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CONTEXT Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. OBJECTIVE To determine whether an intensive educational program in mindfulness, communication, and self-awareness is(More)
book reviews read this book with avid interest and with future generations of physicians, psychiatrists, and nonpsychiatrists alike in mind. I hope these professionals will be imbued with the same philosophical approach to patient care as is described by the authors. I recommend that every psychiatric educator in America read this book to truly understand(More)
PURPOSE In addition to structural transformations, deeper changes are needed to enhance physicians' sense of meaning and satisfaction with their work and their ability to respond creatively to a dynamically changing practice environment. The purpose of this research was to understand what aspects of a successful continuing education program in mindful(More)
When provided by a skilled, multidisciplinary team, pallia-tive care is highly effective at addressing the physical, psychological, social, and spiritual needs of dying patients and their families. However, some patients who have witnessed harsh death want reassurance that they can escape if their suffering becomes intolerable. In addition, a small(More)
OBJECTIVE The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) End-of-Life Care Consensus Panel was convened in 1997 to identify clinical, ethical, and policy problems in end-of-life care, to analyze critically the available evidence and guidelines, and to offer consensus recommendations on how to improve care of the dying.(More)
OBJECTIVE To determine the pattern and characteristics of palliative care (PC) consultations in patients with stroke and compare them with the characteristics of nonstroke consultations. METHODS The palliative care program at Strong Memorial Hospital (SMH) was established in October 2001. SMH is a 765-bed academic medical center with approximately 38,000(More)
Interdisciplinary palliative care services have been rapidly expanding in health care settings over the past 10 years, particularly through the establishment of interdisciplinary palliative care teams. Relatively few of these teams formally include psychologists, although their skills of enhancing patients' and families' well-being and lessening suffering(More)
Practice Guidelines and Principles: Guidelines and Principles are intended to be flexible. They serve as reference points or recommendations, not rigid criteria. Guidelines and Principles should be followed in most cases, but there is an understanding that, depending on the patient, the setting, the circumstances, or other factors, care can and should be(More)
Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of(More)
M r. J., a 40-year-old father of two young children, has metastatic non–small-cell lung cancer that has not responded to two different chemotherapy regimens. His physician , Dr. B., explains that the cancer is progressing. Mr. J. says, " Isn't there something you can do? Please don't give up on me. " Dr. B. pauses and says, " Well, there is an experimental(More)