Ruth Engelberg

Summary

Affiliation: University of Washington
Country: USA

Publications

  1. ncbi request reprint Measuring the quality of dying and death: methodological considerations and recent findings
    Ruth A Engelberg
    Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
    Curr Opin Crit Care 12:381-7. 2006
  2. ncbi request reprint Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care
    Ruth Engelberg
    Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, 98104, USA
    J Palliat Med 9:1086-98. 2006
  3. doi request reprint Measuring the quality of end-of-life care
    Ruth A Engelberg
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, Seattle, Washington 98104 2499, USA
    J Pain Symptom Manage 39:951-71. 2010
  4. ncbi request reprint Commentary: observational studies and their importance in improving end-of-life care in the intensive care unit
    Ruth A Engelberg
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Washington Seatle, WA 98104 2499, USA
    J Crit Care 18:141-4. 2003
  5. pmc Responding to families' questions about the meaning of physical movements in critically ill patients
    Ruth A Engelberg
    Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98104, USA
    J Crit Care 23:565-71. 2008
  6. ncbi request reprint Barriers and facilitators to end-of-life care communication for patients with COPD
    Elizabeth Knauft
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
    Chest 127:2188-96. 2005
  7. ncbi request reprint Factors associated with nurse assessment of the quality of dying and death in the intensive care unit
    Naomi M Hodde
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 32:1648-53. 2004
  8. ncbi request reprint Communication about palliative care for patients with chronic obstructive pulmonary disease
    J Randall Curtis
    Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, USA
    J Palliat Care 21:157-64. 2005
  9. ncbi request reprint Treatment preferences for resuscitation and critical care among homeless persons
    Wendi M Norris
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
    Chest 127:2180-7. 2005
  10. ncbi request reprint Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction
    Jonathan R McDonagh
    Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 32:1484-8. 2004

Collaborators

Detail Information

Publications57

  1. ncbi request reprint Measuring the quality of dying and death: methodological considerations and recent findings
    Ruth A Engelberg
    Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
    Curr Opin Crit Care 12:381-7. 2006
    ..In this article, we present methodological considerations and recent findings that pertain to the measurement of the quality of dying and death...
  2. ncbi request reprint Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care
    Ruth Engelberg
    Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, 98104, USA
    J Palliat Med 9:1086-98. 2006
    ..While further validation studies are needed, this assessment of the QOC represents an important step toward providing a measure of the quality of end-of-life communication...
  3. doi request reprint Measuring the quality of end-of-life care
    Ruth A Engelberg
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, Seattle, Washington 98104 2499, USA
    J Pain Symptom Manage 39:951-71. 2010
    ..Although there is a documented need to improve end-of-life care, there are few validated and brief questionnaires that are available as outcome measures for use in improving that care...
  4. ncbi request reprint Commentary: observational studies and their importance in improving end-of-life care in the intensive care unit
    Ruth A Engelberg
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Washington Seatle, WA 98104 2499, USA
    J Crit Care 18:141-4. 2003
  5. pmc Responding to families' questions about the meaning of physical movements in critically ill patients
    Ruth A Engelberg
    Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98104, USA
    J Crit Care 23:565-71. 2008
    ..This study used qualitative methods to describe physicians' responses to families' questions about the meaning of patients' movements in critically ill patients...
  6. ncbi request reprint Barriers and facilitators to end-of-life care communication for patients with COPD
    Elizabeth Knauft
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
    Chest 127:2188-96. 2005
    ..Patients with COPD frequently do not discuss end-of-life care with physicians; therefore, we sought to identify the barriers and facilitators to this communication as a first step to overcoming barriers and capitalizing on facilitators...
  7. ncbi request reprint Factors associated with nurse assessment of the quality of dying and death in the intensive care unit
    Naomi M Hodde
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 32:1648-53. 2004
    ....
  8. ncbi request reprint Communication about palliative care for patients with chronic obstructive pulmonary disease
    J Randall Curtis
    Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, USA
    J Palliat Care 21:157-64. 2005
    ..Further research is needed to develop and test interventions that can enhance patient-physician communication about palliative and EOL care for patients with COPD, and we describe our perspective on a research agenda in each area...
