying patient 62
Advance directives or living wills 62
Breaking bad news 64
Breaking news of unexpected death 69
Multiple bad news 71
Breaking bad news with uncertain prognosis 71
Discussion of medical risks 72
Disclosure of errors 74
References 75
7 Dealing with strong emotions and difficult personalities 77
Peter Maguire and Carolyn Pitceathly
Summary 77
Dealing with strong emotions 77
CONTENTS j vii
Reasons for distancing from strong emotions 78
Problems posed by difficult personalities 79
Techniques for dealing with strong emotions 79
Difficult personality types 82
Conclusions 85
8 Difficult conversations with children and parents 86
Melinda Edwards
Summary 86
Introduction 86
Communicating with the child and family system 87
Communicating complex information to children 92
(living emotive and sensitive information 96
References 98
9 Special adult groups 99
Elisabeth Macdonald
Summary 99
Talking to adolescents 99
Non-compliant adults 102
Talking to the elderly, the hard of hearing and (he
elderly frail /0.?
Barriers to communication with the elderly 104
Talking to the bereaved 106
References 108
10 Difficult practical circumstances 109
Elisabeth Macdonald
Summary 109
Telephone consultations 109
Consultation through an interpreter / /(
Recording consultations on audiotapc /12
Conversations with spouse or partner / /¦/
Collusive relatives 115
References lib
11 Communication in a multiprofessional setting 117
Cathy Heaven
Summary 117
Differences in conversations 117
Working with colleagues 119
Communication within a multiprofessional team 121
CONTENTS
Supporting colleagues 126
Conclusions 127
References 127
12 Communication in a multicultural society 130
Elisabeth Macdonald
Summary 130
General issues 130
Sensitive cultural questions: topics explored 133
Muslim and Arabic speaking families 134
Patients from the Indian subcontinent 137
Jewish patients and their families 141
Jehovah s Witnesses 143
The Afro-Caribbean community 145
Acknowledgements 147
References 147
13 Apologies in clinical medicine 149
Cartnel O Donovan
Summary 149
Introduction 150
Clinical risk management and governance 151
When things go wrong 151
Communication with patients 153
Verbal and listening skills 154
Liability 154
Confidentiality 155
Case studies 156
References 160
14 Legal constraints and guidelines to good practice 161
Liz Martinez
Summary 161
Society s expectations: not just Bristol 161
Dispelling the myth 162
Litigation should be the last resort 163
What do patients want? 164
A brief word about criminal/disciplinary proceedings 166
CONTENTS | ix
Practical recommendations for good communication 167
Finally 170
Summary of the law and practice relating to consent 170
References 172
15 Maintaining a balance 173
Peter Maguire and Carolyn Pitceathly
Summary 173
The demands of medicine 173
Common pitfalls and solutions 174
Conclusions 176
Postscript: Practical tips for junior doctors on maintaining a balance
(by Catherine Hood and Elisabeth Macdonald) 177
16 Conclusions and future directions ]78
Elisabeth Macdonald
Summary 178
The influence of computer technology on the doctor-patient
relationship 178
Internet support groups 179
Future relationships 180
References 180
Useful internet addresses 181
Appendix I. Transcripts of useful illustrative conversations 182
Catherine Hood and Elisabeth Macdonald
Summary 182
Conversation 1: handling the angry patient (enacted) 183
Conversation 2: a conversation concerning the relapse of
cancer (enacted) 192
Conversation 3: cardiopulmonary resuscitation (CPR)
(representative conversation) 193
Conversation 4: sex and sexuality; taking a history (enacted) 196
Conversation 5: raising issues of sex in hospital; acute abdominal
pain (enacted) 200
Conversation 6: conversation concerning unexpected
death (enacted) 204
Conversation 7: handling a difference of opinion over treatment; doctor s
unwillingness to treat (representative conversation) 207
References 208
ONTENTS
Appendix II. A curriculum for communication in medical
education 209
Theo Schofield, on behalf of the steering committee of the RSM Forum on
Communication in Healthcare
Background 209
Methods 210
Underlying philosophy 211
The role of a junior hospital doctor 212
Core competences 213
Approaches to learning 216
Approaches to assessment 217
Conclusions 218
Acknowledgements 218
References 220
Index 223
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| indexdate | 2024-12-20T15:05:47Z |
| institution | BVB |
| isbn | 0198527748 |
| language | English |
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| spellingShingle | Difficult conversations in medicine |
| title | Difficult conversations in medicine |
| title_auth | Difficult conversations in medicine |
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| title_short | Difficult conversations in medicine |
| title_sort | difficult conversations in medicine |
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