基本説明
Explores communication at the end of life, with a 'biopsychosocial' approach to health care.
Full Description
This exceptional work explores the complexities of communication at one of the most critical stages of the life experience--during advanced, serious illness and at the end of life. Challenging the predominantly biomedical model that informs much communication between seriously ill and/or dying patients and their physicians, caregivers, and families, Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, and Sandra Sanchez-Reilly pose palliative care--medical care designed to comfort rather than to cure patients--as an antidote to the experience of most Americans at the most vulnerable juncture of their lives.
With an author team comprised of three health communication scholars and one physician certified in geriatrics and palliative medicine, this volume integrates the medical literature on palliative care with that of health communication researchers who advocate a biopsychosocial approach to health care. Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients' suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.
Contents
Chapter One The American Way of Death: Dying in Silence Western Medicine and the Ignoring of Human Suffering Theoretical Approaches to Palliative Care Communication Social construction of health and illness Dialectical theory Uncertainty management theory Problematic integration theory Performance and dramaturgical theories Narrative theory Chapter Two A brief history of Hospice and Palliative Medicine What is Palliative Care? Specific features of palliative care A rationale for palliative care The vital role of communication in palliative care Chapter Three - The Patient's Perspective Re/Considering Illness Narrative(s) Diagnosis, Recurrence, Prognosis Wresting Physician Communication Decision-making and Quality of Life To Pursue Curative or Palliative Treatments Online support groups Dealing with Doctors: A Lack of Control Patient's Body and Its Interpreter Patient Communication in the SPIKES Strategy Pain Reciprocal Suffering: Anxiety over Family Burden Conclusion Chapter Four - The Medical Perspective Overview - the Medical Backdrop Medical disclosure, decision-making, and information exchange between doctors and patients Medical Prognosis Research findings on breaking bad news Challenges to the practice of palliative care: medical socialization, emotional, turmoil, stress and burnout How one physician practices palliative care communication: Analysis of case studies Chapter Five - The Family/Caregiver Perspective Reception of a Diagnosis/Prognosis Sharing decisions and collaborating about treatment Communication with Physician Locating or reframing hope Reciprocal suffering: Caregiver burden and anxiety Quality of life Stressors of caregiving Pain management Mental and physical labor Financial concerns/burdens Family conflict and palliative care Family communication/meetings The death event Satisfaction with care and communication with staff at death Bereavement and displacement Chapter Six - The Health Care Team's Perspective Chaplaincy Psychology Social Work Nurse Communication Challenges Chapter Seven - The Authors' Voices
