Research Topics
| JAMES AARON TULSKYSummaryAffiliation: Duke University Medical Center Country: USA Publications
Research Grants
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Detail Information
Publications
Enhancing communication between oncologists and patients with a computer-based training program: a randomized trialJames A Tulsky
Duke University, Veterans Affairs Medical Center, Durham, North Carolina, USA
Ann Intern Med 155:593-601. 2011..Quality cancer care requires addressing patients' emotions, which oncologists infrequently do. Multiday courses can teach oncologists skills to handle emotion; however, such workshops are long and costly...- Beyond advance directives: importance of communication skills at the end of lifeJames A Tulsky
The Center for Palliative Care and the Department of Medicine, Veterans Affairs Medical Center and Duke University, Durham, NC, USA
JAMA 294:359-65. 2005..However, such planning should occur within a framework that emphasizes responding to patient and family emotions and focuses more on goals for care and less on specific treatments... - Interventions to enhance communication among patients, providers, and familiesJames A Tulsky
Center for Palliative Care and the Department of Medicine, Duke University, and the Veterans Affairs Medical Center, Durham, North Carolina 27705, USA
J Palliat Med 8:S95-102. 2005.... - Approaching difficult communication tasks in oncologyAnthony L Back
University of Washington Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, USA
CA Cancer J Clin 55:164-77. 2005.... - Communication at times of transitions: how to help patients cope with loss and re-define hopeWendy G Evans
Department of Medicine, Section of Medical Ethics and Palliative Care, Institute for Doctor Patient Communication, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
Cancer J 12:417-24. 2006..This is accomplished with the Ask-Tell-Ask and Hope for the Best, Prepare for the Worst techniques, and most importantly by being curious about patients' hopes and fears... - Efficacy of communication skills training for giving bad news and discussing transitions to palliative careAnthony L Back
Department of Medicine Oncology, University of Washington, 825 Eastlake Ave E, PO Box 19023, Seattle, WA 98109 1023, USA
Arch Intern Med 167:453-60. 2007..This study evaluated the efficacy of Oncotalk in changing observable communication behaviors... - One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort studyMark Unroe
Duke University, Durham, North Carolina 27710, USA
Ann Intern Med 153:167-75. 2010..Little is known about the patterns of care as patients transition from acute care hospitals to postacute care facilities or about the associated resource utilization... - Resident approaches to advance care planning on the day of hospital admissionAlexander K Smith
Division of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA
Arch Intern Med 166:1597-602. 2006..Previous research has demonstrated a need to improve patient-physician communication around advance care planning. A critical time for advance care planning conversations is the day of admission to the hospital... - Provider-patient communication about antidepressants among veterans with mental health conditionsBetsy Sleath
Cecil G Sheps Center for Health Services Research and the Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599 7590, USA
Am J Geriatr Pharmacother 5:9-17. 2007..Little is known about provider-patient communication regarding antidepressants in primary care settings... - Do unmet expectations for specific tests, referrals, and new medications reduce patients' satisfaction?B Mitchell Peck
College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
J Gen Intern Med 19:1080-7. 2004..Patient-centered care requires clinicians to recognize and act on patients' expectations. However, relatively little is known about the specific expectations patients bring to the primary care visit... - What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?Donald H Taylor
Terry Sanford Institute of Public Policy, Duke University Durham, Durham, NC, USA
Soc Sci Med 65:1466-78. 2007..Given the length of hospice use observed in the Medicare program, increasing the length of hospice use for 7 in 10 Medicare hospice users would increase savings... - Racial differences in the growth of noncancer diagnoses among hospice enrolleesKimberly S Johnson
Department of Medicine, Duke University School of Medicine, Durham, North Carolina 27710, USA
J Pain Symptom Manage 34:286-93. 2007..Targeted efforts to increase hospice use among African Americans with noncancer diagnoses may be important in reducing racial disparities in overall hospice use and improving the quality of care for dying African Americans... - Do patient attributes predict oncologist empathic responses and patient perceptions of empathy?Kathryn I Pollak
