John MacArtney

@johnmacartney.bsky.social

Marie Curie Associate Professor Sociologist of dying, palliative and end-of-life care, and bereavement. https://profiles.warwick.ac.uk/u1772723-john-macartney

Multiple conditions, complex treatments and unpredictable disease means it is often not possible to know the expected course of a patient's illness. This is prognostic uncertainty. New Marie Curie funded paper on improving communication of prognostic uncertainty 👉 bmjopen.bmj.com/content/16/7...

Improving communication of prognostic uncertainty in advanced illness: a realist review

Objectives Prognostic uncertainty is common in advanced illness, driven by multimorbidity, treatment complexities and unpredictable disease trajectories. When inadequately acknowledged or discussed, i...

bmjopen.bmj.com

'the Humanities and Social Sciences....disciplines ask not just “what works?” but “for whom?”, “at what cost?”, “under what assumptions?” and “towards what kind of society?” They are central to good policy, democratic accountability and social mobility.' Essential reading. Read it. 3/3

We know, "How long do I have?" is a big question often asked when someone has a terminal illness. Yet doctors often struggle to answer it, as the answer is rarely clear. But they also find it hard to explain their uncertainty. Our review of over *200 papers* identified...

Abstract
Objectives: Prognostic uncertainty is common in advanced illness, driven by multimorbidity, treatment complexities and unpredictable disease trajectories. When inadequately acknowledged or discussed, it can lead to patient and family distress and inhibit decision-making.

We aimed to build a programme theory of how, why and for whom communication of prognostic uncertainty ‘works’ (or not) in advanced illness and palliative care contexts.

Design Realist systematic review, reported according to RAMESES criteria.

Results From 4634 search results, we included 205 studies with 46 579 participants across 11 countries. The final programme theory identified contexts of communication: socio-cultural norms and values, patient and family preferences, communication models and interventions, clinician uncertainty tolerance, training and experience. Mechanisms of communication were mediated by the care relationship, the timing and initiation of discussion, the content of communication and explicit versus implicit communication. Relevant outcomes were emotions, hope, distress, decision making and care planning. There was no single model of effective communication as this varied based on individual characteristics and preferences, but openness was usually viewed positively.

Conclusion This programme theory provides a new understanding of the contexts and mechanisms, such as explicitness of discussion, that support effective communication of prognostic uncertainty across advanced illness contexts to reduce distress and aid decision making. Sociocultural factors are important, but they have the most limited supporting evidence, especially in low- and middle-income countries. The model presented here may support professionals in individualised and compassionate communication of prognostic uncertainty
MarieCurieEOLC@mariecurieeolc.bsky.social · 2w ago

Multiple conditions, complex treatments and unpredictable disease means it is often not possible to know the expected course of a patient's illness. This is prognostic uncertainty. New Marie Curie funded paper on improving communication of prognostic uncertainty 👉 bmjopen.bmj.com/content/16/7...

Hi! For reporting I'm doing at @motherjones.com, I'm looking to connect with people on how workplace accommodations has helped their mental health when it comes to changing in function due to Long Covid. Please reach out at jmetraux@motherjones.com. Reposts appreciated.

It was not lost on me that I was wearing a mask and talking about the "dark side" of academia (😆) Research cultures that perpetuate negative and pernicious experiences of "failure". This including sharing our "safe to fail" interactive resource: warwick.ac.uk/fac/sci/med/...

Man wearing a mask speaking next to a lectern in front of a projection of a slide from the presentation.Panel of six people sat in a row. The first person in the row holds a microphone and the others are looking at her.
John MacArtney@johnmacartney.bsky.social · last mo.

Very fortunate to have been invited to speak at the International Consortium for Research Culture symposium in Stellenbosch (nr Cape Town) @suhealthsci.bsky.social. Will be talking tomorrow about academic "failure", until then I will be enjoying the wonderful hospitality, scenery and talks!

Ok folks, last chance to complete the CURVE study and help us understand more about communicating uncertain recovery in acute care. We now have over 300 responses from across the UK, can you help us get to 350 before the end of the week? cambridge.eu.qualtrics.com/jfe/form/SV_...

Communicating Uncertain RecoVEry in acute care: a survey of physicians’ views. (The CURVE Study)

Communicating Uncertain RecoVEry in acute care: a survey of physicians’ views. (The CURVE Study)

cambridge.eu.qualtrics.com

This is about as comprehensive as things get. Would love to know what - if any - pushback it could receive from those representatives of the system itself. But maybe there aren’t any left. Even VCs would agree with much of it www.lrb.co.uk/the-paper/v4...

Stefan Collini · Squadrons of Pigs: Bonfire of the Universities

The problems with Britain’s universities are systemic and deep-rooted, not just local or contingent. Yet political and...

lrb.co.uk

This feels relevant today. This research finds that at least in UK HE Geography, precarity is now a generalised condition. As a highly casualised geographer, I believe this is the basis on which we must build solidarity across the sector (and between sectors). However...1/2.

States of Precarity@statesofprecarity.bsky.social · 7mo ago

Today we launch States of Precarity in UK HE Geography. Thank you to the 364 colleagues whose experiences shaped this work. Download the report, share widely, and join us in advocating for change. Launch event (1:00-2:30GMT): www.rgs.org/events/upcom... Read report: www.rgs.org/research/hig...