HANDLING DIFFERENT PERSONALITIES IN ACP CONVERSATIONS
- Author:
Sharon Ganga-Krishnan
;
Lee Gan Goh
- Publication Type:Journal Article
- Keywords:
Advance Care Planning;
Primary Care Physicians;
Tenet of Patient-centred Care;
The Angry Patient;
The Patient in Collusion;
The Patient in Denial;
Blocking Behaviours
- From:The Singapore Family Physician
2016;42(3):18-23
- CountrySingapore
- Language:English
-
Abstract:
Documented advance care planning (ACP) discussions
with patients enable doctors to have continuity and
collaboration across all settings as patients move from
one setting to another. These shared decision-making
discussions generally consist of 3 steps: giving
information; assisting patients to understand the
options in the context of their situations; and helping
these patients make informed decisions based on their
individual preferences. Primary care physicians should
take advantage of their position as healthcare
providers to continue the care of the patient and the
relationship they have with the patient by initiating
ACP discussions. The National Medical Ethics
Committees recommendation in 2010 is that such
discussions should be started as part of routine care in
primary care and outpatient settings before individuals
become acutely unwell. Important barriers that need
to be overcome are negative encounters with different
personalities who can present themselves as
difficult - the angry patient, the anxious patient, the
patient in collusion, and the patient in denial. In this
paper are some guiding principles on how to carry out
ACP discussions with such patients. There is also a need
for doctors to recognise that as caregivers, they may be
exhibiting blocking behaviours to ACP discussions that
patients are trying to initiate. These should be avoided.
