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https://www.readbyqxmd.com/read/28924687/comskil-communication-training-in-oncology-adaptation-to-german-cancer-care-settings
#1
Tim J Hartung, David Kissane, Anja Mehnert
Medical communication is a skill which can be learned and taught and which can substantially improve treatment outcomes, especially if patients' communication preferences are taken into account. Here, we give an overview of communication training research and outline the COMSKIL program as a state-of-the-art communication skills training in oncology. COMSKIL has a solid theoretical foundation and teaches core elements of medical communication in up to ten fully operationalized modules. These address typical situations ranging from breaking bad news to responding to difficult emotions, shared decision-making, and communicating via interpreters...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28923844/red-flag-screening-for-low-back-pain-nothing-to-see-here-move-along-a-narrative-review
#2
REVIEW
Chad E Cook, Steven Z George, Michael P Reiman
Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making...
September 18, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#3
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28922208/patient-centered-outcome-spectrum-an-evidence-based-framework-to-aid-in-shared-decision-making
#4
Angela M Ingraham, Suresh K Agarwal, Hee Soo Jung, Amy E Liepert, Ann P O'Rourke, John E Scarborough
OBJECTIVE: Our objective was to develop an alternate construct for reporting anticipated outcomes after emergency general surgery (EGS) that presents risk in terms of a composite measure. BACKGROUND: Currently available prediction tools generate risk outputs for discrete as opposed to composite measures of postoperative outcomes. A construct to synthesize multiple discrete estimates into a global understanding of a patient's likely postoperative health status is lacking and could augment shared decision-making conversations...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28921599/the-stories-we-tell-introduction-to-the-special-issue-on-ethical-challenges-in-community-psychology-research-and-practice
#5
Rebecca Campbell, Michael Morris
This Special Issue examines ethical challenges in community psychology research and practice. The literature on ethics in community psychology has remained largely abstract and aspirational, with few concrete examples and case studies, so the goal of this Special Issue was to expand our written discourse about ethical dilemmas in our field. In these articles, researchers and practitioners share stories of specific ethical challenges they faced and how they sought to resolve them. These first-person narratives examine how ethical challenges come about, how community psychology values inform ethical decision making, and how lessons learned from these experiences can inform an ethical framework for community psychology...
September 18, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28918669/unexpected-effects-of-a-system-distributed-mobile-application-in-maternity-care-a-randomized-controlled-trial
#6
Christy J W Ledford, Jasmyne J Womack, Heather A Rider, Angela B Seehusen, Stephen J Conner, Rebecca A Lauters, Joshua A Hodge
BACKGROUND: As pregnant mothers increasingly engage in shared decision making regarding prenatal decisions, such as induction of labor, the patient's level of activation may influence pregnancy outcomes. One potential tool to increase patient activation in the clinical setting is mobile applications. However, research is limited in comparing mobile apps with other modalities of patient education and engagement tools. AIM: This study was designed to test the effectiveness of a mobile app as a replacement for a spiral notebook guide as a patient education and engagement tool in the prenatal clinical setting...
September 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/28917833/values-based-shared-decision-making-in-the-antenatal-period
#7
REVIEW
Stephanie K Kukora, Renee D Boss
Despite advances in life-saving technology for critically ill neonates, challenges continue to arise for infants delivered with extreme prematurity, congenital anomalies, and genetic conditions that exceed the limits of currently available interventions. In these situations, parents are forced to make cognitively and emotionally difficult decisions, in discussion with a neonatologist, regarding how aggressively to provide supportive measures at the time of delivery and at what point burdens of therapy outweigh benefits...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#8
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28913817/return-to-play-in-2017-and-the-role-of-shared-decision-making-in-patients-with-inherited-and-acquired-channelopathies-and-cardiomyopathies
#9
REVIEW
Kia Afshar, T Jared Bunch
Shared decision-making is based upon a physician-patient encounter in which there is adequate education using aids if needed, a mutual discussion of how to assist the patient in weighing risks and benefits, and a supportive environment that allows the patient to deliberate on the clinical decision and make their own choice. This decision-making paradigm centers on the principles of autonomy and self-determination. Physical activity is a critical part of healthy lifestyle choices that helps lower risk of cardiovascular disease or the progression of it...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913725/exercise-and-competitive-sport-physiology-adaptations-and-uncertain-long-term-risks
#10
REVIEW
Patrick T Gleason, Jonathan H Kim
The benefits of regular and moderate exercise training on cardiovascular outcomes have been well established. In addition, strenuous exercise training leads to corollary cardiac structural and functional adaptations that are sport-specific and facilitate athletic performance. In this review, the normal physiologic and hemodynamic changes that occur during exercise and the subsequent differential exercise-induced cardiac remodeling patterns that develop will be discussed. Paradoxically, recent data have raised concern about the long-term impact of higher doses of physical activity and exercise on mortality and cardiovascular health outcomes...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913677/thus-far-and-no-further-should-diastolic-hypotension-limit-intensive-blood-pressure-lowering
#11
REVIEW
Marcel Ruzicka, Cedric Edwards, Brendan McCormick, Swapnil Hiremath
Intensive blood pressure lowering to systolic blood pressure thresholds of less than 120 mmHg is making a slow comeback with the publication of trials supporting its benefit, especially in lowering stroke and congestive heart failure. At the same time, there is an increasing awareness of the prevalence and risk of diastolic hypotension, especially at levels of less than 60 mmHg, with support for the existence of a J-curve coming from post hoc analyses of trials and epidemiological data from large cohort studies...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28905303/measuring-what-matters-to-the-patient-health-related-quality-of-life-after-aortic-valve-and-thoracic-aortic-surgery
#12
Frederiek de Heer, Arjen L Gökalp, Jolanda Kluin, Johanna J M Takkenberg
With improved outcomes following cardiac surgery, health related quality of life (HRQoL) gains increasing importance for the better judgement of choosing the preferred treatment strategy in the individual patient. The physician perception of patient preferences can differ considerably from actual patient preferences, underlining the importance of gathering evidence of actual patient preferences before and quality of life after cardiac surgery. The objective of the current review is to provide an overview of current insights into the quality of life measurements after aortic valve and thoracic aortic surgery and to provide starting points for the application of HRQoL measurements toward the future...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28904031/shared-decision-making-in-preventive-health-care-what-it-is-what-it-is-not
#13
Roland Grad, France Légaré, Neil R Bell, James A Dickinson, Harminder Singh, Ainsley Elizabeth Moore, Danielle Kasperavicius, Kaylyn L Kretschmer
No abstract text is available yet for this article.
