图书简介
The Relational Medicine project is growing. In 2014 we published our practice framework "Relational Medicine — Personalizing Modern Healthcare: The Practice of High-Tech Medicine As A RelationalAct" . Building on this foundation, we now present a cutting-edge and fully developed single case recording analysis of consecutive encounter interactions in a dramatically accelerating life-and-death decision-making situation in the high-tech medical practice of Advanced Heart Failure during which practitioners, patient, and family face multiple uncertainties as the decision-making process unfolds and the patient’s condition deteriorates.We show how a multi-professional team including a cardiologist, cardiac surgeon, critical care unit nurse and fellows discuss life-prolonging options with their patient and family. We make visible the essential roles of each multi-disciplinary team member in helping frame for the patient and family what is going on and the changing options while attending to the patient’s PERSON-soul-mind-body-HOOD.In bringing different data, perspectives, and facets of understanding to bear, this book offers a novel approach to studying high-tech medical care grounded in Federica Raia’s Relational Ontology framework of understanding everyday practice. Using a micro-ethnographic data analysis and a participatory research strategy, we unravel a heretofore unrecognized universe of practice themes and present suggestions for medical education and training aimed at continuous practice improvement.Key FeaturesThis book offers a novel research approach to study high-tech medical care grounded in the actual everyday practiceIt translates the results of these analyses into groundbreaking Medical Education/Training ModulesBy doing so, it has the potential to radically change the practice of high-tech medicine globally
Introduction: Introducing the Case; Organization of the Book; Conceptual Framework: Breakdown of Familiarity; Caring for the Other; Framing; Facing Uncertainty; Research Methodology; Framing the Options: Evidence-Based Reasoning; Framing as Care for the Other; Changing Conditions and Evolving Options; Framing Uncertainty: A First Discussion; Interactions with Doctors in Training: Multi-Party Conversation; Overlaps and Interruptions: Competition Over Care; Creating Obstacles by Ignoring Uncertainties; Re-Framing by Using Caring Power; The Iterative Nature of Decision Making: Multiparty Perspectives — Building the Team; Questions, Ambiguities and Explanations; Projecting into the Future with Transplantation; Increasing Urgency: Meeting the Surgeon; Urgency-Related Tension in the Team; Backstage and Frontstage Communication; Assigning Agency; Transitioning from Urgency to Emergency: The Role of the Existential Dimension: Professional Visions; A Bridge to a Bridge to Transplantation; Another Professional Vision in the Room; Affordances in Teamwork; Conclusion: Becoming a Team; Leaning to Care for the Other; Our Approach to Concluding this Book;
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