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Autonomy quality surgery

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https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#1
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
November 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27793621/operative-autonomy-among-senior-surgical-trainees-during-infra-inguinal-bypass-operations-is-not-associated-with-worse-long-term-patient-outcomes
#2
Erin K Greenleaf, Faisal Aziz, Christopher S Hollenbeak
BACKGROUND: In an era of rapidly evolving surgical training, intra-operative teaching remains paramount to the education of surgical trainees. The impact of surgical trainees' level of expertise on outcomes after infra-inguinal bypass surgery, a technically demanding operation, remains unknown. The purpose of this study was to explore the effects of surgical residents' experience on outcomes after infra-inguinal bypass surgery. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, we identified patients who underwent infra-inguinal bypass from 2005-2012...
October 25, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27738719/burden-of-first-osteoporotic-hip-fracture-in-spain-a-prospective-12-month-observational-study
#3
Jose Ramón Caeiro, Agustí Bartra, Manuel Mesa-Ramos, Íñigo Etxebarría, Jorge Montejo, Pedro Carpintero, Francesc Sorio, Sonia Gatell, Andrea Farré, Laura Canals
The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included...
October 14, 2016: Calcified Tissue International
https://www.readbyqxmd.com/read/27719794/-the-eb-2%C3%A2-dummy-a-therapeutic-patient-education-tool-in-ent-surgery
#4
Pauline Mezerette, Élise Lefèvre
The day-to-day management and support of patients undergoing a total laryngectomy has led multi-disciplinary nursing teams to create a therapeutic patient education programme aiming to improve the quality of care and the autonomy of these people. In this context, the eb(2®) dummy is an essential tool.
October 2016: Revue de L'infirmière
https://www.readbyqxmd.com/read/27676898/creation-of-a-brochure-for-amputees-living-with-an-amputation
#5
Aurelie Vouilloz, François Luthi
OBJECTIVE: A lower limb amputation is a major event for a patient with many questions arising for him and his family. Individual and environmental factors could influence patient's quality of life and adaptation to amputation. Most of the time brochures concern post operative care after limb amputation (surgery type, stump medical care, prosthetics…). Rehabilitation is often only briefly dealt with these brochures. OBJECTIVES OF THIS STUDY: (1) To write a brochure specifically concerning rehabilitation for lower limb amputees...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27676895/tunisian-lower-limb-amputees-and-satisfaction-towards-their-prosthesis-about-74-cases
#6
Houda Migaou Miled, Hichem Ben Brahim, Yafa Hadj Hassine, Soumaya Boudokhane, Nesrine Abdelkafi, Aymen Haj Salah, Sana Salah, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: Assess satisfaction of lower limb amputees towards their device. PATIENTS AND METHODS: Prospective study of device-fitted lower limb amputees followed at the Physical Medicine and Rehabilitation department at the University Hospital of Monastir. Epidemiological and clinical parameters were assessed with evaluation of fitted patients' satisfaction towards their prosthesis (survey on the satisfaction of patients with lower limb amputations towards their prosthesis) (SAT-PRO)...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27603429/confidence-crisis-among-general-surgery-residents-a-systematic-review-and-qualitative-discourse-analysis
#7
Dawn M Elfenbein
Importance: In the surgical community, there is concern that general surgery residents are choosing subspecialty training in large numbers because of a crisis in confidence at the end of training. Confidence is an essential quality of surgeons, and recent studies have attempted to quantify and measure it in graduating general surgery residents. Objectives: To systematically review the quality of evidence provided and to critically analyze the language used to describe the findings using quantitative methods...
September 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27599307/fast-track-surgery-for-uncomplicated-appendicitis-in-children-a-matched-case-control-study
#8
Thomas P Cundy, Kyra Sierakowski, Alexandra Manna, Celia M Cooper, Laura L Burgoyne, Sanjeev Khurana
BACKGROUND: Standardized post-operative protocols reduce variation and enhance efficiency in patient care. Patients may benefit from these initiatives by improved quality of care. This matched case-control study investigates the effect of a multidisciplinary criteria-led discharge protocol for uncomplicated appendicitis in children. METHODS: Key protocol components included limiting post-operative antibiotics to two intravenous doses, avoidance of intravenous opioid analgesia, prompt resumption of diet, active encouragement of early ambulation and nursing staff autonomy to discharge patients that met assigned criteria...
