Marie Haverfield

• PhD
• Assistant Professor at San Jose State University

Objectives: Patients often struggle with psychological and social stressors that accompany life-limiting chronic illness. Because psychosocial concerns may be conveyed through emotional sentiments, this study aimed to identify emotional expressions to describe psychosocial contexts communicated during goals of care conversations. Methods: This q...

Background Advance care planning initiatives are becoming more widespread, increasing expectations for providers to engage in goals of care conversations. However, less is known about how providers communicate advance care planning within and throughout a health care system. Aim To explore perspectives of communication processes in the rollout of...

Importance Surrogate misunderstanding of patient survival prognosis in the intensive care unit (ICU) is associated with poor patient and surrogate outcomes. Shared decision-making (SDM) may reduce misunderstanding. Objective To evaluate the association between SDM-aligned communication and prognostic misunderstanding. Design, Setting, and Partici...

Background Documenting goals of care in the electronic health record is meant to relay patient preferences to other clinicians. Evaluating the content and documentation of nurse and social worker led goals of care conversations can inform future goals of care initiative efforts. Methods As part of the ADvancing symptom Alleviation with Palliative...

The use of telehealth, specifically virtual visits, has increased and adoption continues. Providers need effective training for how to communicate with patients to develop a connection during virtual visits. This article describes the implementation and evaluation of a course called Mastering Presence in Virtual Visits. Results show that although p...

Prognostic conversations present many challenges for patients, caregivers, and providers alike. Most research examining the context of prognostic conversations have used a more siloed approach to gather the range of perspectives of those involved, typically through the lens of patient-centered care. However, the mutual influence evident in prognost...

Relationship‐centered care is a conceptual framework that places value on humanism in the clinical encounter and treats conversational exchange as the irreducible unit of analysis. Bridging features of interpersonal relationships with patient–clinician interactions, the framework positions the relationship between patient and clinician as central t...

Emotion regulation is an important skill that adolescents typically learn through early interactions with their primary caregivers. Associations between parental communication and adolescent emotion regulation are well-documented however, it is unclear whether the parent’s actual communication behavior or adolescents’ perceptions of the parent’s be...

Objective To explore qualitative patient experience comments before and after a relationship-centered communication skills training to understand patient experience, program impact, and opportunities for improvement. Methods Qualitative patient experience evaluation data was captured from January 2016 to December 2018 for 483 health care clinician...

Objective: To identify communication practices that clinicians can use to address racism faced by Black patients, build trusting relationships, and empower Black individuals in clinical care. Data sources: Qualitative data (N=112 participants, August 2020 to March 2021) collected in partnership with clinics primarily serving Black patients in Le...

Introduction: Anti-Black racism has strong roots in American health care and medical education. While curricula on social determinants of health are increasingly common in medical training, curricula directly addressing anti-Black racism are limited. Existing frameworks like the Presence 5 framework for humanism in medicine can be adapted to devel...

Context . The Life Sustaining Treatment Decision Initiative is a national effort by the Veterans Health Administration to ensure goals of care documentation occurs among all patients at high risk of life-threatening events. Objectives . Examine likelihood to receive goals of care documentation and explore associations between documentation and per...

Background The United States Veterans Health Administration National Center for Ethics in Health Care implemented the Life-Sustaining Treatment Decisions Initiative throughout the Veterans Health Administration health care system in 2017. This policy encourages goals of care conversations, referring to conversations about patient’s treatment and en...

Objective Although social and environmental factors are central to provider–patient interactions, the data that reflect these factors can be incomplete, vague, and subjective. We sought to create a conceptual framework to describe and classify data about presence, the domain of interpersonal connection in medicine. Methods Our top-down approach fo...

Objective Although social and environmental factors are central to provider patient interactions, the data that reflect these factors can be incomplete, vague, and subjective. We sought to create a conceptual framework to describe and classify data about presence, the domain of interpersonal connection in medicine. Methods Our top down approach for...

Human-centered design (HCD), an empathy-driven approach to innovation that focuses on user needs, offers promise for the rapid design of health care interventions that are acceptable to patients, clinicians, and other stakeholders. Reviews of HCD in healthcare, however, note a need for greater rigor, suggesting an opportunity for integration of ele...

In response to the rising childhood obesity rates in the state of Louisiana, Baton Rouge has integrated the 5210+10 program into a citywide campaign known as HealthyBR. This article presents a first step in (re)designing the 5210+10 campaign through a critical community-centered approach. Using Bacchi’s ‘what’s the problem represented to be’ method...

Objectives Rising costs in oncology care often impact patients and families directly, making communication about costs and financial impacts of treatment crucial. Cost expenditures could offer opportunities for estimation and prediction, affording personalized conversations about financial impact. We sought to explore providers’, patients’, and car...

Background The Veterans Health Administration (VA) National Center for Ethics in Healthcare (NCEHC) implemented the Life-Sustaining Treatment Decisions Initiative (LSTDI) including policy and practice standards, clinician communication training, a documentation template, and central implementation support to foster advance care planning (ACP) via g...

Background Although studies have examined how depressed patients’ baseline characteristics predict depression course, still needed are studies of how depression course is associated with modifiable long-term outcomes. Aims This study examined six outcomes of three groups representing distinct depression courses (low baseline severity, rapid declin...

