Baran Caitlin N, Sanders Justin J
Division of Geriatrics and Palliative Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, LW670, Boston, MA 02215, USA.
Prim Care. 2019 Sep;46(3):353-372. doi: 10.1016/j.pop.2019.05.003. Epub 2019 Jun 10.
Primary care clinicians face difficult conversations with patients across the life cycle. As clinicians care for patients in different health states, the focus of these challenging conversations shifts. Even the most skilled clinicians struggle to find the right words at the right time in these scenarios. This article focuses on communication skills to make difficult conversations easier, whether through assigning a health care proxy, breaking bad news, having conversations about serious illness, or leading a family meeting to discuss goals of care.
初级保健临床医生在患者的整个生命周期中都面临着与患者进行艰难对话的情况。随着临床医生照顾处于不同健康状态的患者，这些具有挑战性的对话重点也会发生变化。即使是最熟练的临床医生在这些情况下也难以在合适的时间找到合适的话语。本文重点介绍沟通技巧，以使艰难对话更轻松，无论是通过指定医疗保健代理人、告知坏消息、进行关于重病的对话，还是主持家庭会议来讨论护理目标。
