Shunichi Nakagawa @snakagawa_md
Director, Inpatient Palliative Care Services at Columbia University Irving Medical Center. Associate Professor @ColumbiaMed. Posts are personal opinions ncbi.nlm.nih.gov/pubmed/?term=N… New York, NY Joined May 2012-
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In a family meeting, more information is not always helpful, sometimes useless, and often harmful.
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救急の現場では、医療者は、家族の間で共有されてるであろう価値観を尋ね、あらかじめ共有されていなければ、その価値観を引き出すようなコミュニケーションが必要です。 結局、スライドにあるような質問を尋ねる必要があります（そうではなくて「挿管どうしますか？」になってると思いますけど）。
救急の現場では、医療者は、家族の間で共有されてるであろう価値観を尋ね、あらかじめ共有されていなければ、その価値観を引き出すようなコミュニケーションが必要です。 結局、スライドにあるような質問を尋ねる必要があります（そうではなくて「挿管どうしますか？」になってると思いますけど）。
Shunichi Nakagawa retweeted
その絶対数が足りないので日本の緩和ケア医はがんに集中せざるを得ません でもがんによる死亡は全体の25%にすぎません それ以外はどうするのか？ 緩和ケア専門医に期待するのは物理的に無理です それぞれの医師が各自で緩和ケアを勉強して提供しないとダメだと思います
胃ろうをするかしないか、を予め決めておく必要はありません。 決めてもいいですが、それよりも、どうしてそう思うかの方が重要。 「どうして」なしで「〇〇する（しない）」という情報は、役に立ちません。 というか、ぶっちゃけ、有害ですらあります。
When a family meeting doesn't go well, in my experience, suboptimal preparation is the main reason in more than 90% of the time.
In a family meeting, after you deliver bad news (headline), you should take a pause.
Answer the question with one word or one sentence first.
2週間の日本滞在で7つの講演を完遂。 いろいろなところで喋り倒してしまいました。楽しかったです。 Poll Everywhereの投票機能を取り入れたのが好評でした。 今日の飛行機でアメリカに戻ります。また年末に。
本日です。
昨日は「おうちにかえろう。病院」にお邪魔して、意思決定支援の話を在宅医療用にアレンジして講演しました。 皆さん、モチベーションが高くて、話しているこちらも楽しかったです。
今週末から2週間帰国します。 いくつか病院を訪れて講演させていただきます。 話す内容はあまり他の人と変わりないと思います。ただ、どう伝えたらより面白く、より刺さるかを常に考えています。
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