Duke Comprehensive Cancer Center, Cancer Prevention, Detection and Control Research Program, Duke University School of Medicine, Durham, USA
Support Care Cancer 18:1405-11. 2010..Oncologists may respond more empathically to some patients, and patients may perceive different levels of empathy and trust given past documentation of disparities in cancer care... - Studying communication in oncologist-patient encounters: the SCOPE TrialCeline M Koropchak
Department of Medicine and Center for Palliative Care, Duke University Medical Center, Durham, NC 27705, USA
Palliat Med 20:813-9. 2006..In this report, we describe the study methods and identify challenges to implementation and how these were overcome... - Identifying, recruiting, and retaining seriously-ill patients and their caregivers in longitudinal researchKaren E Steinhauser
Center for Health Services Research in Primary Care, Durham VA Medical Center, Duke University, NC 27705, USA
Palliat Med 20:745-54. 2006..The palliative care literature is replete with descriptions of studies unable to meet enrollment goals, and that as a result, do not have adequate power to test hypotheses or draw conclusions... - Racial differences in self-reported exposure to information about hospice careKimberly S Johnson
Department of Medicine, Division of Geriatrics, Duke University Medical Center, Durham, NC 27710, USA
J Palliat Med 12:921-7. 2009..Previous research suggests that lack of knowledge of hospice is a barrier to the use of hospice care by African Americans. However, there is little data examining racial differences in exposure to hospice information... - Communication strategies and cultural issues in the delivery of bad newsJoshua S Barclay
Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27705 3860, USA
J Palliat Med 10:958-77. 2007..Through good communication practices, clinicians can help to avoid conflict and understand patients' desires for end of life care... - Fertility patients' views about frozen embryo disposition: results of a multi-institutional U.S. surveyAnne Drapkin Lyerly
Department of Obstetrics and Gynecology, Duke University, Box 3040, Durham, North Carolina 27710, USA
Fertil Steril 93:499-509. 2010..To describe fertility patients' preferences for disposition of cryopreserved embryos and determine factors important to these preferences... - Negative emotions in cancer care: do oncologists' responses depend on severity and type of emotion?Sarah L Kennifer
Center for Palliative Care, Duke University Medical Center, Durham, NC 27705, United States
Patient Educ Couns 76:51-6. 2009..To examine how type and severity of patients' negative emotions influence oncologists' responses and subsequent conversations... - Do preparation and life completion discussions improve functioning and quality of life in seriously ill patients? Pilot randomized control trialKaren E Steinhauser
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina 27705, USA
J Palliat Med 11:1234-40. 2008..Significant palliative care intervention has focused on physical pain and symptom control; yet less empirical evidence supports efforts to address the psychosocial and spiritual dimensions of experience... - What explains racial differences in the use of advance directives and attitudes toward hospice care?Kimberly S Johnson
Department of Medicine, Duke University, Durham, North Carolina 27710, USA
J Am Geriatr Soc 56:1953-8. 2008..This study has implications for the design of healthcare delivery models and programs that provide culturally sensitive end-of-life care to a growing population of ethnically diverse older adults... - Primary care physicians' discussions of weight-related topics with overweight and obese adolescents: results from the Teen CHAT Pilot studyKathryn I Pollak
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, North Carolina 27705, USA
J Adolesc Health 45:205-7. 2009..When physicians used MI skills, patients increased exercise, lost weight, and reduced screen time. Physicians should use MI techniques to help adolescents change... - Racial differences in hospice revocation to pursue aggressive careKimberly S Johnson
Department of Medicine, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina 27710, USA
Arch Intern Med 168:218-24. 2008..Because of a greater preference for life-sustaining therapies at the end of life, African American patients may be more likely than white patients to withdraw from hospice to seek life-prolonging therapies... - Characterizing hospice discharge patterns in a nationally representative sample of the elderly, 1993-2000Donald H Taylor
Terry Sanford Institute of Public Policy, Duke University, Durham, NC 27708, USA
Am J Hosp Palliat Care 25:9-15. 2008..After controlling for survival time, costs per day survived are similar for all groups. This study suggests several motivations for being discharged alive that are worthy of more research... - Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosisTracy M Robinson
