Communication as Comfort: Multiple Voices in Palliative Care

by Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, Sandra Sanchez Reilly

Overview

This exceptional work explores the complexities of communication at one of the most critical stages of the life experience—during advanced, serious illness and at the end of life. Challenging the predominantly biomedical model that informs much communication between seriously ill and/or dying patients and their physicians, caregivers, and families, Sandra L. Ragan, Elaine M. Wittenberg-Lyles, Joy Goldsmith, and Sandra Sanchez-Reilly pose palliative care—medical care designed to comfort rather than to cure patients—as an antidote to the experience of most Americans at the most vulnerable juncture of their lives.

With an author team comprised of three health communication scholars and one physician certified in geriatrics and palliative medicine, this volume integrates the medical literature on palliative care with that of health communication researchers who advocate a biopsychosocial approach to health care. Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients’ suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.

Product Details

ISBN-13:	9780805858099
Publisher:	Taylor & Francis
Publication date:	03/13/2008
Series:	Routledge Communication Series
Edition description:	New Edition
Pages:	184
Product dimensions:	6.00(w) x 9.00(h) x (d)

About the Author

Sandra Ragan (Ph.D. University of Texas at Austin) is Professor Emerita of communication at the University of Oklahoma. She has been studying communication and palliative care/end-of-life issues for many years, and has contributed to numerous volumes on the topic, including several in the LEA list. Elaine Wittenberg-Lyles (Ph.D. University of Oklahoma) is an assistant professor at the University of North Texas, and Joy Goldsmith (Ph.D. University of Oklahoma) is an assistant professor at Young Harris College in Georgia. Sandra Sanchez-Reilly (M.D., Colegio Mayor de Nuestra Señora del Rosario, Colombia) is an assistant professor of Geriatrics and Palliative Care and the director of the Palliative Care program at the University of Texas Health Science Center and the South Texas Veterans Health Care System in San Antonio, Texas.

Table of Contents

Chapter One The American Way of Death: Dying in Silence Western Medicine and the Ignoring of Human Suffering Theoretical Approaches to Palliative Care Communication Social construction of health and illness Dialectical theory Uncertainty management theory Problematic integration theory Performance and dramaturgical theories Narrative theory Chapter Two A brief history of Hospice and Palliative Medicine What is Palliative Care? Specific features of palliative care A rationale for palliative care The vital role of communication in palliative care Chapter Three – The Patient’s Perspective Re/Considering Illness Narrative(s) Diagnosis, Recurrence, Prognosis Wresting Physician Communication Decision-making and Quality of Life To Pursue Curative or Palliative Treatments Online support groups Dealing with Doctors: A Lack of Control Patient’s Body and Its Interpreter Patient Communication in the SPIKES Strategy Pain Reciprocal Suffering: Anxiety over Family Burden Conclusion Chapter Four - The Medical Perspective Overview – the Medical Backdrop Medical disclosure, decision-making, and information exchange between doctors and patients Medical Prognosis Research findings on breaking bad news Challenges to the practice of palliative care: medical socialization, emotional, turmoil, stress and burnout How one physician practices palliative care communication: Analysis of case studies Chapter Five - The Family/Caregiver Perspective Reception of a Diagnosis/Prognosis Sharing decisions and collaborating about treatment Communication with Physician Locating or reframing hope Reciprocal suffering: Caregiver burden and anxiety Quality of life Stressors of caregiving Pain management Mental and physical labor Financial concerns/burdens Family conflict and palliative care Family communication/meetings The death event Satisfaction with care and communication with staff at death Bereavement and displacement Chapter Six – The Health Care Team’s Perspective Chaplaincy Psychology Social Work Nurse Communication Challenges Chapter Seven – The Authors’ Voices

Editorial Reviews

'This book's various perspectives make it a useful resource for health care providers, patients, caregivers, family members, and students pursuing health professions or studying communications, especially those seeking to enhance their sensitivity when dealing with seriously ill patients... Summing Up: Recommended.' - CHOICE

'Applying communication theories and insights to illuminate problems and to explain their complexities, the authors advocate a patient-centered approach to care that recognizes and seeks to lessen patients'suffering and the many types of pain they may experience (physical, psychological, social, and spiritual) during life-threatening illness.' Counselling Magazine

'This book's various perspectives make it a useful resource for health care providers, patients, caregivers, family members, and students pursuing health professions or studying communications, especially those seeking to enhance their sensitivity when dealing with seriously ill patients... Recommended.' - CHOICE

From the Publisher