  9. ncbi request reprint Treatment preferences for resuscitation and critical care among homeless persons
    Wendi M Norris
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
    Chest 127:2180-7. 2005
    ..Consequently, clinicians must make decisions independently or with input from others such as ethics committees or guardians. No prior studies have examined treatment preferences of homeless to guide such decision makers...
  10. ncbi request reprint Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction
    Jonathan R McDonagh
    Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 32:1484-8. 2004
    ..The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family satisfaction...
  11. ncbi request reprint Evaluation of a standardized order form for the withdrawal of life support in the intensive care unit
    Patsy D Treece
    Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA
    Crit Care Med 32:1141-8. 2004
    ..We describe a quality improvement project implementing and evaluating a "withdrawal of life support order form" to improve quality of end-of-life care in the intensive care unit...
  12. ncbi request reprint Integrating palliative and critical care: description of an intervention
    Patsy D Treece
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, Washington, USA
    Crit Care Med 34:S380-7. 2006
    ..Future reports will need to examine the ability of the interventions to improve outcomes of palliative care in the ICU...
  13. ncbi request reprint Refinement, scoring, and validation of the Family Satisfaction in the Intensive Care Unit (FS-ICU) survey
    Richard J Wall
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 35:271-9. 2007
    ..To refine the Family Satisfaction in the Intensive Care Unit (FS-ICU) survey and develop a validated method for scoring the instrument...
  14. pmc Nurses' identification of important yet under-utilized end-of-life care skills for patients with life-limiting or terminal illnesses
    Lynn F Reinke
    Department of Veterans Affairs, VA Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington 98195, USA
    J Palliat Med 13:753-9. 2010
    ..This study was designed to identify nurses' perspectives on nursing skills that are important yet under-utilized in end-of-life care...
  15. doi request reprint Discussing religion and spirituality is an advanced communication skill: an exploratory structural equation model of physician trainee self-ratings
    Dee W Ford
    Medical University of South Carolina, Division of Pulmonary and Critical Care, Department of Medicine, Charleston, South Carolina 29425, USA
    J Palliat Med 15:63-70. 2012
    ..The goal of this study was to develop an improved understanding of physicians' perspectives on their communication competence about religious and spiritual issues...
  16. pmc Improving social work in intensive care unit palliative care: results of a quality improvement intervention
    Andrew J McCormick
    Division of Pulmonary and Critical Care Medicine, Harborview Medical Center University of Washington, Seattle, Washington 98104 2499, USA
    J Palliat Med 13:297-304. 2010
    ..Social workers are involved in providing this care for patients and families. Our goal was to examine the social worker component of an intervention to improve interdisciplinary palliative care in the ICU...
  17. doi request reprint An approach to understanding the interaction of hope and desire for explicit prognostic information among individuals with severe chronic obstructive pulmonary disease or advanced cancer
    J Randall Curtis
    Department of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98104, USA
    J Palliat Med 11:610-20. 2008
    ....
  18. pmc Managed care, access to specialists, and outcomes among primary care patients with pain
    David E Grembowski
    Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle 98195 7660, USA
    Health Serv Res 38:1-19. 2003
    ..To determine whether managed care controls were associated with reduced access to specialists and worse outcomes among primary care patients with pain...
  19. pmc Potential for response bias in family surveys about end-of-life care in the ICU
    Erin K Kross
    Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, WA 98104, USA
    Chest 136:1496-502. 2009
    ....
  20. pmc Supporting hope and prognostic information: nurses' perspectives on their role when patients have life-limiting prognoses
    Lynn F Reinke
    Department of Veterans Affairs, VA Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington, USA
    J Pain Symptom Manage 39:982-92. 2010
    ..Few studies have examined nurses' perspectives on their roles in meeting these patient and family needs...
  21. ncbi request reprint Measuring success of interventions to improve the quality of end-of-life care in the intensive care unit
    J Randall Curtis
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
    Crit Care Med 34:S341-7. 2006
    ..In this article, we examine some of the data supporting potential process and outcome measures that could be used to evaluate the success of interventions designed to improve end-of-life care in the ICU...