Duke University School of Medicine, Durham, NC, USA
Support Care Cancer 16:1049-57. 2008..This study was designed to identify the communication factors that influence patient-oncologist concordance about chance of cure... - Oncologist communication about emotion during visits with patients with advanced cancerKathryn I Pollak
Duke Comprehensive Cancer Center, Cancer Prevention, Detection, and Control Research Program, Durham, NC, USA
J Clin Oncol 25:5748-52. 2007..We studied whether oncologist traits were associated with empathic opportunities and empathic responses... - Expectations and outcomes of prolonged mechanical ventilationChristopher E Cox
Duke University, Durham, NC, USA
Crit Care Med 37:2888-94; quiz 2904. 2009..Prolonged mechanical ventilation provision is increasing markedly despite poor patient outcomes. Misunderstanding prognosis in the prolonged mechanical ventilation decision-making process could provide an explanation for this phenomenon... - A controlled trial of a short course to improve residents' communication with patients at the end of lifeStewart C Alexander
Durham VA Medical Center, North Carolina, USA
Acad Med 81:1008-12. 2006..The goal was to evaluate the effect of a short course to improve residents' communication skills delivering bad news and eliciting patients' preferences for end-of-life care... - Racial differences in next-of-kin participation in an ongoing survey of satisfaction with end-of-life care: a study of a studyKimberly S Johnson
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
J Palliat Med 9:1076-85. 2006..Given the growing diversity of the U.S. population, researchers in end-of-life care must use strategies aimed at recruiting racially and ethnically diverse samples... - The influence of spiritual beliefs and practices on the treatment preferences of African Americans: a review of the literatureKimberly S Johnson
Department of Medicine, Division of Geriatrics, Duke University Medical Center, DUMC Box 3003, Durham, NC 27710, USA
J Am Geriatr Soc 53:711-9. 2005..Given the growing ethnic diversity of the United States, some understanding of the complexities of culture and spirituality is essential for healthcare providers... - Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trialAmy P Abernethy
Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA
Lancet 376:784-93. 2010..We assessed the effectiveness of oxygen compared with room air delivered by nasal cannula for relief of breathlessness in this population of patients... - An integrative approach to advanced kidney disease in the elderlyJane O Schell
Department of Medicine, Duke University Medical Center, Durham, NC 27705 3860, USA
Adv Chronic Kidney Dis 17:368-77. 2010..This comprehensive approach to patient care involves the integration of nephrology, geriatric, and palliative medicine practices... - How do non-physician clinicians respond to advanced cancer patients' negative expressions of emotions?Stewart C Alexander
Department of Medicine, Duke University Medical Center, Durham, NC, USA
Support Care Cancer 19:155-9. 2011.... - Physician communication techniques and weight loss in adults: Project CHATKathryn I Pollak
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, North Carolina, USA
Am J Prev Med 39:321-8. 2010..Physicians are encouraged to counsel overweight and obese patients to lose weight... - Comparing oncologist, nurse, and physician assistant attitudes toward discussions of negative emotions with patientsPerri A Morgan
Duke University PA Program, Department of Community and Family Medicine, DUMC 104780, Durham, NC 27710, USA
J Physician Assist Educ 21:13-7. 2010..Nurses and physician assistants (PAs) may be able to help fill the need for empathic communication. Our study compares the attitudes of oncologists, nurses, and PAs toward communication with patients who demonstrate negative emotions... - Evolution in measuring the quality of dyingKaren E Steinhauser
Program on the Medical Encounter and Palliative Care, Durham VA Medical Center and Division of General Internal Medicine, Center for the Study of Aging and Human Development, Duke University, North Carolina 27705, USA
J Palliat Med 5:407-14. 2002..The purpose of this paper is to evaluate quality-of-life instruments currently used to assess the experiences of dying patients, and to offer a design for a next generation instrument to measure quality at the end of life... - Do the five A's work when physicians counsel about weight loss?Stewart C Alexander
Durham VA Medical Center, Durham, NC 27705, USA
Fam Med 43:179-84. 2011..An effective and efficient tool for smoking cessation is the Five A's (Ask, Advise, Assess, Assist, and Arrange). We studied the effectiveness of the Five A's in weight-loss counseling... - Initial assessment of a new instrument to measure quality of life at the end of lifeKaren E Steinhauser
