Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, JF 805D, Boston, MA 02215, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02215, USA.
Harvard Medical School, 25 Shattuck Street, Boston, MA 02215, USA; Adult Palliative Care, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, JF 821, Boston, MA 02215, USA; Serious Illness Care Program, Ariadne Labs, 401 Park Drive, 3rd floor, Boston, MA 02215, USA. Electronic address: https://twitter.com/rbernack.
Med Clin North Am. 2020 May;104(3):375-389. doi: 10.1016/j.mcna.2019.12.001.
Clinicians working with seriously ill patients need the skills to effectively communicate with patients and their families throughout the trajectory of illness. Common communication tasks that arise in the care of seriously ill patients include advance care planning, delivering serious news, discussing prognosis, eliciting values, and medical decision making. Clinicians often use goals of care conversations to facilitate these tasks. Similar to other procedures, goals of care conversations require a systematic, evidence-based approach to ensure quality and value. This article provides a framework that clinicians can follow to effectively communicate with seriously ill patients and families and promote patient-centered care.
临床医生在治疗重病患者时需要掌握与患者及其家属进行有效沟通的技能，贯穿整个疾病过程。在重病患者的护理中常见的沟通任务包括预先医疗照护计划、传达坏消息、讨论预后、了解价值观和医疗决策。临床医生通常使用目标关怀对话来促进这些任务的完成。与其他程序类似，目标关怀对话需要系统的、基于证据的方法，以确保质量和价值。本文提供了一个框架，临床医生可以遵循该框架与重病患者及其家属进行有效沟通，并促进以患者为中心的护理。