September 6, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27442857/current-state-and-future-perspectives-of-energy-sources-for-totally-implantable-cardiac-devices
#9
Peter A Bleszynski, Jessica G Y Luc, Peter Schade, Steven Phillips, Vakhtang Tchantchaleishvili
There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions.Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes; though infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival...
July 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27395750/does-physician-communication-style-impact-patient-report-of-decision-quality-for-breast-cancer-treatment
#10
Kathryn A Martinez, Ken Resnicow, Geoffrey C Williams, Marlene Silva, Paul Abrahamse, Dean A Shumway, Lauren P Wallner, Steven J Katz, Sarah T Hawley
OBJECTIVE: Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. METHODS: Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality...
June 22, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27150916/tranexamic-acid-in-chronic-subdural-hematomas-tracs-study-protocol-for-a-randomized-controlled-trial
#11
Christian Iorio-Morin, Jocelyn Blanchard, Maxime Richer, David Mathieu
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most frequent reason for cranial neurosurgical consultation. There is no widely accepted medical treatment for this condition. Herein, we present the protocol for the Tranexamic Acid (TXA) in Chronic Subdural Hematomas (TRACS) trial aiming at determining whether TXA can increase the rate of CSDH resolution following conservative management, lower the number of required surgical procedures and decrease the rate of CSDH recurrence following surgical evacuation...
2016: Trials
https://www.readbyqxmd.com/read/27091641/quality-of-postoperative-recovery-after-breast-surgery-general-anaesthesia-combined-with-paravertebral-versus-serratus-intercostal-block
#12
M A Pérez Herrero, S López Álvarez, A Fadrique Fuentes, F Manzano Lorefice, C Bartolomé Bartolomé, J González de Zárate
INTRODUCTION: The quality of postoperative recovery is one of the most important among all the quality indicators used in clinical situations. This is even more important after cancer surgery. Our aim was to evaluate this after non-reconstructive breast surgery under general anesthesia and paravertebral blockade or serratus-intercostal plane blockade, in the early and late post-operative period. MATERIAL AND METHODS: A prospective observational study was conducted on 60 patients (25 paravertebral blockade group and 35 serratus-intercostal plane blockade group) scheduled for non-reconstructive breast surgery during a 6 month period...
April 15, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/26999497/outcome-of-acute-intestinal-failure
#13
J J Atema, B Mirck, I Van Arum, S M Ten Dam, M J Serlie, M A Boermeester
BACKGROUND: Type 2 acute intestinal failure is characterized by the need for parenteral nutrition (PN) for several months, and is typically caused by complications of abdominal surgery with enteric fistulas or proximal stomas. This study aimed to evaluate clinical management according to quality indicators established by the Association of Surgeons of Great Britain and Ireland. METHODS: Consecutive patients with type 2 intestinal failure referred to a specialized centre were analysed...
March 21, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26740906/a-threat-to-autonomy-the-intrusion-of-predictive-brain-implants
#14
Frederic Gilbert
The world's first-in-human clinical trial using invasive intelligent brain devices-devices that predict specific neuronal events directly to the implanted person-has been completed with significant success. Predicting brain activity before specific outcomes occur brings a raft of unprecedented applications, especially when implants offer advice on how to respond to the neuronal events forecasted. Although these novel predictive and advisory implantable devices offer great potential to positively affect patients following surgery by enhancing quality of life (e...
