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trust to physicians

Nao Hagiwara, Briana Mezuk, Jennifer Elston Lafata, Scott R Vrana, Michael D Fetters
INTRODUCTION: Patient-physician racial discordance is associated with Black patient reports of dissatisfaction and mistrust, which in turn are associated with poor adherence to treatment recommendations and underutilisation of healthcare. Research further has shown that patient dissatisfaction and mistrust are magnified particularly when physicians hold high levels of implicit racial bias. This suggests that physician implicit racial bias manifests in their communication behaviours during medical interactions...
October 18, 2018: BMJ Open
Carina Ahlstedt, Carin Eriksson Lindvall, Inger K Holmström, Åsa Muntlin Athlin
BACKGROUND: Registered nurses' work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts...
September 12, 2018: International Journal of Nursing Studies
Esteban A Cedillo-Couvert, Jesse Y Hsu, Ana C Ricardo, Michael J Fischer, Ben S Gerber, Edward J Horwitz, John W Kusek, Eva Lustigova, Amada Renteria, Sylvia E Rosas, Milda Saunders, Daohang Sha, Anne Slaven, James P Lash
BACKGROUND AND OBJECTIVES: In the general population, the quality of the patient experience with their primary care physician may influence health outcomes but this has not been evaluated in CKD. This is relevant for the growing Hispanic CKD population, which potentially faces challenges to the quality of the patient experience related to language or cultural factors. We evaluated the association between the patient experience with their primary care physician and outcomes in Hispanics with CKD...
October 18, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Mohamed Mahjoub, Sihem Ben Fredj, Nebiha Bouafia, Rym Bouriga, Naceur Ben Jalleb, Mansour Njah
BACKGROUND: promoting patient safety culture is a strategic priority and converges towards improving quality of health care. The healthcare professionals-patient relationship is an essential concept of patient safety culture. However, the increase of patient safety awareness is still delayed in Tunisia. OBJECTIVE: to assess and analyze the healthcare professional-patient relationship level among all healthcare professionals' categories in university hospital centre (UHC)FarhatHached, Sousse¬ Tunisia in order to further direct our strategies...
February 2018: La Tunisie Médicale
Thomas R Porter
In a study, published in this issue of Echo Research and Practice, Ntoskas et al. retrospectively analyzed the safety of a cardiac physiologist performing, and interpreting, Dobutamine stress echocardiography (DSE) in of 300 patients undergoing DSE for the detection of inducible reversible ischemia, myocardial viability and valvular heart disease. While safety during the tests themselves did not appear to be compromised with this unsupervised approach, the interpretation of these DSEs causes concerns regarding broad patient safety relative to misread results...
September 1, 2018: Echo Research and Practice
Arthur L Caplan, Brendan Parent, Jeffrey Kahn, Wendy Dean, Laura L Kimberly, W P Andrew Lee, Eduardo D Rodriguez
BACKGROUND: Despite early skepticism, the field of vascularized composite allotransplantation (VCA) has demonstrated feasibility. The ethics of VCA have moved past doubts about the morality of attempting such transplant to how to conduct them ethically. METHODS: Leaders of each program performing and/or evaluating VCA in the United States were invited to participate in a working group to assess the state and future of VCA ethics and policy. Four meetings were held over the course of 1 year to describe key challenges and potential solutions...
