The Permanente journal
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The Permanente journal · Jan 2013
Nonbeneficial treatment and conflict resolution: building consensus.
We established a fair and explicit nonbeneficial treatment and conflict resolution policy at our medical center. The policy was designed to help us acknowledge and respect both patients and clinicians involved in treatment planning and decision making. ⋯ A fair and explicit nonbeneficial treatment and conflict resolution policy can result in a high level of consensus between patients/surrogates and the treatment teams responsible for their care when treatment is withheld or withdrawn.
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The Permanente journal · Jan 2013
Inpatient palliative care consultation: describing patient satisfaction.
This study identified and measured common patterns of patients' positive care experiences during inpatient palliative consultation, and helped better understand how the journey of discovery experienced by both patients and life-care consult teams can be used to improve the quality of care. ⋯ We were encouraged by our findings: the feedback from patients and families showed us we were effective, from their perspective, in helping them shape their treatment journey. It also emphasized where we could have been even more effective in improving our communication.
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The Permanente journal · Jan 2013
Effects and linguistic analysis of written traumatic emotional disclosure in an eating-disordered population.
In previous studies, writing about traumatic life events produced positive physical and psychological outcomes in various populations. Specific linguistic trends, such as increasing insight and cognitive words, have paralleled health benefits. ⋯ Whereas the expected linguistic trends were evident in the disclosure group writings, no correlating health benefits could be found between the disclosure and control groups. Eating-disordered populations, often alexithymic, may have difficulty engaging with the disclosure task and could potentially benefit from guidance in processing traumatic events and their affective states.
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The Permanente journal · Jan 2013
Case ReportsPropofol-related infusion syndrome: role of propofol in medical complications of sedated critical care patients.
Propofol is a popular anesthetic and sedative. Use of propofol has increased manifold in this country over the last decade, and it is most commonly used in intensive care settings. Its rapid action with short half-life, decreased cerebral oxygen consumption, and reduction of intracranial pressure are properties that have made it a favorite in the intensive care unit. Many of these patients are critically ill or injured and require prolonged sedation. Propofol has been associated with morbidity and mortality, and in such cases the question often arises regarding the role propofol plays in these complications. ⋯ It is hoped that this short report will bring more awareness of this entity so that it will be considered in the differential diagnosis in sedated critical care patients.
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The Permanente journal · Jan 2013
From the patient's perspective: is there a need to improve the quality of informed consent for surgery in training hospitals?
This study was performed to evaluate the presurgical informed consent process at a training hospital in Jamaica. ⋯ The current informed consent process in use in the surgical training program at the University Hospital of the West Indies requires improvement to meet expected ethical and legal standards.