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https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#1
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28429620/physician-perspectives-on-decision-making-for-treatment-of-pediatric-sleep-disordered-breathing
#2
Emily F Boss, Anne R Links, Ron Saxton, Tina L Cheng, Mary Catherine Beach
Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#3
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28427915/-multimorbidity-in-general-practice-and-the-ariadne-principles-a-person-centred-approach
#4
Alexandra Prados-Torres, Isabel Del Cura-González, Juan Daniel Prados-Torres, Francisca Leiva-Fernández, Juan Antonio López-Rodríguez, Amaia Calderón-Larrañaga, Christiane Muth
Multimorbidity, defined as the coexistence of two or more chronic conditions in one same individual, has negative consequences for people suffering from it and it poses a real challenge for health systems. In primary care, where most of these patients are attended, the clinical management of multimorbidity can be a complex task due, among others, to the high volume of clinical information that needs to be handled, the scarce scientific evidence available to approach multimorbidity, and the need for coordination among multiple health providers to guarantee continuity of care...
April 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28426540/family-functioning-predicts-end-of-life-care-quality-in-patients-with-cancer-multicenter-prospective-cohort-study
#5
Myung Kyung Lee, Young Ho Yun
BACKGROUND: Treating patients with cancer within a family setting is the accepted standard of care and a hallmark of end-of-life (EoL) quality of care (QoC). OBJECTIVE: The aim of this study was to determine whether family caregiver functioning predicts EoL QoC received by terminally ill patients with cancer. METHODS: Family caregivers of terminally ill patients with cancer (n = 264) were enrolled from oncology inpatient and outpatient units of 12 large hospitals located in different regions throughout South Korea...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28426465/neoadjuvant-treatment-a-novel-standard
#6
Sandro Pasquali, Elena Palassini, Silvia Stacchiotti, Paolo G Casali, Alessandro Gronchi
PURPOSE OF REVIEW: The aim of this study was to summarize developments in the adjuvant/neoadjuvant chemotherapy of high-risk adult-type soft tissue sarcomas (STS). RECENT FINDINGS: The role of adjuvant/neaodjuvant chemotherapy in these patients is controversial, with a meta-analysis suggesting a 10% survival benefit. Recently, a randomized controlled trial in high-risk STS of extremities and trunk wall showed a 20% improvement in progression-free and overall survival after three preoperative cycles of epirubicin along with ifosfamide compared with a histology-tailored chemotherapy...
April 19, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28424546/perspectives-of-older-people-living-in-long-term-care-facilities-and-of-their-family-members-toward-advance-care-planning-discussions-a-systematic-review-and-thematic-synthesis
#7
REVIEW
Veronica Mignani, Francesca Ingravallo, Elena Mariani, Rabih Chattat
OBJECTIVE: We aimed to search and synthesize qualitative studies exploring the perspectives of older people living in long-term care facilities and of their family members about advance care planning (ACP) discussions. METHODS: The enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) framework was used to guide the review and report its results. PubMed, CINAHL, and PsycINFO were searched for studies published between January 2000 and November 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28423756/shared-decision-making-via-personal-health-record-technology-for-routine-use-of-diabetic-youth-a-study-protocol
#8
Selena Davis, Abdul Roudsari, Karen L Courtney
Engaging patients in the self-management decision-making provides opportunities for positive health outcomes. The process of shared decision making (SDM) is touted as the pinnacle of patient-centred care, yet it has been difficult to implement in practice. Access to tools resulting from the integration of all health data and clinical evidence, and an ease of communications with care providers are needed to engage patients in decision making. Personal health record (PHR) technology is a promising approach for overcoming such barriers...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#9
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28421426/decision-making-preferences-among-older-hispanics-participating-in-a-colorectal-cancer-crc-screening-program
#10
Jennifer C Molokwu, Eribeth Penaranda, Navkiran Shokar
Shared decision making has been shown to improve patients experience and satisfaction with care within the health care setting but it is not clear that all patients want to play an active role in health care decisions. The aim of this study is to describe general decision control preferences among a predominantly Spanish speaking Hispanic population. This is a cross-sectional study using the Control Preference Scale to assess decision-making preference. A total of 780 subjects completed the survey (response rate 89...
April 18, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28421425/the-role-of-alaska-s-tribal-health-workers-in-supporting-families
#11
Miriam Chernoff, Katie Cueva
Alaska's Community Health Aides/Practitioners (CHA/Ps) are often the sole medical workers in their communities in rural Alaska, and are instrumental in providing healthcare services and education to otherwise underserved individuals. This qualitative study explored how CHA/Ps support healthy families. Six CHA/Ps from two rural communities in western Alaska were interviewed about their scope of practice, interactions with mothers, infants, families, and teens, relationship to other medical providers, and perceptions of their work...
