Asunto(s)
Malformaciones Arteriovenosas/terapia , Embolización Terapéutica , Mola Hidatiforme/secundario , Neoplasias Pulmonares/secundario , Nódulos Pulmonares Múltiples/secundario , Arteria Pulmonar , Venas Pulmonares , Neoplasias Uterinas/patología , Adolescente , Malformaciones Arteriovenosas/diagnóstico por imagen , Malformaciones Arteriovenosas/etiología , Femenino , Humanos , Mola Hidatiforme/complicaciones , Mola Hidatiforme/diagnóstico por imagen , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/diagnóstico por imagen , Nódulos Pulmonares Múltiples/complicaciones , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Embarazo , Arteria Pulmonar/diagnóstico por imagen , Venas Pulmonares/diagnóstico por imagen , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess the feasibility of a team-based prognosis and treatment goal discussion for women living with advanced breast cancer. METHODS: Female patients diagnosed with advanced breast cancer (n = 25) participated in a mixed methods study that evaluated the feasibility and effects of a planned and structured prognosis discussion. Audio analysis of the intervention appointments was conducted to assess intervention feasibility. Patient self-reports of prognosis related beliefs and treatment preferences were compared across intervention and usual care groups. RESULTS: Most patients found the T-PAT appointment challenging but worthwhile. Intervention uptake by clinicians was good, but some fidelity disruptions were noted. T-PAT participants were more likely to hold realistic beliefs about disease curability after the appointment. CONCLUSION: Productive prognosis discussions can be delivered effectively by a practice-based clinical team within a semi-structured patient education appointment. It was perceived by patients with advanced breast cancer as both valuable and acceptable. T-PAT clinicians found the intervention easy to deliver. PRACTICE IMPLICATIONS: Regular implementation of T-PAT may help clinicians' build prognosis discussion communication skills. T-PAT documentation provides valuable information that can be used to tailor ongoing care.
Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Comunicación en Salud , Grupo de Atención al Paciente , Relaciones Profesional-Paciente , Planificación Anticipada de Atención , Estudios de Factibilidad , Femenino , Objetivos , Humanos , Persona de Mediana Edad , PronósticoRESUMEN
By examining mental illness through the lens of intimate firsthand accounts of caregivers and patients, including caregiver blogposts and a conversation between Liza Long and her son as recorded by StoryCorps, we demonstrate how new media can be leveraged to shift societal perceptions of those with mental illness from blameworthy potential perpetrators of terror to vulnerable persons in need of compassion and support. Exploring patient, caregiver, and societal roles through a close reading of new media firsthand accounts, we argue for shared responsibility in caring for those with mental illness and, in particular, for physicians to leverage their unique knowledge of the patient experience by promoting media coverage of stories of mental illness recovery.