Practicum UCSF: Advance in Palliative care confernce

ช่วงอยู่ที่ UCSF นั้น ฉันค่อนข้างเวิ่นเว้อ กับอะไรหลายอย่าง ทั้งเรื่องงาน เรื่องกินอยู่ เลยไม่ได้เขียนลงใน blog อย่างสม่ำเสมอ มีเพียงบันทึกใน note pad สำหรับส่ง progress ถึง Practicum advisor ( คือ Dr.Meera Agar)..

The 37 th Annual Advances in Internal Medicine 2009 helded on 23th June 2009.This course is CME project which does not recieve support from the pharmaceutical company.
Topic:There are many topics (explore here)
I attend only topic 'Advance in palliative care' by Dr.Steven Pantilat

Content:
1.Spectrum of palliative care
- Palliate of symptom
- communication of illness
- psychosocial support
2. Update in palliate symptom
- Methylnaltrexone for Opioid-Induced Constipation in Advanced Illness
Rubiales A. S et al. NEJM 2008; 359:1070-1071
3. Update in communication skill
- VALUE end of life conference lower 90 day after death
breavment and distress symptom of family members.
A. Lautrette et al.NEJM 2007;356:469-478
Note:mnemonic VALUE come from
Value and appreciate what the family members said
Acknowledge the family member's emotion
Listen
Understand who the patient was a person
Elicit questions from the family members

- End of life discussion lower rate of invasive intervention and higher caregiver quality of life
6 month afterdeath
A. A. Wright.Associations Between End-of-Life Discussions,PatientMental Health,Medical Care Near Death, and Caregiver Bereavement Adjustment.JAMA. 2008;300:1665-1673

- Prognosis discussion: made at least one statement of pessimism, patients were more likely to agree with their prognosis.
Robinson et al.Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis.Support Care Cancer.2008;16:1049–1057
Note:false hope is no hope
It is nessesary to give realistic information to patients because they may be influenced
by TV eg. Resuscitation successful rate in ER series is about 76% (have study!) while in real life is about 12%

Teaching skill learning point:
- Engage audience to pay attention with humor sense story 'make it relax'
- Well organized topic and concise content 'make it easy'
style: Introduction topic
focus only new/interesting points - more detail read ref.
Last slide wrap up or take home mass
This style is appropriate for update or CME event because the audience will not burden
with informations.They could get idea and explore more from reference.
- Giving evidence support esp.communication skill issue 'make it in magic number'

เขียนใน GotoKnow โดย ป.
ใน Live for lives

คำสำคัญ (Tags): #advance in palliative care#ucsf

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