A5004469825- Palliative Care and End-of-Life Issues
- Grief, Bereavement, and Mental Health
- Patient Dignity and Privacy
- Childhood Cancer Survivors' Quality of Life
- Counseling, Therapy, and Family Dynamics
- Patient-Provider Communication in Healthcare
- Family Support in Illness
- Cancer survivorship and care
- Psychotherapy Techniques and Applications
- Psychosomatic Disorders and Their Treatments
- Empathy and Medical Education
- Healthcare professionals’ stress and burnout
- Attachment and Relationship Dynamics
- COVID-19 and Mental Health
- Child Nutrition and Feeding Issues
- Health and Well-being Studies
- Interdisciplinary Research and Collaboration
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Counseling Practices and Supervision
- Ethics in medical practice
- Emotional Labor in Professions
- COVID-19 and healthcare impacts
- Schizophrenia research and treatment
- Electroconvulsive Therapy Studies
- Family Caregiving in Mental Illness
Stanford University
2019-2024
Massachusetts General Hospital
2017-2021
Palo Alto University
2019-2021
Stanford Medicine
2020-2021
Harvard University
2017-2020
Many patients with serious illness struggle to talk about the possibility of dying; yet basic prognostic awareness is crucial for informed decision making. In this article, we aim help outpatient clinicians working seriously ill ambivalent, uncomfortable, or fearful further discussion future. We describe a dual framework that focuses on living well while acknowledging dying and equips hold both possibilities. This facilitates developmental process as fully possible also preparing dying.
Studies have shown gaps in prognostic understanding among patients with cancer. However, few studies explored patients' perceptions of their treatment goals versus how they perceive oncologist's goals, and the association these views psychological distress.We conducted a cross-sectional study 559 incurable lung, gastrointestinal, breast, brain cancers. The Prognosis Treatment Perception Questionnaire was used to assess reports goal goal, Hospital Anxiety Depression Scale symptoms.We found...
Background: No reliable instruments exist to measure prognostic awareness and its psychological behavioral impacts for patients with advanced cancer. Methods: We developed the Prognostic Awareness Impact Scale (PAIS) using a qualitative approach. During phase 1, we convened working group transdisciplinary team of clinicians from oncology (n = 2), psychology psychiatry 1), palliative care 3), survey development 1) identify key domains PAIS. Using consensus-driven process, generated an item...
Addressing the psychiatric aspects of serious illness in palliative care (PC) is crucial to both delivery and outcomes. Psychiatric comorbidities are common among patients with PC needs can significantly impact their total burden symptomatic distress, overall quality life, functional independence, healthcare utilization. Yet, these often deferred mental health consultant teams context busy services limited human resources. To provide comprehensive person-centered care, clinicians must...
Mental health issues are widespread and significant among individuals with serious illness. Among patients receiving palliative care (PC), psychiatric comorbidities common impact patient quality of life. Despite their prevalence, PC clinicians face challenges in effectively addressing the intricate relationship between medical disorders due to complex, intertwined bidirectionally influential nature. This article, created collaboratively a team psychiatric-palliative experts, is second...
Palliative care has been shown to help patients live well with serious illness, but the specific psychological factors that contribute this benefit remain investigational. Although support of patient coping emerged as a likely factor, it is unclear how palliative helps cope illness. The therapeutic relationship proposed key element in beneficial outcomes, possibly undergirding effective and family coping. Understanding distress our depth requires input varied clinicians thinkers. complex...
Establishing an empathic clinical relationship is a cornerstone of high-quality palliative care. More than simply approaching patients with pleasant affect or "being nice," we propose that skilled clinicians routinely employ distinct psychological elements when creating effective bonds seriously ill and their families. Palliative care involvement has been shown to improve variety outcomes for serious cancer, yet the components this salutary effect are still becoming known in literature. Many...
Palliative care supports referring colleagues in multiples ways. This support to is not often explored the literature, yet psychological concept that best describes it holding environment. The environment relational space palliative offers clinicians for processing emotions and information. Using case of Gloria, a patient living with cancer, this article discusses ways creates her oncologist, Dr. Ko. As clinicians, we create when change dynamic, accompany clinician, recognize challenges,...
Palliative care clinicians provide psychological support throughout their patients' journeys with illness. Throughout our series exploring the elements of palliative (PEPC), we suggested that quality is enhanced when have a deeper understanding experience serious are uniquely poised to offer patients grounded, boundaried, and uplifting relationship chart own course through life-altering or terminal This final installment on PEPC has two aims. First, integrate into comfort-focused hospice...
This is the second article in psychological elements of palliative care (PEPC) series. series focuses on how key concepts from psychotherapy can be used context to improve communication and fine tune interventions. In this article, we introduce two foundational concepts: frame formulation. The which delivered; it includes concrete aspects clinical such as where takes place, for long, with what frequency. It also conceptual care, including specific roles clinician patient, emergency...
Attunement, the process of understanding and responding to another's spoken unspoken needs, is a fundamental concept human development basis meaningful relationships. To specialize attunement for palliative care, this article introduces clinical attunement. This term accounts how care clinicians must repeatedly balance patients' readiness talk about future with cadence illness need medical decision making. Using case Gloria, an example patient living cancer, discusses three skills foster...
Background: Palliative care (PC) clinicians provide mental healthcare to individuals with serious illnesses. Despite this, there is limited knowledge regarding their health training opportunities. Methods: To identify predictors of satisfaction opportunities and assess the relationship between clinician comfort in managing comorbidities, we conducted a secondary analysis nationwide survey involving 708 PC clinicians. Results: Satisfaction was moderate (M = 2.75/5, SD .915). Access...
Psychological symptoms are notably prevalent in palliative care (PC) settings, significantly impacting quality of life for patients and their families. Given the inherent multidimensionality suffering PC, addressing these psychological aspects is essential. This article aims to introduce integrate discrete concepts from various schools psychotherapy, which directly applicable PC practices, thereby providing clinicians with a rich toolkit manage distress. The focuses on 10 key different...
Relationships of care for those facing illness are inherent to the practice medicine. Palliative provides interpersonal space patients and families that helps them face serious dying. We consider therapeutic holding uniquely critical in palliative but see it as applying varied forms throughout Its optimization requires a deep understanding its nature. use theoretical foundations psychodynamic therapy, which uses relationship sole intervention, identify key elements care's holding. draw...