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Table of Contents
Intro
Preface
Contents
Part ICommunication and Cultural Competency in End of Life Care
1 Redefining Cultural Competency: Practicing Cultural Humility
1.1 Introduction
1.2 Historical Context for Cultural Humility as a Core Element in Healthcare
1.3 Cultural Humility and Behavior
1.4 The Practice of Cultural Humility and Self-awareness
1.5 The Practice of Cultural Humility and Self-reflection
1.6 Cultural Challenges in Ethnic Minority End-Of-Life Care
1.7 Building Cultural Confidence: Get Comfortable with Being Uncomfortable
1.8 Implications of COVID-19 in Practicing Cultural Humility at End-Of-Life Care
1.8.1 Reflection
1.8.2 Case Scenario
1.9 Conclusion
References
2 Cultural Competency Models at the End of Life
2.1 Introduction
2.2 The Sunshine Model
2.3 Transcultural Assessment Model-Giger and Davidhizar
2.4 Model for Cultural Competence-Purnell
2.5 The Process of Cultural Competence in the Delivery of Healthcare Services
A Model of Care
2.6 Culturally Competent Care Model-Kim Godwin
2.7 Summary
References
3 A Mindset for Communication for End of Life Care
3.1 Blueprint for Intuitive Communication
3.2 Self-Reflection for Providers to Maintain Whole Open Connection
3.3 Awareness for Practitioners
3.4 Communication to Patients
3.5 Awareness of Presence
3.6 Intentions
3.7 Model of Establishing a Blueprint for Open Connection as a Field of Resonance
4 Discussing Difficult News: Reframing Patient and Family Preferences Surrounding the Content and Style of Communication
4.1 Scope of the Issue
4.2 Established Protocols for Discussing Difficult News
4.3 Difficult News is in the Eye of the Beholder: Discordance Between Clinical Teams and Patients and Families
4.4 Patients, Families, and Providers Have Differing Preferences Surrounding Discussing Difficult News
4.4.1 Patient, Family, and Provider Perceptions Influence Communication
4.4.2 Impact of Communication Style on Patient and Family Experience
4.5 Moving Beyond Existing Protocols-Some Actionable Steps
4.5.1 Don't Assume that the Information Shared is "Bad News"
4.5.2 Re-assess, Even if You Know the Patient Well
4.6 Conclusions
References
5 Demystifying Prognosis
5.1 Introduction
5.2 The History of Prognosis: Understanding the Past and Looking to the Future
5.3 What and Why We Prognosticate
5.4 Conceptualizing Prognostication
5.5 The Science of Formulating Prognosis
5.5.1 Clinical Judgement
5.5.2 Actuarial Judgement
5.5.3 Performance Status
5.5.4 The Karnofsky Performance Scale
5.5.5 Palliative Performance Scale
5.5.6 Eastern Cooperative Oncology Groupe Scale
5.5.7 Symptoms, Clinical Findings, and Biomarkers
5.5.8 Prognostic Tools
5.5.9 Cancer
5.5.10 Heart Failure
Preface
Contents
Part ICommunication and Cultural Competency in End of Life Care
1 Redefining Cultural Competency: Practicing Cultural Humility
1.1 Introduction
1.2 Historical Context for Cultural Humility as a Core Element in Healthcare
1.3 Cultural Humility and Behavior
1.4 The Practice of Cultural Humility and Self-awareness
1.5 The Practice of Cultural Humility and Self-reflection
1.6 Cultural Challenges in Ethnic Minority End-Of-Life Care
1.7 Building Cultural Confidence: Get Comfortable with Being Uncomfortable
1.8 Implications of COVID-19 in Practicing Cultural Humility at End-Of-Life Care
1.8.1 Reflection
1.8.2 Case Scenario
1.9 Conclusion
References
2 Cultural Competency Models at the End of Life
2.1 Introduction
2.2 The Sunshine Model
2.3 Transcultural Assessment Model-Giger and Davidhizar
2.4 Model for Cultural Competence-Purnell
2.5 The Process of Cultural Competence in the Delivery of Healthcare Services
A Model of Care
2.6 Culturally Competent Care Model-Kim Godwin
2.7 Summary
References
3 A Mindset for Communication for End of Life Care
3.1 Blueprint for Intuitive Communication
3.2 Self-Reflection for Providers to Maintain Whole Open Connection
3.3 Awareness for Practitioners
3.4 Communication to Patients
3.5 Awareness of Presence
3.6 Intentions
3.7 Model of Establishing a Blueprint for Open Connection as a Field of Resonance
4 Discussing Difficult News: Reframing Patient and Family Preferences Surrounding the Content and Style of Communication
4.1 Scope of the Issue
4.2 Established Protocols for Discussing Difficult News
4.3 Difficult News is in the Eye of the Beholder: Discordance Between Clinical Teams and Patients and Families
4.4 Patients, Families, and Providers Have Differing Preferences Surrounding Discussing Difficult News
4.4.1 Patient, Family, and Provider Perceptions Influence Communication
4.4.2 Impact of Communication Style on Patient and Family Experience
4.5 Moving Beyond Existing Protocols-Some Actionable Steps
4.5.1 Don't Assume that the Information Shared is "Bad News"
4.5.2 Re-assess, Even if You Know the Patient Well
4.6 Conclusions
References
5 Demystifying Prognosis
5.1 Introduction
5.2 The History of Prognosis: Understanding the Past and Looking to the Future
5.3 What and Why We Prognosticate
5.4 Conceptualizing Prognostication
5.5 The Science of Formulating Prognosis
5.5.1 Clinical Judgement
5.5.2 Actuarial Judgement
5.5.3 Performance Status
5.5.4 The Karnofsky Performance Scale
5.5.5 Palliative Performance Scale
5.5.6 Eastern Cooperative Oncology Groupe Scale
5.5.7 Symptoms, Clinical Findings, and Biomarkers
5.5.8 Prognostic Tools
5.5.9 Cancer
5.5.10 Heart Failure