Program on the Medical Encounter and Palliative Care, Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina 27705, USA
J Palliat Med 5:829-41. 2002..We conducted this study to pilot a new multidimensional instrument to assess the quality of life at the end of life... - Seriously ill patients' discussions of preparation and life completion: an intervention to assist with transition at the end of lifeKaren E Steinhauser
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina, USA
Palliat Support Care 7:393-404. 2009..We developed an intervention based on life review and emotional disclosure literatures and conducted a pilot study to determine feasibility and acceptability. This article presents qualitative intervention responses... - Behind closed doors: management of patient expectations in primary care practicesSheri A Keitz
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
Arch Intern Med 167:445-52. 2007..Managed care restrictions on resource use may affect communication between patients and health care professionals... - Factors that affect infertility patients' decisions about disposition of frozen embryosAnne Drapkin Lyerly
Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, USA
Fertil Steril 85:1623-30. 2006..To describe factors that affect infertility patients' decision making regarding their cryopreserved embryos... - Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregiversChristopher E Cox
Duke University, Durham, NC, USA
Crit Care Med 37:2702-8. 2009..However, the experiences of acute respiratory distress syndrome survivors have not been reported... - Measuring quality of life at the end of life: validation of the QUAL-EKaren E Steinhauser
Program on the Medical Encounter and Palliative Care, Durham VA Medical Center, Durham, North Carolina 27705, USA
Palliat Support Care 2:3-14. 2004..To validate the QUAL-E, a new measure of quality of life at the end of life... - Is there no place like home? Caregivers recall reasons for and experience upon transfer from home hospice to inpatient facilitiesWendy G Evans
Department of Medicine, Duke University, and Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, North Carolina 27705, USA
J Palliat Med 9:100-10. 2006..We can improve their experience by treating patients and their caregivers as unique individuals, exploring and respecting treatment preferences, and creating a pleasant physical environment... - "Are you at peace?": one item to probe spiritual concerns at the end of lifeKaren E Steinhauser
Centers for Palliative Care, Veterans Affairs Medical Center, and Department of Medicine, Division of Geriatrics, School of Nursing, Center for the Study of Aging and Human Development, Duke University, Durham, NC 27705, USA
Arch Intern Med 166:101-5. 2006..A practical, evidence-based approach to discussing spiritual concerns in a scope suitable to a physician-patient relationship may improve the quality of the clinical encounter... - Ethnic differences in the place of death of elderly hospice enrolleesKimberly S Johnson
Department of Medicine, Duke University, Durham, North Carolina, USA
J Am Geriatr Soc 53:2209-15. 2005..37-1.53). Admission to hospice reduces but does not eliminate ethnic differences in place of death. Further research should examine the effect of individual and cultural preferences for place of death on decisions to enroll in hospice... - Is a home-care network necessary to access the Medicare hospice benefit?Courtney Harold Van Houtven
Center for Health Services Research and Development in Primary Care, VA Medical Center, Durham, North Carolina 27705, USA
J Palliat Med 12:687-94. 2009..To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns... - Teaching communication skills to medical oncology fellowsAnthony L Back
Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, S-111, Seattle, WA 98108, USA
J Clin Oncol 21:2433-6. 2003 - Beyond autonomy: diversifying end-of-life decision-making approaches to serve patients and familiesGary S Winzelberg
Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
J Am Geriatr Soc 53:1046-50. 2005..The goal of these priorities is to promote understanding of patients' and families' decision-making preferences and goals and to minimize decision-making burdens on families... - On saying goodbye: acknowledging the end of the patient-physician relationship with patients who are near deathAnthony L Back
University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1023, USA
Ann Intern Med 142:682-5. 2005 - Palliative care curriculum development: a model for a content and process-based approachWayne A Ury
New York Medical College, Valhalla, New York, USA
J Palliat Med 5:539-48. 2002..Two hypothetical institutions are used to illustrate relevant issues. Methods that have been successfully used to develop residency curricula are discussed... - Objectives for advance care planningRuss C Kolarik
