BORA - UiB

Bergen Open Research Archive

‘‘So you think I’ll survive?’’: a qualitative study about doctor-patient dialogues preceding high-risk cardiac surgery or intervention

Bergen Open Research Archive

Show simple item record

dc.contributor.author Schaufel, Margrethe Aase eng
dc.contributor.author Nordrehaug, Jan Erik eng
dc.contributor.author Malterud, Kirsti eng
dc.date.accessioned 2011-07-28T12:18:37Z
dc.date.available 2011-07-28T12:18:37Z
dc.date.issued 2009 eng
dc.identifier.citation Heart 95(15): 1245-1249 en_US
dc.identifier.issn 1355-6037 eng
dc.identifier.uri http://hdl.handle.net/1956/4858
dc.description.abstract Objective: To explore doctor-patient interactions and decision-making processes before high-risk cardiac surgery or intervention with special attention to existential challenges. Design, setting and participants: We conducted a qualitative study with data drawn from doctor-patient dialogues preceding high-risk procedures. The study setting was the cardiac department of a university hospital with 24-hour emergency service. We recruited a purposive sample of 10 patients and eight doctors. The patients were categorised as high-risk patients in accordance with EuroSCORE and established angiographic procedural high-risk criteria. Transcripts from the dialogues were analysed with systematic text condensation, inspired by discourse analysis. Main outcome measure: Accounts of doctor-patient interaction reflecting existential aspects of the decisionmaking process. Results: The main existential concerns identified in the doctor-patient interactions were surviving uncertainty, negotiating responsibility and trusting the doctor’s proficiency. When handling uncertainty, doctors imparted complex information about risk, warnings and recommendations, while patients sought and trusted the doctors’ advice. Though the decisions were made in asymmetrical power relations, they were based on a shared responsibility discussed and defined throughout the dialogues. The patients expressed a profound confidence in the doctor’s ability to get them through the high-risk treatment and give the best help possible. Conclusions: Uncertainty, mortality, responsibility and trust are fundamental existential issues concerning both patients and doctors before high-risk procedures, with an impact on decision-making processes. Increasing focus on underlying existential conditions, ethical reasoning and power relations in medical education may improve the quality of shared decision-making and informed consent related to high-risk treatment. en_US
dc.language.iso eng eng
dc.publisher BMJ Publishing Group eng
dc.title ‘‘So you think I’ll survive?’’: a qualitative study about doctor-patient dialogues preceding high-risk cardiac surgery or intervention eng
dc.type Journal article eng
dc.type Peer reviewed eng
dc.subject.nsi VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 eng
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800::Medical/dental ethics, behavioural sciences, history: 805 eng
dc.rights.holder Copyright 2009 BMJ Publishing Group Ltd and the British Cardiovascular Society
dc.rights.holder BMJ Publishing Group Ltd and the British Cardiovascular Society eng
dc.type.version publishedVersion eng
bora.peerreviewed Peer reviewed eng
bibo.doi http://dx.doi.org/10.1136/hrt.2008.164657 eng
dc.identifier.doi http://dx.doi.org/10.1136/hrt.2008.164657


Files in this item

 

This item appears in the following Collection(s)

Show simple item record

Search BORA


Browse

My Account