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192 records · Page 11Linked to original sources
PubMed1998

The author of Roe.

Explore the source record for details and available documents.

Abortion, Induced↗
PubMed1991

Teaching intubation skills using newly deceased infants.

This prospective study was designed to (1) test the hypothesis that the majority of families of newly dead infants in a tertiary neonatal intensive care unit would consent to their infants' being intubated for teaching purposes, (2) determine factors related to family consent, and (3) determine the effects of participation on resident physicians and respiratory therapists. Family consent for intubation was requested following 44 (80%) of the 55 deaths that occurred during the 10-month study period. Of these requests, 32 (73%) were granted. Proportionately more white than black families consented and consent was positively related to autopsy permission. Fifty-three (75%) of 71 trainees completed a mailed questionnaire after their first intubation experience. Although each respondent found the experience helpful, many reported mixed feelings categorized as doubt about participating, apprehension and discomfort, respect for the body, appreciation for the opportunity, a sense of achievement, and feelings of comfort knowing that consent had been obtained. These findings confirm our initial hypothesis and suggest that (1) newly dead infants can be a valuable resource for teaching intubation skills, and (2) others considering a similar approach need to be aware of and sensitive to trainees' feelings.

Adolescent↗
PubMedDate not supplied

Elderly outpatients respond favorably to a physician-initiated advance directive discussion.

BACKGROUND: Little is known about the emotional impact of physician-initiated advance directive discussions. METHODS: One hundred ambulatory patients aged 65 years and older were randomly assigned to receive either a physician-initiated discussion of advance directive choices of a discussion of health promotion issues. Prediscussion, immediate postdiscussion, and 1-week postdiscussion measures of positive and negative affect were measured for both groups. RESULTS: Neither discussion topic resulted in adverse emotional or attitudinal responses. Only the advance directive participants showed positive affective and attitudinal responses to the discussion, including an increase in positive affect, an increased sense of physician-patient understanding, and increased thought and discussion about life-support issues in the week following the discussion. For those participants receiving the advance directive discussion, longer physician-patient relationships and higher educational levels significantly predicted a more positive affective response. Lower scores on indices of mental and physical health and a stronger belief that physicians should discuss advance directive issues significantly predicted a more negative affective response to the advance directive discussion. CONCLUSIONS: Physicians should anticipate positive emotional responses when they initiate advance directive discussions with their elderly outpatients. Advance directive discussions will be received most positively by patients who enjoy good psychological and physical health and when initiated in the context of an established physician-patient relationship.

Advance Directives↗
PubMed1993

Physicians' predictions of elderly outpatients' preferences for life-sustaining treatment.

BACKGROUND: Research has shown that physicians are poor predictors of patients' life-sustaining treatment preferences. Our study examined the association between three aspects of physician experience and their ability to accurately predict patients' preferences for two different life-sustaining treatments in the event of two serious medical conditions. METHODS: Seventeen physicians predicted the treatment preferences of 57 patients and then interviewed patients regarding their actual treatment preferences. Physicians' professional experience, length of their relationship with the patient, and experience with direct feedback were measured to determine the association of these factors with the accuracy of the physicians' predictions. RESULTS: Physicians became more accurate predictors as they interviewed more patients and received direct feedback regarding the accuracy of their predictions (P < .001). Residents were more accurate than faculty in predicting patients' preferences (P < .05). CONCLUSIONS: Increased experience with life-sustaining treatment discussions improved the physicians' abilities to accurately predict patient preferences. Although possibly resulting from small sample size, neither greater professional experience nor longer relationship with a patient improved the accuracy of physicians' predictions. Future research should examine whether discussing end-of-life issues with patients more often makes physicians more sensitive predictors of patients' life-sustaining treatment preferences.

Aged↗