April 18, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28421019/gender-moderates-the-influence-of-self-construal-priming-on-fairness-considerations
#12
Nic Flinkenflogel, Sheida Novin, Mariette Huizinga, Lydia Krabbendam
Research in social and cultural psychology has identified that self-construal, or the way the self is defined in relation to others, plays an important role in social decision-making processes. Yet it remains difficult to isolate the effect of self-construal in a comparative approach. Therefore, we used priming methodology in three studies to induce either an independent or interdependent mindset to test direct consequences on fairness considerations. Specifically, we asked whether participants would accept an unfair ultimatum game offer: a split of 10 euros, where the participant is allocated the marginal share of 3 and the proposer 7...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28420639/implementing-shared-decision-making-in-the-nhs-lessons-from-the-magic-programme
#13
Natalie Joseph-Williams, Amy Lloyd, Adrian Edwards, Lynne Stobbart, David Tomson, Sheila Macphail, Carole Dodd, Kate Brain, Glyn Elwyn, Richard Thomson
No abstract text is available yet for this article.
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28420596/the-behaviors-and-experiences-of-the-community-pharmacy-team-on-the-provision-of-multi-compartment-compliance-aids
#14
Derek Stewart, Craig McDonald, Joan MacLeod, Katie MacLure, Gwen Gray, Trudi McIntosh
BACKGROUND: Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines. Acknowledging the lack of evidence that MCAs improve adherence or clinical outcomes, the Royal Pharmaceutical Society has expressed concern that MCAs have 'become regarded as a panacea for medicines use'. OBJECTIVES: To determine the behaviors and experiences of the community pharmacy team around MCA provision. METHODS: A cross-sectional survey was conducted in 26 community pharmacies in the north east of Scotland...
April 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28419019/complexities-of-consent-ethics-in-the-pediatric-emergency-department
#15
Naomi Dreisinger, Nathan Zapolsky
Informed consent is a communicative process of sharing information with patients, which helps assure their understanding of the information provided and asks for their permission to proceed. Informed consent allows a patient or a patient's family to use his or her own value system to determine the need for a particular procedure or test. Asking a patient for permission to treat requires the provider to respect the patient's autonomy through allowing him or her to be an active part of the decision-making process...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28417662/clinician-views-of-patient-decisional-conflict-when-deciding-between-dialysis-and-conservative-management-qualitative-findings-from-the-palliative-care-in-chronic-kidney-disease-packs-study
#16
Helen Noble, Kevin Brazil, Aine Burns, Sarah Hallahan, Charles Normand, Paul Roderick, Colin Thompson, Peter Maxwell, Magdi Yaqoob
BACKGROUND: Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care). AIM: To explore clinician views on decisional conflict in patients with end-stage kidney disease. DESIGN: Interpretive, qualitative study. SETTING AND PARTICIPANTS: As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28416138/patient-centered-outcomes-of-breast-reconstruction-in-the-setting-of-post-mastectomy-radiotherapy-a-comprehensive-review-of-the-literature
#17
REVIEW
Bassim El-Sabawi, Adelyn L Ho, Michael Sosin, Ketan M Patel
BACKGROUND: The impact of post-mastectomy radiotherapy (PMRT) on patient-centered outcomes of breast reconstruction remains unclear. This comprehensive review aims to consolidate the available data regarding aesthetic outcomes, patient satisfaction, and the BREAST-Q(©) following breast reconstruction in the setting of PMRT to facilitate the informed consent and shared decision-making process. MATERIALS AND METHODS: A systematic search of the literature published from 2000 to 2016 in the PubMed/MEDLINE database was performed to identify all manuscripts reporting aesthetic outcome, patient satisfaction, or BREAST-Q(©) scores of patients undergoing PMRT and breast reconstruction...
February 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28412895/self-stigma-and-consumer-participation-in-shared-decision-making-in-mental-health-services
#18
Johannes Hamann, Markus Bühner, Nicolas Rüsch
OBJECTIVE: People with mental illness struggle with symptoms and with public stigma. Some accept common prejudices and lose self-esteem, resulting in shame and self-stigma, which may affect their interactions with mental health professionals. This study explored whether self-stigma and shame are associated with consumers' preferences for participation in medical decision making and their behavior in psychiatric consultations. METHODS: In a cross-sectional study conducted in Germany, 329 individuals with a diagnosis of a schizophrenia spectrum disorder or an affective disorder and their psychiatrists provided sociodemographic and illness-related information...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28410651/advance-care-planning-for-patients-approaching-end-stage-kidney-disease
#19
REVIEW
Rebecca J Schmidt
Patients with chronic kidney disease typically suffer a cascade of comorbid conditions, the magnitude of which have formidable impact on advance care planning (ACP). Complex health care decisions are complicated further by contextual issues that may change over time. A dynamic and evolving process, ACP ideally begins early in the continuum of chronic kidney disease, long before end-stage kidney disease is reached. Planning ahead for care is preparatory to making decisions about kidney replacement therapy and can make for a smooth transition in addition to preventing the start of dialysis by default...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410647/disease-trajectories-before-esrd-implications-for-clinical-management
#20
REVIEW
Keiichi Sumida, Csaba P Kovesdy
One of the biggest challenges nephrologists face is to predict complex clinical pathways of kidney disease progression that do not follow a steady linear decline. This unpredictability often becomes a barrier to timely shared decision making between patients and physicians and could lead to adverse patient outcomes. By using numerous analytic approaches to characterize the longitudinal changes in kidney function, emerging evidence has disclosed the heterogeneous trajectories of kidney disease progression, particularly in late-stage chronic kidney disease (CKD) nearing end-stage renal disease (ESRD), and showed their independent associations with various clinical outcomes...
March 2017: Seminars in Nephrology
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