October 8, 2018: Transplantation
Constance R Chu, Scott Rodeo, Nidhi Bhutani, Laurie R Goodrich, Johnny Huard, James Irrgang, Robert F LaPrade, Christian Lattermann, Ying Lu, Bert Mandelbaum, Jeremy Mao, Louis McIntyre, Allan Mishra, George F Muschler, Nicolas S Piuzzi, Hollis Potter, Kurt Spindler, John M Tokish, Rocky Tuan, Kenneth Zaslav, William Maloney
Concern that misinformation from direct-to-consumer marketing of largely unproven "biologic" treatments such as platelet-rich plasma and cell-based therapies may erode the public trust and the responsible investment needed to bring legitimate biological therapies to patients have resulted in calls to action from professional organizations and governing bodies. In response to substantial patient demand for biologic treatment of orthopaedic conditions, the American Academy of Orthopaedic Surgeons convened a collaborative symposium and established a consensus framework for improving and accelerating the clinical evaluation, use, and optimization of biologic therapies for musculoskeletal diseases...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
Sandro Vento, Francesca Cainelli, Alfredo Vallone
Defensive medicine is widespread and practiced the world over, with serious consequences for patients, doctors, and healthcare costs. Even students and residents are exposed to defensive medicine practices and taught to take malpractice liability into consideration when making clinical decisions. Defensive medicine is generally thought to stem from physicians' perception that they can easily be sued by patients or their relatives who seek compensation for presumed medical errors. However, in our view the growth of defensive medicine should be seen in the context of larger changes in the conception of medicine that have taken place in the last few decades, undermining the patient-physician trust, which has traditionally been the main source of professional satisfaction for physicians...
October 6, 2018: World Journal of Clinical Cases
Areej El-Jawahri, Thomas W LeBlanc, Linda J Burns, Ellen Denzen, Christa Meyer, Lih-Wen Mau, Eric J Roeland, William A Wood, Effie Petersdorf
BACKGROUND: Despite its established benefits, palliative care (PC) is rarely utilized for hematopoietic stem cell transplant (HSCT) patients. We sought to examine transplant physicians' perceptions of PC. METHODS: We conducted a cross-sectional survey of transplant physicians recruited from the American-Society-for-Blood-and-Marrow-Transplantation. Using a 28-item questionnaire adapted from prior studies, we examined physicians' access to PC services, and perceptions of PC...
October 5, 2018: Cancer
Mirko Ancillotti, Stefan Eriksson, Jorien Veldwijk, Jessica Nihlén Fahlquist, Dan I Andersson, Tove Godskesen
BACKGROUND: High consumption of antibiotics has been identified as an important driver for the increasing antibiotic resistance, considered to be one of the greatest threats to public health globally. Simply informing the public about this consequence is insufficient to induce behavioral change. This study explored beliefs and perceptions among Swedes, with the aim of identifying factors promoting and hindering a judicious approach to antibiotics use. The study focused primarily on the medical use of antibiotics, also considering other aspects connected with antibiotic resistance, such as travelling and food consumption...
October 3, 2018: BMC Public Health
Garey Noritz, James Naprawa, Susan D Apkon, Kathi Kinnett, Fabrizio Racca, Elizabeth Vroom, David J Birnkrant
Primary care providers (PCPs) are usually the first point of contact with the health care system for patients with Duchenne muscular dystrophy (DMD), and patients often present to emergency departments in which providers have little experience in dealing with this condition. With this article, we give primary care and emergency medicine providers a background in the common issues that affect people with DMD. By acquiring some specialized knowledge about the multisystem medical complications of DMD and by applying general principles of primary care, such as timely immunization, anticipatory safety counseling, behavioral screening, and routine nutritional and developmental assessments, the PCP can be a valued and effective medical provider to patients with DMD...
October 2018: Pediatrics
V Kalaiselvan, Sushma Srivastava, Abhishank Singh, S K Gupta
Pharmacovigilance in India was initiated way back in 1986 with a formal adverse drug reaction (ADR) monitoring system, under supervision of the drug controller of India. India joined the World Health Organization (WHO) Programme for International Drug Monitoring in 1998, but was not successful. Later, the National Programme of Pharmacovigilance was launched in 2005, and was renamed as the Pharmacovigilance Programme of India (PvPI) in 2010. In consideration of having a robust pharmacovigilance system in India, steps were taken...
September 29, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Kimberly C McKeirnan, Linda Garrelts MacLean
OBJECTIVES: To determine physician, pharmacist, and patient perceptions of pharmacist-provided treatment services for minor ailments and conditions and to assess the potential for community pharmacists to improve access to care in medically underserved areas. DESIGN: Qualitative and quantitative semi-structured key informant interview. SETTING: Rural eastern Washington State from March to June 2016. PARTICIPANTS: Physicians, pharmacists, and pharmacy patients in rural eastern Washington State...