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28903733/increasing-confidence-and-changing-behaviors-in-primary-care-providers-engaged-in-genetic-counselling
#14
Michael S Wilkes, Frank C Day, Tonya L Fancher, Haley McDermott, Erik Lehman, Robert A Bell, Michael J Green
BACKGROUND: Screening and counseling for genetic conditions is an increasingly important part of primary care practice, particularly given the paucity of genetic counselors in the United States. However, primary care physicians (PCPs) often have an inadequate understanding of evidence-based screening; communication approaches that encourage shared decision-making; ethical, legal, and social implication (ELSI) issues related to screening for genetic mutations; and the basics of clinical genetics...
September 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28903664/preferences-and-actual-chemotherapy-decision-making-in-the-greater-plains-collaborative-breast-cancer-study
#15
Ann M Berger, Russell J Buzalko, Kevin A Kupzyk, Bret J Gardner, Dilorom M Djalilova, Julie L Otte
INTRODUCTION: There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC...
September 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28902724/validation-of-the-integrated-model-of-health-literacy-in-patients-with-breast-cancer
#16
Wen-Hsuan Hou, Yi-Jing Huang, Yen Lee, Cheng-Te Chen, Gong-Hong Lin, Ching-Lin Hsieh
BACKGROUND: Health literacy (HL) enables patients with breast cancer to actively participate in health decisions and promote positive health outcomes. The Integrated Model of Health Literacy (IMHL), defined as the personal, situational, and societal/environmental factors that predict the level of HL that can influence health outcomes, incorporates the concepts, determinants, and consequences of HL. OBJECTIVE: The aim of this study was to examine the mechanisms and completeness of the IMHL in patients with breast cancer...
September 11, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28901600/ethical-issues-raised-by-thyroid-cancer-overdiagnosis-a-matter-for-public-health
#17
Wendy A Rogers, Wendy L Craig, Vikki A Entwistle
Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side effects...
October 2017: Bioethics
https://www.readbyqxmd.com/read/28901568/shared-decision-making-in-the-paediatric-field-a-literature-review-and-concept-analysis
#18
REVIEW
Eun Sook Park, In Young Cho
AIM: The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. METHOD: Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field...
September 13, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28901207/characterizing-citizens-preferences-for-engagement-in-patient-care-and-research-in-adult-and-pediatric-intensive-care-units
#19
Karen E A Burns, Leena Rizvi, Anna Charteris, Samuel Laskey, Saima B Bhatti, Kamalprit Chokar, Karen L M Choong
RATIONALE: Engagement promotes and supports the active participation of patients and families in health care and research to strengthen their influence on decision-making. We sought to characterize how citizens wish to be engaged in care and research in the intensive care unit (ICU). METHODS: Interviewers administered questionnaires to visitors in 3 adult ICUs and 1 pediatric ICU. RESULTS: We surveyed 202 (adult [n = 130] and pediatric [n = 72]) visitors...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28899714/qualitative-evaluation-of-a-narrative-reflection-program-to-help-medical-trainees-recognize-and-avoid-overuse-am-i-doing-what-s-right-for-the-patient
#20
Tanner Caverly, Daniel Matlock, Jocelyn Thompson, Brandon Combs
OBJECTIVE: The Do No Harm Project is a novel reflective writing program that encourages medical trainees to reflect on and write up clinical narratives about instances of avoidable medical overuse. Our goal is to describe this program and to explore the effect of the program on those participating. METHODS: Semi-structured interviews were conducted to explore how participating in the project influenced the thinking, attitudes, and behaviors of participating internal medicine residents...
September 8, 2017: Patient Education and Counseling
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