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Physician–patient communication

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https://www.readbyqxmd.com/read/29351712/-immigrated-physicians-chances-and-challenges
#1
Isabel Hohmann, Heide Glaesmer, Yuriy Nesterko
BACKGROUND AND OBJECTIVE: In the health care infrastructure of Germany a demand for physicians with immigrant background exists. The situation of immigrated physicians is largely unexplored so far. In the framework of a pilot study stressors and resources of physicians with immigrant background have been explored concerning their migration-related experiences at German hospitals, and within the medical team. METHODS: As part of a qualitative analysis 8 physicians with immigrant background have been interviewed (problem-centered interview) from July to September 2014...
January 19, 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/29348272/use-of-computer-technology-during-family-centered-rounds-a-qualitative-study-of-parent-perspectives
#2
Jeremy Kern, Priti Bhansali
OBJECTIVES: Physicians often use computer technologies to assist in work activities, including family-centered rounds (FCR), but little is known about the attitudes of families on the use of these technologies. We aimed to describe these perceptions on the presence and use of computer technologies during FCR. METHODS: We conducted observations of FCR from a parent's visual perspective to "see what they see." This was followed by in-depth interviews with the families of patients admitted to the hospitalist service at our institution to describe their experience with the use of computer technology by the medical team during FCR...
January 18, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29342485/-driving-ability-in-mild-cognitive-impairment-and-dementia
#3
Klaus Schmidtke
Executive functions, visuo-spatial processing and control of behaviour are pertinent for safe driving. In patients with mild cognitive impairment and dementia, these abilities can be impaired, in addition to age-related impairments, and driving ability can be compromised at an early stage. Neurologists and psychiatrists play an important role in the examination, counseling and, if required, the issuing of a medical driving ban. Mistakes in this process may ensue forensic sequelae for the involved physicians...
January 2018: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29342479/time-spent-on-dedicated-patient-care-and-documentation-tasks-before-and-after-the-introduction-of-a-structured-and-standardized-electronic-health-record
#4
Erik Joukes, Ameen Abu-Hanna, Ronald Cornet, Nicolette F de Keizer
BACKGROUND:  Physicians spend around 35% of their time documenting patient data. They are concerned that adopting a structured and standardized electronic health record (EHR) will lead to more time documenting and less time for patient care, especially during consultations. OBJECTIVE:  This study measures the effect of the introduction of a structured and standardized EHR on documentation time and time for dedicated patient care during outpatient consultations...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#5
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29340148/reducing-unnecessary-culturing-a-systems-approach-to-evaluating-urine-culture-ordering-and-collection-practices-among-nurses-in-two-acute-care-settings
#6
Robert Redwood, Mary Jo Knobloch, Daniela C Pellegrini, Matthew J Ziegler, Michael Pulia, Nasia Safdar
Background: Inappropriate ordering and acquisition of urine cultures leads to unnecessary treatment of asymptomatic bacteriuria (ASB). Treatment of ASB contributes to antimicrobial resistance particularly among hospital-acquired organisms. Our objective was to investigate urine culture ordering and collection practices among nurses to identify key system-level and human factor barriers and facilitators that affect optimal ordering and collection practices. Methods: We conducted two focus groups, one with ED nurses and the other with ICU nurses...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#7
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29332503/-they-said-on-the-death-certificate%C3%A2-but-really-what-i-think-happened-characterizing-cause-of-death-in-va-medical-centers
#8
Beverly Rosa Williams, F Amos Bailey, Patricia S Goode, Kathryn L Burgio
Cause of death information is a vital resource for family and public health, yet significant issues persist regarding its determination, documentation and communication. In this study, we aim to characterize cause of death attribution process from the perspective of next-of-kin of Veterans who died in Veterans Affairs (VA) Medical Centers. Using a semi-structured guide, we explored next-of-kin's experiences of the Veteran's terminal hospitalization and conducted a content analysis of interview texts. In over two-third of cases next-of-kin's understanding was not consistent with their recollection of physicians' determination of cause of death...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29332187/human-bite-injuries-to-the-head-and-neck-current-trends-and-management-protocols-in-england-and-wales
#9
Glyndwr W Jenkins, Robert Isaac, Shakir Mustafa
INTRODUCTION: Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper. MATERIALS AND METHOD: A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate...