September 25, 2018: Journal of the American Pharmacists Association: JAPhA
Scott Koenig, Vidushan Nadarajah, Michael P Smuda, Sean Meredith, Jonathan D Packer, R Frank Henn
Background: Current research is sparse regarding how patients with orthopaedic injuries perceive and use internet-based information resources. Hypothesis: The majority of patients use the internet to research their orthopaedic condition and are receptive to guidance from their provider. Study Design: Cross-sectional study. Methods: A total of 213 patients attending a sports medicine clinic on the East Coast of the United States were asked to complete a questionnaire regarding their use of internet-based information...
September 2018: Orthopaedic Journal of Sports Medicine
Hajar Dehghan, Ali Keshtkaran, Niloofar Ahmadloo, Zahra Bagheri, Nahid Hatam
In cancer patients, improving the quality of life is a basic goal of treatment, with the patient – physician relationship as a major factor. Therefore the aim of this structural equation modeling study was to analyze the influence of patient involvement in care on quality of life in 411 breast cancer patients undergoing outpatient chemotherapy and radiotherapy. Two questionnaires were used: 1-patient-physician questionnaire, 2-EORTC QLQC-30 (to measure QOL). The structural equation model exhibited an excellent data fit (Chi-Square= 31...
September 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Marc Völker, Pojjana Hunchangsith
Physicians are in a unique position to be first-hand observers of the effects of environmental factors on population health. As a source of information which is highly trusted, they are also well-suited to raise awareness about the linkages between ecosystem and population health. Yet, current clinical practice in many parts of the world rarely includes environmental health assessments and patient education. The empirical evidence on the reasons for this lack of engagement is limited by the small number of studies published, its narrow geographical scope and the dearth of multivariate statistical analysis...
September 24, 2018: EcoHealth
C Ives, L Gregg, C Trust, M Green
Traditionally lymphoscintigrams are taken after injection of peri-areolar Technetium-99m (Tc-99m) to quantify sentinel nodes before biopsy (SNB). However, recent research suggests that scintigraphy is not an essential adjunct. For service improvement, we stopped using lymphoscintigraphy so as to minimize delay to operating theater and reduce demand on the Nuclear Medicine Department. We audited early outcomes to ensure quality was maintained. 100 consecutive patients undergoing SNB with lymphoscintigrams were investigated...
2018: Lymphology
Ingrid Klingmann, Andrea Heckenberg, Kay Warner, David Haerry, Amy Hunter, Matthew May, Wolf See
Involvement of patients in the research and development process (R&D) of new medicines-in all areas of indications-today is a widely accepted strategy in pharmaceutical industry to ensure relevance and suitability of the treatment under development. This may consist in, but is not limited to, patient input to achieve more patient-friendly protocol design, endpoint, and comparator selection as well as disease-adapted study conditions in a pre- or post-marketing clinical trial. Ethical aspects and especially the balance of benefit and risk in a clinical trial are frequently judged differently by clinical researchers, regulators, ethics committees, and patients due to their different focus...
2018: Frontiers in Medicine
Kimberly D Campbell-Voytal, Kendra L Schwartz, Hiam Hamade, Florence J Dallo, Anne Victoria Neale
Background: The Arab Muslim and Chaldean Christian American community is unified by language but culturally diverse. Researchers are challenged to engage the Arab/Chaldean community to meet immigrant health needs. Arabs/Chaldeans are identified as white in clinical data sets making it difficult to identify health behaviours and patterns unique to the community. Objectives: To explore the views of members of the Arab/Chaldean community, including researchers and the lay public, regarding health research participation and the role of clinicians, researchers and community leaders in the research process...
September 17, 2018: Family Practice
Rosediani Muhamad, Dell Horey, Pranee Liamputtong, Wah Yun Low
Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence...
September 20, 2018: Archives of Sexual Behavior
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