  22. ncbi request reprint Clinician statements and family satisfaction with family conferences in the intensive care unit
    Renee D Stapleton
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 34:1679-85. 2006
    ..In this exploratory analysis, we hypothesized that clinicians' communication behaviors providing emotional support to families during intensive care unit conferences would be associated with increased family satisfaction...
  23. ncbi request reprint Agreement among family members in their assessment of the Quality of Dying and Death
    Richard Mularski
    Department of Medicine, VA Greater Los Angeles Healthcare System, The University of California, 90073, USA
    J Pain Symptom Manage 28:306-15. 2004
    ....
  24. ncbi request reprint Correspondence between patients' preferences and surrogates' understandings for dying and death
    Ruth A Engelberg
    Department of Medicine, University of Washington, Seattle, Washington 98104, USA
    J Pain Symptom Manage 30:498-509. 2005
    ..These discussions may enable surrogates and clinicians to more accurately follow patient preferences...
  25. ncbi request reprint A measure of the quality of dying and death. Initial validation using after-death interviews with family members
    J Randall Curtis
    Department of Medicine, University of Washington, Seattle, WA 98104, USA
    J Pain Symptom Manage 24:17-31. 2002
    ..Future work will assess the potential role of the QODD in improving the quality of the dying experience...
  26. pmc Managed care, access to mental health specialists, and outcomes among primary care patients with depressive symptoms
    David E Grembowski
    Center for Cost and Outcomes Research, Department of Health Services, University of Washington, Seattle, Wash 98195 7660, USA
    J Gen Intern Med 17:258-69. 2002
    ..To determine whether managed care is associated with reduced access to mental health specialists and worse outcomes among primary care patients with depressive symptoms...
  27. doi request reprint Medicine residents' self-perceived competence in end-of-life care
    Martha E Billings
    Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington 98104, USA
    Acad Med 84:1533-9. 2009
    ..Understanding how residents' experiences and attitudes affect their perceived competence in providing end-of-life care is important for targeting educational interventions...
  28. pmc The Quality of Dying and Death Questionnaire (QODD): empirical domains and theoretical perspectives
    Lois Downey
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington 98104, USA
    J Pain Symptom Manage 39:9-22. 2010
    ..We conclude that research based on the current version of the QODD might benefit from the use of composite measures representing the four identified domains, but that future expansion and modification of the questionnaire are in order...
  29. pmc Predictors of symptoms of posttraumatic stress and depression in family members after patient death in the ICU
    Cynthia J Gries
    University of Washington, Division of Pulmonary and Critical Care, Seattle, WA 98104, USA
    Chest 137:280-7. 2010
    ..Patients' deaths in the ICU have been associated with a high burden of psychologic symptoms in families. This study identifies characteristics associated with psychologic symptoms in family members...
  30. pmc Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients
    Lois Downey
    Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195, USA
    Am J Hosp Palliat Care 26:246-53. 2009
    ....
  31. ncbi request reprint Narcotic and benzodiazepine use after withdrawal of life support: association with time to death?
    Jeannie D Chan
    Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, USA
    Chest 126:286-93. 2004
    ..To determine whether the dose of narcotics and benzodiazepines is associated with length of time from mechanical ventilation withdrawal to death in the setting of withdrawal of life-sustaining treatment in the ICU...
  32. pmc Predictors of time to death after terminal withdrawal of mechanical ventilation in the ICU
    Colin R Cooke
    Division of Pulmonary and Critical Care Medicine, University of Michigan, 6 Ann Arbor, MI 48109 5604, USA
    Chest 138:289-97. 2010
    ..Little information exists about the expected time to death after terminal withdrawal of mechanical ventilation. We sought to determine the independent predictors of time to death after withdrawal of mechanical ventilation...
  33. ncbi request reprint Family satisfaction in the ICU: differences between families of survivors and nonsurvivors
    Richard J Wall
    Department of Medicine, University of Washington, Seattle, WA 98104, USA
    Chest 132:1425-33. 2007
    ..In the current study, we sought to confirm these findings and identify specific aspects of care that were rated more highly by the family members of patients dying in the ICU compared to family members of ICU survivors...