General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
J Palliat Med 5:697-704. 2002..If we are to improve care at the end of life, future patient care, research, and education about ACP should proceed with specific objectives in mind... - Discussing religious and spiritual issues at the end of life: a practical guide for physiciansBernard Lo
JAMA 287:749-54. 2002..By responding to patients' spiritual and religious concerns and needs, physicians may help them find comfort and closure near the end of life... - Responding to requests regarding prayer and religious ceremonies by patients near the end of life and their familiesBernard Lo
Program in Medical Ethics, Division of General Internal Medicine, University of California, San Francisco, USA
J Palliat Med 6:409-15. 2003..Physicians can respond to requests and respect patients' spiritual needs in ways that may deepen the therapeutic doctor-patient relationship, without compromising their own religious and spiritual beliefs or professional roles... - Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failureLarry A Allen
Duke Clinical Research Institute and Division of Cardiology, Durham, NC 27705, USA
JAMA 299:2533-42. 2008..Patients with chronic heart failure have impaired long-term survival, but their own expectations regarding prognosis have not been well studied... - Reflective teaching practices: an approach to teaching communication skills in a small-group settingKelly Fryer-Edwards
Department of Medical History and Ethics, University of Washington School of Medicine, Seattle, Washington 98195, USA
Acad Med 81:638-44. 2006..These reflective teaching practices, while developed for communication skills training, may be useful for teaching other challenging topics such as ethics and professionalism... - Measuring the quality of dying in long-term careJean C Munn
College of Social Work, Florida State University, Tallahassee, Florida 32306, USA
J Am Geriatr Soc 55:1371-9. 2007.... - "What concerns me is..." Expression of emotion by advanced cancer patients during outpatient visitsWendy G Anderson
Department of Medicine, Division of Hospital Medicine and Palliative Care Program, University of California, San Francisco, 521 Parnassus Avenue, Suite C 126, Box 0903, San Francisco, CA, 94143 0903, USA
Support Care Cancer 16:803-11. 2008..Cancer patients have high levels of distress, yet oncologists often do not recognize patients' concerns. We sought to describe how patients with advanced cancer verbally express negative emotion to their oncologists... - Manualized communication interventions to enhance palliative care research and training: rigorous, testable approachesJoseph S Weiner
Long Island Jewish Medical Center, Department of Medicine, New Hyde Park, NY 11040, USA
J Palliat Med 9:371-81. 2006..The advantages of manualized communication approaches; some concepts underlying manual construction; and challenges to extending manualized communication to the palliative care domain are discussed... - Dreaded conversations: moving beyond discomfort in patient-physician communicationSarah L Clever
J Gen Intern Med 17:884-5. 2002 - Hope and hubrisJames A Tulsky
J Palliat Med 5:339-41. 2002 - Advance care planning by proxy for residents of long-term care facilities who lack decision-making capacityLadislav Volicer
Geriatric Research, Education and Clinical Center, Dementia Study Unit, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA
J Am Geriatr Soc 50:761-7. 2002..Instead, local facilities are advised to develop their own policies and then evaluate their effect. The report contains specific recommendations for the advance proxy planning process... - Recommendations for the ethical conduct of quality improvementEllen Fox
National Center for Ethics in Health Care, Veterans Health Administration, Washington D.C, USA
J Clin Ethics 16:61-71. 2005
Research Grants
- Communication in Oncologist Patient Encounters: A Patient InterventionJAMES AARON TULSKY; Fiscal Year: 2010..If successful, we will have developed a tool that is easily accessible to cancer patients, will enhance their communication with their oncologists, and improve their quality of life. ..
- Communication in Oncologist Patient Encounters: A Patient InterventionJames Tulsky; Fiscal Year: 2009..If successful, we will have developed a tool that is easily accessible to cancer patients, will enhance their communication with their oncologists, and improve their quality of life. ..
- Trajectories of Serious Illness: Patients and CaregiversJames Tulsky; Fiscal Year: 2007....
- Enhancing Patient-Oncologist CommunicationJames Tulsky; Fiscal Year: 2007....
- Self-Management Interventions in Life-Limiting IllnessJAMES AARON TULSKY; Fiscal Year: 2010..Through all of these approaches, we hope to learn when and how to intervene and to further develop the theory of self-management in life-limiting illness. ..