Empathy and Life Support Decisions in Intensive Care Units
Journal of General Internal MedicinePublished 23 June 2008Open access
R. Brac Selph, Julia Shiang, Ruth A. Engelberg, J. Randall Curtis, Douglas B. White
Citations153
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TL;DR
Physicians vary considerably in the extent to which they express empathy to surrogates during deliberations about life support, with no empathic statements in one-third of conferences, and there is an association between more empathic Statements by clinicians and higher family satisfaction with communication.
Abstract
Physicians vary considerably in the extent to which they express empathy to surrogates during deliberations about life support, with no empathic statements in one-third of conferences. There is an association between more empathic statements and higher family satisfaction with communication.
Keywords
MedicineHealth Professions
Sage eBooksBasics of qualitative research : techniques and procedures for developing grounded theory
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PubMedEnhancing the quality and credibility of qualitative analysis.
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Annals of Internal MedicineClinical Epidemiology: A Basic Science for Clinical Medicine.
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JAMAVariation of Mood and Empathy During Internship
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American Psychological Association eBooksEmpathy reconsidered: New directions in psychotherapy.
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