October 2, 2015: AJOB Neuroscience
https://www.readbyqxmd.com/read/26708344/self-determination-and-motivation-for-bariatric-surgery-a-qualitative-study
#15
Juyeon Park
This study examined how obese individuals acquire their motivation to undergo weight loss surgery and characterized the motivations within the framework of the self-determination theory (SDT). Participants expecting to have bariatric surgery were recruited and participated in semi-structured interviews. Interview accounts characterized different types of motivation for individuals seeking surgical weight loss treatments on the SDT continuum of relative autonomy. This study demonstrated that the more one's motivation was internally regulated, related to one's personal life and supported for competency, the more personal and hopeful were the anecdotes participants mentioned in accounts, thus the more positive the surgical outcomes were anticipated...
October 2016: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/26689582/end-of-life-care-planning-and-fragility-fractures-of-the-hip-are-we-missing-a-valuable-opportunity
#16
Robin H Dunn, Jaimo Ahn, Joseph Bernstein
BACKGROUND: Approximately 20% of all geriatric patients who sustain low-energy hip fractures will die within 1 year of the injury, and approximately 3% will die during the initial inpatient hospital stay. Accordingly, the event of a geriatric hip fracture might be an apt prompt for discussing end-of-life care: in light of the risk of death after this injury, the topic of mortality certainly is germane. However, it is not clear to what degree physicians and patients engage in end-of-life planning even when faced with a hospital admission for this potentially life-threatening condition...
July 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26656337/advance-directives-and-communication-skills-of-prehospital-physicians-involved-in-the-care-of-cardiovascular-patients
#17
Fabienne Gigon, Paolo Merlani, Bara Ricou
Advance directives (AD) were developed to respect patient autonomy. However, very few patients have AD, even in cases when major cardiovascular surgery is to follow. To understand the reasons behind the low prevalence of AD and to help decision making when patients are incompetent, it is necessary to focus on the impact of prehospital practitioners, who may contribute to an increase in AD by discussing them with patients. The purpose of this study was to investigate self-rated communication skills and the attitudes of physicians potentially involved in the care of cardiovascular patients toward AD...
December 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26652492/pathologic-and-impending-fractures-biological-and-clinical-aspects
#18
M S Spinelli, S Campi, F M Sacchetti, B Rossi, A Di Martino, S Giannini, A Piccioli
Bone metastases from carcinomas are epidemiologically rising because of the increased survival rate of oncologic patients, related to several factors such as improvement of primary and secondary screening, advancement of medical research and technology and the better understanding of mechanisms underlying bone metastases origination from primary tumor. Skeletal Related Events (SREs) can seriously affect quality of life in patients with metastatic disease. These events include the necessity of radiotherapy or bone surgery, malignant hypercalcemia, pathologic fractures and spinal cord compression...
October 2015: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/26590842/reverse-shoulder-arthroplasty-in-older-patients-is-it-worth-it-a-subjective-functional-outcome-and-quality-of-life-survey
#19
T Mangano, P Cerruti, I Repetto, L Felli, N Ivaldo, M Giovale
BACKGROUND: Reverse shoulder arthroplasty (RSA) use has largely spread in the last decade. Doubts still exist, however, about its use in the elder population, because of high risk of complications and possibly limited cost-efficiency of the procedure. AIMS: Our work was aimed at defining the subjective outcome, complication and satisfaction rate, and perceived recovery of individual autonomy and quality of life after RSA, in a cohort of patients 79 or more years old at the time of surgery...
October 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/26419844/implementing-a-home-based-exercise-program-for-patients-with-advanced-incurable-diseases-after-discharge-and-their-caregivers-lessons-we-have-learned
#20
Waldemar Siemens, Anja Wehrle, Jan Gaertner, Michael Henke, Peter Deibert, Gerhild Becker
BACKGROUND: Palliative care (PC) patients experience loss of physical function which usually impedes mobility, autonomy and quality of life. We aimed at examining the feasibility of a home-based exercise program for patients with advanced, incurable diseases after discharge. RESULTS: This was a single-arm pilot study (WHO-ICTRP: DRKS00005048). The 12-week home-based program comprised strength, balance, flexibility and endurance components. Patients with a presumed life expectancy of 6-12 months were recruited during a 6-months period on a specialized PC and a radiation therapy ward...
2015: BMC Research Notes
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