Prognostication Accuracy, Confidence, and Decisional Conflict Across Training Levels of Internal Medicine Providers.
J Palliat Care
; 35(4): 226-231, 2020 Oct.
Article
em En
| MEDLINE
| ID: mdl-31405315
ABSTRACT
CONTEXT Providing patient care at the end of a patient's life is a humbling and sacred experience for both patient and provider. Without a truthful and meaningful conversation about end-of-life care preferences, the care that is delivered may not be the care that the patient prefers. OBJECTIVES:
Determine if there is a relationship between level of training, confidence, and presence of decisional conflict in making an accurate prognosis for 2 standardized cases. Additionally, we evaluated the correctness of the prognosis as measured against survival outcomes for patients with similar diagnoses.METHODS:
Decisional conflict was measured with the SURE tool, a validated 4-item tool that has been used in assessing for the presence of decisional conflict.RESULTS:
Following analysis of data, it was found that providers with no decisional conflict were much more likely to be attendings with more than 5 years' experience. Providers were more conflicted overall when confronted with a case with a more grave prognosis. It was determined that providers with a lower level of training were more likely to have decisional conflict.CONCLUSIONS:
Provider confidence increases and decisional conflict decreases as one increases their level of training. However, the degree in which the provider is correct in their prognosis does not change as one increases their level of training. These findings have broad implications on patients, providers, and the health-care system.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Conflito Psicológico
/
Tomada de Decisões
/
Medicina Interna
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Palliat Care
Ano de publicação:
2020
Tipo de documento:
Article