  34. ncbi request reprint Measuring and improving the quality of dying and death
    Donald L Patrick
    University of Washington and Harborview Medical Center, Seattle 98195 7660, USA
    Ann Intern Med 139:410-5. 2003
    ..Overcoming these challenges is of great importance in the search for the social, organizational, and individual determinants of high-quality dying in the U.S. cultural and health care context...
  35. ncbi request reprint Studying communication about end-of-life care during the ICU family conference: development of a framework
    J Randall Curtis
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    J Crit Care 17:147-60. 2002
    ..The purpose of this study was to develop an understanding of the way this communication is currently conducted...
  36. pmc ICU care associated with symptoms of depression and posttraumatic stress disorder among family members of patients who die in the ICU
    Erin K Kross
    Department of Medicine, Division of Pulmonary and Critical Care, Harborview Medical Cente, University of Washington, Seattle, WA, USA
    Chest 139:795-801. 2011
    ..The patient-level risk factors for these family symptoms are not well understood but may help to target future interventions...
  37. pmc Effect of a quality-improvement intervention on end-of-life care in the intensive care unit: a randomized trial
    J Randall Curtis
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle Washington, USA
    Am J Respir Crit Care Med 183:348-55. 2011
    ..Because of high mortality, end-of-life care is an important component of intensive care...
  38. pmc The influence of race/ethnicity and socioeconomic status on end-of-life care in the ICU
    Sarah Muni
    Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, 325 Ninth Ave, Seattle, WA 98104, USA
    Chest 139:1025-33. 2011
    ..There is conflicting evidence about the influence of race/ethnicity on the use of intensive care at the end of life, and little is known about the influence of socioeconomic status...
  39. pmc Abandonment at the end of life from patient, caregiver, nurse, and physician perspectives: loss of continuity and lack of closure
    Anthony L Back
    Fred Hutchinson Cancer Research Center, School of Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
    Arch Intern Med 169:474-9. 2009
    ..Surveys and anecdotes suggest that patients and family members sometimes feel abandoned by their physicians at the transition to end-of-life care. To our knowledge, no prior studies describe abandonment prospectively...
  40. ncbi request reprint Missed opportunities during family conferences about end-of-life care in the intensive care unit
    J Randall Curtis
    Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Box 359762, 325 Ninth Avenue, Seattle, WA 98104 2499, USA
    Am J Respir Crit Care Med 171:844-9. 2005
    ..Improved communication with family members of critically ill patients can decrease the prolongation of dying in the intensive care unit (ICU), but few data exist to guide the conduct of this communication...
  41. pmc The language of prognostication in intensive care units
    Douglas B White
    Program in Medical Ethics, Department of Medicine, University of California, San Francisco, CA, USA
    Med Decis Making 30:76-83. 2010
    ..Rationale. Although misunderstandings about prognosis are common in intensive care units (ICUs), little is known about how physicians actually communicate prognostic information...
  42. ncbi request reprint Measuring intensive care nurses' perspectives on family-centered end-of-life care: evaluation of 3 questionnaires
    Lois Downey
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle WA 98195, USA
    Am J Crit Care 15:568-79. 2006
    ..Attempts to improve end-of-life care increasingly focus on family-centered care, but few validated assessment tools exist...
  43. ncbi request reprint Expressions of nonabandonment during the intensive care unit family conference
    Heather F West
    Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    J Palliat Med 8:797-807. 2005
    ..This analysis examines expressions of nonabandonment during ICU family conferences. Our goal was to categorize these expressions and develop a conceptual model for understanding this issue as it arises in the ICU setting...
  44. ncbi request reprint Prognostication during physician-family discussions about limiting life support in intensive care units
    Douglas B White
    Division of Pulmonary and Critical Care Medicine, Program in Medical Ethics, Department of Medicine, University of California, San Francisco, USA
    Crit Care Med 35:442-8. 2007
    ....
  45. ncbi request reprint Spiritual care of families in the intensive care unit
    Richard J Wall
    Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 35:1084-90. 2007
    ....
