Vnitr Lek 2023, 69(8):E4-E9 | DOI: 10.36290/vnl.2023.106

Rationale and benefits of value history in clinical practice: attitudes of internal medicine teachers and physicians

Kateřina Rusinová1, Tereza Sládková2, Michal Vrablík3, Alexandra Židková4, Tereza Petrů5, Pavel Dušek6, Martin Matějovič7
1 Klinika paliativní medicíny, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice, Praha
2 studentka 5. ročníku oboru Všeobecné lékařství, 1. lékařská fakulta, Univerzita Karlova, Praha
3 III. interní klinika, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice, Praha
4 Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň
5 Konziliární tým paliativní péče, Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň
6 Neurologická klinika, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice, Praha
7 I. interní klinika, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň

Aim: In patients with severe illnesses, particularly in situations of unfavorable prognosis, it is essential to consider and decide on the appropriateness of further treatment. The ability to conduct a values-oriented conversation is crucial for providing care that aligns with the patient's values and preferences. Values History Taking (VHT) should be included in the curriculum of medical schools.

Method: A questionnaire survey mapping the attitudes of internal medicine educators at the 1st Faculty of Medicine, Charles University, and the Faculty of Medicine in Plzeň, Charles University, regarding the significance, experiences, potential benefits, and barriers of incorporating value history taking into the teaching of standard medical history interviews.

Results: A total of 123 questionnaires were evaluated in the study. Currently, value history taking, as well as its individual elements, are not widely integrated into medical education or practice. However, most physicians (83%) consider it very important. Among the potential benefits, they see higher patient and family satisfaction, greater ability to respect the patient's wishes, and the potential reduction in the number of unplanned or unwanted rehospitalizations towards the end of life.

Conclusion: The positive attitude of educators supports the need for the integration of value history taking into both education and routine clinical practice. Value history taking becomes a part of the structured medical history interview in the subject of Internal Propaedeutics and Internal Medicine at the 1st Faculty of Medicine, Charles University, and the Faculty of Medicine in Plzeň, Charles University.

Keywords: palliative medicine, internal medicine, communication, education, values and preferences, understanding, information needs.

Accepted: December 5, 2023; Published: December 18, 2023  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Rusinová K, Sládková T, Vrablík M, Židková A, Petrů T, Dušek P, Matějovič M. Rationale and benefits of value history in clinical practice: attitudes of internal medicine teachers and physicians. Vnitr Lek. 2023;69(8):E4-9. doi: 10.36290/vnl.2023.106.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Fulmer T, Escobedo M, Berman A, et al. Physicians' Views on Advance Care Planning and End­‑of­‑Life Care Conversations. J Am Geriatr Soc. 2018;66(6):1201-1205. Go to original source... Go to PubMed...
    2. Dzeng E, Batten JN, Dohan D, et al. Hospital Culture and Intensity of End­‑of­‑Life Care at 3 Academic Medical Centers. JAMA Intern Med. 2023;183(8):839-848. Available from: DOI: . Go to original source... Go to PubMed...
    3. Denney­‑Koelsch EM, Horowitz R, Quill T, et al. An Integrated, Developmental Four­‑Year Medical School Curriculum in Palliative Care: A Longitudinal Content Evaluation Based on National Competency Standards. J Palliat Med. 2019;21(9):1221-1233. Available from: . Go to original source... Go to PubMed...
    4. Nolan JP, Sandroni C, Böttiger BW, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post­‑resuscitation care. Intensive Care Med. 2021;47(4):369-421. Available from: DOI: . Go to original source... Go to PubMed...
    5. Sdělení č. 96/2001 Sb. m. s., Ministerstva zahraničních věcí o přijetí Úmluvy na ochranu lidských práv a důstojnosti lidské bytosti v souvislosti s aplikací biologie a medicíny: Úmluva o lidských právech a biomedicíně. © AION CS 2010-2023 [cit. 2023-08-31]. Dostupné z WWW: .
    6. Odpovědnost nemocnice za smrt dlouhodobě nemocné pacientky při jednostranném vydání pokynu Do Not Resuscitate ("ne­‑resuscituj"). Ústavní soud, Brno, TZ 64/2023 [cit. 2023-08-31]. Available from: .
    7. Reidy JA, Clark MA, Berman HA, et al. Paving the way for universal medical student training in serious illness communication: the Massachusetts Medical Schools' Collaborative. BMC Med Educ. 2022;22(1):654. Dostupné z DOI: . Go to original source... Go to PubMed...
    8. Zdraví 2030: Strategický rámec rozvoje péče o zdraví v České republice do roku 2030. Praha: Ministerstvo zdravotnictví České republiky 2019. [cit. 2023-08-31]. Available from: .
    9. Committee on Approaching Death: Addressing Key End of Life Issues; Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Washington (DC): National Academies Press (US) 2015. Available from: DOI: .
    10. Morden NE, Chang CH, Jacobson JO, et al. End­‑of­‑life care for Medicare beneficiaries with cancer is highly intensive overall and varies widely. Health Aff (Millwood) 2012; 31(4):786-96. Available from: DOI: . Go to original source... Go to PubMed...
    11. Slezáčková A, Dvořáčková K, Kopecký O, et al. Factors influencing the end­‑of­‑life decisionmaking process about care in hospitalized patients. Faktory ovlivňující proces rozhodování o péči v závěru života u hospitalizovaných pacientů. Cas Lek Cesk. 2021;160(5):176-184.
    12. Curtis JR, et al. Intervention to promote communication about goals of care for hospitalized patients with serious illness: A randomized clinical trial. JAMA 2023 May 21; 329(23):2028-2037. Available from: DOI: . Go to original source... Go to PubMed...
    13. Desai AV, Klimek VM, Chow K, et al. 1-2-3 Project: A Quality Improvement Initiative to Normalize and Systematize Palliative Care for All Patients With Cancer in the Outpatient Clinic Setting. J Oncol Pract. 2018;14(12):e775-e785. Available from: DOI: . Go to original source... Go to PubMed...
    14. Suk D, Kopecký O, Mlčochová D, et al. Studentská evaluace výuky paliativní medicíny na lékařské fakultě. Paliativní medicína. 2022;3(3):18-27.
    15. Kentish­‑Barnes N, Poujol AL, Banse E, et al. Giving a voice to patients at high risk of dying in the intensive care unit: a multiple source approach. Intensive Care Med. 2023;49(7):808-819. Available from: DOI: . Go to original source... Go to PubMed...
    16. Heyland DK, Dodek P, Rocker G, et al. What matters most in end­‑of­‑life care: perceptions of seriously ill patients and their family members. CMAJ. 2006;174(5):627-33. Available from: DOI: .
    17. Rusinová K. Smrt nesmí být tabu a s pacienty se musí mluvit. Rozhovor s JUDr. Jaromírem Jirsou, soudcem Ústavního soudu. Paliativní medicína. 2023;4(3):1-9.

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.