Background Prior to national spread, the Department of Veterans Affairs implemented a pilot of the life-sustaining treatment decisions initiative (LSTDI) to promote proactive goals of care conversations (GoCC) with seriously ill patients, including policy and practice standards, an electronic documentation template and order set, and implementation...

Objective Screening for pain in routine care is one of the efforts that the Veterans Health Administration has adopted in its national pain management strategy. We aimed to understand patients’ perspectives and preferences about the experience of being screened for pain in primary care. Design Semistructured interviews captured patient perceptions...

Background: Human connection is at the heart of medical care, but questions remain as to the effectiveness of interpersonal interventions. The purpose of this review was to characterize the associations between patient-provider interpersonal interventions and the quadruple aim outcomes (population health, patient experience, cost, and provider exp...

Importance Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction. Objective To identify evidence and narrative-based practices that promote clinician presence, a state of awareness, focus, and attention wi...

This study applied emotion regulation theory to examine parental communication that predicts possible markers of adolescent resilience in families of harmful versus non-harmful parental alcohol use. Parent-adolescent dyads (30 with and 30 without harmful parental alcohol use) participated in video-taped interactions rated for parents' emotion coach...

Background In order to close the gap between discoveries that could improve health, and widespread impact on routine health care practice, there is a need for greater attention to the factors that influence dissemination and implementation of evidence-based practices. Evidence synthesis projects (e.g., systematic reviews) could contribute to this e...

Objective We sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts. Design In 2017–2018, we conducted qualitative semistructured interviews with 10 physic...

Background Despite consensus about the need to assess study design quality in systematic reviews, there remains a need for practical tools that can be used for quality assessment across diverse study designs. Methods We developed the Study Quality Assessment of Design (SQUAD) tool by combining and streamlining the Cochrane tool for grading randomiz...

Patients entering an inpatient psychiatry program (N = 406) with co-occurring mental health and substance use disorders reported on their social support networks (source, type) at treatment intake, and completed symptom measures at baseline and 3-, 9-, and 15-month follow-ups (77%). Longitudinal growth models found aspects of participants’ support...

BACKGROUND: While barriers to physician wellness have been well detailed, concrete solutions are lacking. OBJECTIVE: We looked to professionals across diversefields whose work requires engagement and interpersonalconnection with clients. The goal was to identify effective strategies from non-medical fields that could be applied to preserve physicia...

Background: Pain management discussions between patient and provider can be stressful to navigate and greatly impact the care received. Because of the complexity, emotional color, and sensitivity of pain management, such discussions require a high degree of skill. Objective: To identify patients' perspectives of patient-centered care communicati...

Introduction Pain is a longstanding and growing concern among US military veterans. Although many individuals rely on medications, a growing body of literature supports the use of complementary non-pharmacologic approaches when treating pain. Our objective is to characterize veteran experiences with and barriers to accessing alternatives to medicat...

The authors categorized communication strategies employed to exchange social support (type and person centeredness) in three online forums about parents with harmful drinking. Data included discussion postreplies over 2 months; N = 1,644 units of analysis. Support type categories were identification, emotional, informational, network, and esteem. F...

59 Background: The development of “big data” methods offers an opportunity to more precisely predict patient outcomes. We explored physicians, patients, and caregivers’ perspectives about the use of predictive models in oncology practice. Methods: We conducted 12 patient, 12 provider, and 12 caregiver interviews (N = 36) from Stanford University ou...

Background: Polysubstance use, the consumption of more than one substance over a defined period, is common and associated with psychiatric problems and poor treatment adherence and outcomes. This study examined past-month polysubstance use at intake among psychiatry inpatients with co-occurring mental health and substance use disorders, and outcom...

Interactions between parents and children establish norms for managing emotions and behavior, which are markers of resilience. This study examines how features of interpersonal communication between parents and children facilitate the resilience of children of alcoholic parents versus nonalcoholic parents. Parent–adolescent dyads (30 families of al...

Family communication is a strong predictor of the attitudes and behaviors children and adolescents have toward alcohol. This study explored perspectives of family communication about the topic of alcohol in focus groups consisting of adult children of alcoholics and adult children of nonalcoholics. The study utilized Koerner and Fitzpatrick’s (2002...

Conflict resolution involves various behaviors, tactics, and strategies that help to resolve disputes, reduce interference in personal goals, and rebuff negative emotions toward a partner. Individuals balance a variety of goals during conflict, including instrumental goals, relational goals, identity goals, and process goals. Interpersonal power dy...

In the U.S., roughly 43% of adults have encountered alcoholism in their family and one in four children lives with an alcoholic parent (Grant, 2000). Prior research suggests that alcoholism can negatively impact the nature and quality of family relations, but studies rarely consider the specific ways in which family communication dynamics are impac...

Alcoholism is a highly stigmatized condition, with both alcohol-dependent individuals and family members of the afflicted experiencing stigmatization. This study examined the severity of a parent’s alcoholism and family topic avoidance about alcohol as two factors that are associated with family members’ perceptions of stigma. Three dimensions of s...

Growing up with an alcoholic parent can have a lasting effect on children and contribute to a variety of challenging outcomes in adulthood. This study identified the various experiences that adult children of alcoholics (ACoA) discuss with their peers in online support groups. Trained coders conducted a thematic analysis of 504 message board posts...