  46. pmc Family member satisfaction with end-of-life decision making in the ICU
    Cynthia J Gries
    Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA 98195, USA
    Chest 133:704-12. 2008
    ..The identification of chart-based quality indicators of palliative care that predict family satisfaction with decision making may help to guide interventions to improve decision making and family outcomes...
  47. pmc Quality-of-life trajectories at the end of life: assessments over time by patients with and without cancer
    Lois Downey
    Division of Pulmonary and Critical Care, Department of Medicine, Harborview Medical Center, School of Medicine, University of Washington, Seattle, Washington 98104, USA
    J Am Geriatr Soc 58:472-9. 2010
    ..To compare quality-of-life (QOL) ratings of terminally ill patients with and without cancer over time...
  48. ncbi request reprint Association of depression and life-sustaining treatment preferences in patients with COPD
    Renee D Stapleton
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    Chest 127:328-34. 2005
    ..No prior studies have examined the effects of depression and quality of life on treatment preferences in this population...
  49. pmc Using the medical record to evaluate the quality of end-of-life care in the intensive care unit
    Bradford J Glavan
    Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Washington, Seattle, WA, USA
    Crit Care Med 36:1138-46. 2008
    ..We investigated whether proposed "quality markers" within the medical record are associated with family assessment of the quality of dying and death in the intensive care unit (ICU)...
  50. doi request reprint Transitions regarding palliative and end-of-life care in severe chronic obstructive pulmonary disease or advanced cancer: themes identified by patients, families, and clinicians
    Lynn F Reinke
    Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
    J Palliat Med 11:601-9. 2008
    ..Patients may experience transitions in different ways than clinicians. No prior studies have examined this issue from patients', families', and clinicians' perspectives...
  51. pmc Shared priorities for the end-of-life period
    Lois Downey
    Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
    J Pain Symptom Manage 37:175-88. 2009
    ..This change would reduce respondent burden in future investigations, simplify analyses aimed at identifying domains underlying the dying-and-death experience, and exclude the top-priority item of fewer than 4% of respondents...
  52. pmc Integrating palliative and critical care: evaluation of a quality-improvement intervention
    J Randall Curtis
    Division of Pulmonary and Critical Care, Box 359762, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA
    Am J Respir Crit Care Med 178:269-75. 2008
    ..Palliative care in the intensive care unit (ICU) is an important focus for quality improvement...
  53. pmc Determinants of medical students' perceived preparation to perform end-of-life care, quality of end-of-life care education, and attitudes toward end-of-life care
    Martha E Billings
    Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98104, USA
    J Palliat Med 13:319-26. 2010
    ..In this study, we evaluated associations between survey items assessing these learning modalities and students' perceptions of their preparation, quality of education, and attitudes toward end-of-life care...
  54. ncbi request reprint Social workers in palliative care: assessing activities and barriers in the intensive care unit
    Andrew J McCormick
    Harborview Medical Center, Seattle, Washington 98104, USA
    J Palliat Med 10:929-37. 2007
    ....
  55. ncbi request reprint Quality of dying and death in two medical ICUs: perceptions of family and clinicians
    Cari R Levy
    Division of Healthcare Policy and Research, University of Colorado Health Sciences Center, Aurora, CO 80011, USA
    Chest 127:1775-83. 2005
    ..The aim was to obtain a surrogate assessment of the quality of the dying process and examine differences in the perceptions of different types of raters...
  56. pmc Duration of withdrawal of life support in the intensive care unit and association with family satisfaction
    Eric Gerstel
    Departments of Internal Medicine and Critical Care, Geneva University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
    Am J Respir Crit Care Med 178:798-804. 2008
    ..Most deaths in the intensive care unit (ICU) involve withholding or withdrawing multiple life-sustaining therapies, but little is known about how to proceed practically and how this process affects family satisfaction...
  57. pmc Alterations during medical interpretation of ICU family conferences that interfere with or enhance communication
    Kiemanh Pham
    Department of Emergency Medicine, Kern Medical Center, Bakersfield, CA, USA
    Chest 134:109-16. 2008
    ..Despite the importance of medical interpretation, little is known about the alterations that occur and their effect on communication...