Sudden Advanced Illness: An Emerging Concept Among Palliative Care and Surgical Critical Care Physicians

被引：11
作者：
Barnett, Michael D. [1 ,2 ,3 ]
Williams, Beverly R. [1 ,2 ,4 ]
Tucker, Rodney O. [1 ,2 ]
机构：
[1] Univ Alabama Birmingham, Ctr Palliat & Support Care, 1720 2nd Ave S,CH19 219, Birmingham, AL 35294 USA
[2] Univ Alabama Birmingham, Div Geriatr Gerontol & Palliat Care, Birmingham, AL USA
[3] Univ Alabama Birmingham, Div Gen Pediat & Adolescent Med, Birmingham, AL USA
[4] Birmingham VA Med Ctr, Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, Birmingham, AL USA
来源：
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | 2016年 / 33卷 / 04期
关键词：
critical care; surgery; palliative care; prognostication; decision making; caregiver issues; OF-LIFE CARE; INTENSIVE-CARE; END; TRAUMA; SERVICES; UNIT; PROJECT; MODELS;
D O I：
10.1177/1049909114565108
中图分类号：
R19 [保健组织与事业（卫生事业管理）];
学科分类号：
摘要：
Background: End-of-life discussions in critically-ill patients with acute surgical conditions may be rushed and occur earlier during hospitalization. This study explores the concept of sudden advanced illness (SAI) and its relevance to patients requiring Palliative and Surgical Critical Care. Methods: Semi-structured interviews were completed with 16 physicians, querying each about (1) definitional components, (2) illustrative cases, and (3) comfort with SAI. Analysis was done by grounded theory. Results: SAI was characterized as unforeseen, emerging abruptly and producing devastating injury, often in healthy, younger patients. There is (1) prognostic uncertainty, (2) loss of capacity, and (3) unprepared surrogate decision-making. Cases are emotionally-charged and often personal. Conclusion: The emerging concept of SAI is important for understanding how Palliative Care can enhance care for this subset of patients.
引用
收藏
页码：321 / 326
页数：6
相关论文
共 23 条
  • [1] Adolph Michael D, 2011, Int J Crit Illn Inj Sci, V1, P147, DOI 10.4103/2229-5151.84803
  • [2] American College of Surgeons' Committee on Ethics, 1998, B AM COLL SURG, V83, P46
  • [3] Use of intensive care at the end of life in the United States: An epidemiologic study
    Angus, DC
    Barnato, AE
    Linde-Zwirble, WT
    Weissfeld, LA
    Watson, RS
    Rickert, T
    Rubenfeld, GD
    [J]. CRITICAL CARE MEDICINE, 2004, 32 (03) : 638 - 643
  • [4] Addressing access to palliative care services in the surgical intensive care unit
    Bradley, Ciaran
    Weaver, Jessica
    Brasel, Karen
    [J]. SURGERY, 2010, 147 (06) : 871 - 877
  • [5] Developing guidelines that identify patients who would benefit from palliative care services in the surgical intensive care unit
    Bradley, Ciaran T.
    Brasel, Karen J.
    [J]. CRITICAL CARE MEDICINE, 2009, 37 (03) : 946 - 950
  • [6] Who should manage the dying patient? Rescue, shame, and the surgical ICU dilemma
    Buchman, TG
    Cassell, J
    Ray, SE
    Wax, ML
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2002, 194 (05) : 665 - 673
  • [7] Surgeons, intensivists, and the covenant of care: Administrative models and values affecting care at the end of life - Updated
    Cassell, J
    Buchman, TG
    Streat, S
    Stewart, RM
    [J]. CRITICAL CARE MEDICINE, 2003, 31 (05) : 1551 - 1557
  • [8] End-of-life models and emergency department care
    Chan, GK
    [J]. ACADEMIC EMERGENCY MEDICINE, 2004, 11 (01) : 79 - 86
  • [9] Hospital Variation and Temporal Trends in Palliative and End-of-Life Care in the ICU
    DeCato, Thomas W.
    Engelberg, Ruth A.
    Downey, Lois
    Nielsen, Elizabeth L.
    Treece, Patsy D.
    Back, Anthony L.
    Shannon, Sarah E.
    Kross, Erin K.
    Curtis, J. Randall
    [J]. CRITICAL CARE MEDICINE, 2013, 41 (06) : 1405 - 1411
  • [10] Heron M., 2010, National Vital Statistics Report, V58, P1
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