January 14, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29329438/patient-perspectives-on-how-physicians-communicate-diagnostic-uncertainty-an-experimental-vignette-study
#10
Viraj Bhise, Ashley N D Meyer, Shailaja Menon, Geeta Singhal, Richard L Street, Traber D Giardina, Hardeep Singh
Objective: We evaluated the effects of three different strategies for communicating diagnostic uncertainty on patient perceptions of physician competence and visit satisfaction. Design/Setting: Experimental vignette-based study design involving pediatric cases presented to a convenience sample of parents living in a large US city. Participants/Intervention(s): Three vignettes were developed, each describing one of three different ways physicians communicated diagnostic uncertainty to parents-(i) explicit expression of uncertainty ('not sure' about diagnosis), (ii) implicit expression of uncertainty using broad differential diagnoses and (iii) implicit expression of uncertainty using 'most likely' diagnoses...
January 10, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29322515/current-practices-in-perioperative-blood-management-for-patients-undergoing-liver-resection-a-survey-of-surgeons-and-anesthesiologists
#11
Sean Bennett, Abdul Ayoub, Alexandre Tran, Shane English, Alan Tinmouth, Daniel I McIsaac, Dean Fergusson, Guillaume Martel
BACKGROUND: Development of intraoperative techniques and blood management strategies in liver resection, and the multidisciplinary nature of perioperative transfusion decision making, creates an opportunity for practice variation. The aim of this study was to describe the current practices in perioperative blood management and explore differences between surgeons and anesthesiologists. STUDY DESIGN AND METHODS: A Web-based survey was developed, piloted, and circulated to Canadian liver surgeons and anesthesiologists...
January 10, 2018: Transfusion
https://www.readbyqxmd.com/read/29320335/physician-intervention-and-chinese-americans-colorectal-cancer-screening
#12
Judy Huei-Yu Wang, Grace X Ma, Wenchi Liang, Yin Tan, Kepher H Makambi, Roucheng Dong, Sally W Vernon, Shin-Ping Tu, Jeanne S Mandelblatt
OBJECTIVE: We conducted a cluster-randomized trial evaluating an intervention that trained Chinese-American primary care physicians to increase their Chinese patients' colorectal cancer (CRC) screening. METHODS: Twenty-five physicians (13 randomized to the intervention arm and 12 to the control arm) and 479 of their patients (aged 50-75 and nonadherent to CRC screening guidelines) were enrolled. The intervention, guided by Social Cognitive Theory, included a communication guide and 2 in-office training sessions to enhance physicians' efficacy in com- municating CRC screening with patients...
January 1, 2018: American Journal of Health Behavior
https://www.readbyqxmd.com/read/29316609/development-of-a-communication-strategy-to-increase-interprofessional-collaboration-in-the-outpatient-setting
#13
Chelsea Phillips Renfro, Stefanie Ferreri, Tiffany Graham Barber, Stephanie Foley
Managing patient health is a complex task, requiring the support of an interprofessional healthcare team. Collaboration between neighboring community pharmacies and primary care practices can be an alternate solution for team-based patient care. The purpose of this project was to design and implement a communication strategy for patients with diabetes and hypertension between a community pharmacy and physician practice. An interprofessional team for the practice settings was formed to develop a strategy for collaboration...
January 6, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29315989/patients-and-oncologists-views-on-family-involvement-in-goals-of-care-conversations
#14
Jenny J Lin, Cardinale B Smith, Shelli Feder, Nina A Bickell, Dena Schulman-Green
OBJECTIVE: Family members can significantly impact advanced cancer patients' treatment and are important participants in goals of care (GoC) conversations. Yet, research on patient and physician perspectives about family involvement and influence on GoC conversations is limited. Our purpose was to describe patients' and oncologists' perspectives about family involvement and influence on GoC conversations among patients with advanced cancer. METHODS: We conducted semi-structured interviews at academic, community and municipal hospitals (n=4) with patients with advanced cancer (n=39) and their oncologists (n=21)...
January 5, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29315153/overall-emergency-department-rating-identifying-the-factors-that-matter-most-to-patient-experience
#15
Emily L Aaronson, Elizabeth Mort, Jonathan D Sonis, Yuchiao Chang, Benjamin A White
BACKGROUND: Patient experience is becoming an area of interest in Emergency Medicine as more is understood about its impact on outcomes and the expectation that it will soon be tied to reimbursement. No study has investigated the predictors of emergency department (ED) patient satisfaction in over a decade. As the care environment, access to information, and consumer interests change, determinants of satisfaction have likely evolved. Our objective was to examine the factors that were most predictive of ED satisfaction...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29315151/factors-associated-with-delayed-discharge-on-general-medicine-service-at-an-academic-medical-center
#16
Nidhi Rohatgi, Marlena Kane, Marcy Winget, Farnoosh Haji-Sheikhi, Neera Ahuja
Lack of collaboration between care teams and patients/families has been associated with delayed discharge from the hospital. In this study, we determine whether patients' awareness of the estimated date of discharge (EDD) was associated with a decrease in delayed discharge, and determine the factors associated with a delayed discharge. A total of 221 patients admitted to the General Medicine service between July and September 2014 were included in the study. Estimated date of discharge was identified within 36 hours of admission...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29313458/clinician-perspectives-on-strategies-to-improve-patient-maternal-immunization-acceptability-in-obstetrics-and-gynecology-practice-settings
#17
Paula M Frew, Laura A Randall, Fauzia Malik, Rupali Lamaye, Andrew Wilson, Sean T O'Leary, Daniel Salmon, Meghan Donnelly, Kevin Ault, Matthew Z Dudley, Vincent L Fenimore, Saad B Omer
Pregnancy is an ideal time to communicate with women about vaccines for themselves and their infants, yet maternal immunization rates remain suboptimal. This study aimed to identify clinic, provider, and staff-related attributes and facilitators to be utilized for a comprehensive vaccine intervention in ob-gyn clinical settings. We conducted in-depth interviews with 24 providers, both healthcare providers (e.g., physicians, nurse practitioners, midwives) and practice managers, from urban and suburban ob-gyn practices in Georgia and Colorado about their immunization attitudes, practices, and patient experiences...
January 9, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29306883/clinical-decisions-presented-to-patients-in-hospital-encounters-a-cross-sectional-study-using-a-novel-taxonomy
#18
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306586/communication-skills-teaching-in-brazilian-medical-schools-what-lessons-can-be-learned
#19
Rafaela Liberali, Dennis Novack, Pamela Duke, Suely Grosseman
OBJECTIVE: To assess current practices in communication skills (CS) teaching in Brazilian medical schools (MS), looking for similarities and differences with other countries. METHODS: This study was performed with 162 out of the 237 accredited Brazilian MS (68.35%). The quantitative data were analyzed using descriptive statistics and qualitative data using content analysis. RESULTS: 104 MS (64.2%) reported formal CS training. CS were more commonly taught in the pre-clinical years, by physicians and psychologists...
December 28, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29306373/benefit-risk-communication-in-paediatric-imaging-what-do-referring-physicians-radiographers-and-radiologists-think-say-and-do
#20
J L Portelli, J P McNulty, P Bezzina, L Rainford
INTRODUCTION: To assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information. METHODS: This study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta...
February 2018: Radiography
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