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https://www.readbyqxmd.com/read/29052225/peripheral-nerve-block-in-ankle-fracture-surgery-a-qualitative-study-of-patients-experiences
#1
M J Henningsen, R Sort, A M Møller, S F Herling
Peripheral nerve blocks are popular as a mode of anaesthesia for limb surgery and their beneficial effects are well documented in elective surgery. However, concerns have been raised about potential rebound pain outweighing the benefits in acute ankle fracture surgery. Furthermore, pain scores and morphine consumption do not provide a full picture, as pain is subjective. To evaluate the clinical usefulness of peripheral nerve blocks, we explored patients' expectations and experiences by means of semi-structured interviews analysed with systematic text condensation...
October 19, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29040571/patient-centered-early-pregnancy-care-a-systematic-review-of-quantitative-and-qualitative-studies-on-the-perspectives-of-women-and-their-partners
#2
M M J van den Berg, E A F Dancet, T Erlikh, F van der Veen, M Goddijn, P J Hajenius
BACKGROUND: Early pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of therapeutic management. An overview of aspects of care valued by women and/or their partners is missing. OBJECTIVE AND RATIONALE: This systematic review aims to provide an overview of aspects of care valued by women and/or their partners faced with early pregnancy complications and to identify potential targets for improvement in early pregnancy healthcare...
October 11, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#3
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29032036/relationship-between-the-subcostal-and-right-lateral-views-of-inferior-vena-cava-collapse-implications-for-clinical-use
#4
Rian Shah, Rory Spiegel, Christina Lu, Ivan Crnosija, Sahar Ahmad
BACKGROUND: The collapsibility index of the inferior vena cava (cIVC) is traditionally visualized in from the subcostal region in the sagittal plane (SS view), and is referred to here as cIVCSS. Alternatively, cIVC can be visualized from the right mid-axillary line in the coronal plane (RC view), referred to here as cIVCRC. It is unclear whether values of cIVCRC are comparable to values of cIVCSS as the IVC collapses asymmetrically into an elliptical form, quantified as the Flat Ratio of the IVC (F-IVC)...
October 11, 2017: Chest
https://www.readbyqxmd.com/read/29031321/patients-experience-of-decision-making-and-receiving-information-during-radiation-therapy-a-qualitative-study
#5
Sian K Smith, Django Nathan, Jennifer Taylor, Eleni Van Gelder, Ann Dixon, Georgia K B Halkett, Christopher Milross, Haryana M Dhillon
PURPOSE: This study aimed to explore: (i) patient perceptions of how they are involved in treatment decisions about radiation therapy; (ii) patient knowledge and understanding of treatment; and (iii) what patients value in their interactions with the radiation therapy treatment team. METHOD: Patients were recruited through radiation oncology departments at metropolitan hospital sites located in Sydney, New South Wales, Australia. Semi-structured interviews were conducted with 21 radiation therapy patients with different types of cancer...
October 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/29028865/clinical-ethics-in-the-context-of-deep-brain-stimulation-for-movement-disorders
#6
Cynthia S Kubu, Paul J Ford
Objective: Discuss common clinical ethical challenges encountered in working with patients who are candidates for deep brain stimulation (DBS) for the treatment of motor symptoms of Parkinson's disease (PD). Method: The relevant literature is reviewed and supplemented by descriptive, ethically challenging cases stemming from decades of combined experience working on DBS teams. We outline ethical arguments and provide pragmatic recommendations to assist neuropsychologists working in movement disorder teams...
September 25, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28990872/a-comparison-of-the-influence-of-anticipated-death-trajectory-and-personal-values-on-end-of-life-care-preferences-a-qualitative-analysis
#7
Katherine P Supiano, Nancy McGee, Kara B Dassel, Rebecca Utz
OBJECTIVES: We examined anticipated preferences for end-of-life (EOL) care in healthy older adults in the context of various terminal disease scenarios to explore the relationship between personal values and diseases and conditions that would influence EOL care choices. METHODS: Qualitative Descriptive Analysis was used to derive themes and the relationship between EOL preference themes and personal value themes in 365 respondents in a national sample of healthy older adults who completed a survey on their anticipated preferences for end-of-life (EOL) care...
August 17, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28986048/open-reduction-internal-fixation-versus-intramedullary-nailing-for-humeral-shaft-fractures-an-expected-value-decision-analysis
#8
Nicholas J Zarkadis, Emmanuel D Eisenstein, Nicholas A Kusnezov, John C Dunn, James A Blair
BACKGROUND: Previous randomized controlled studies and meta-analyses have failed to collectively favor either open reduction-internal fixation (ORIF) or intramedullary nailing (IMN) fixation. The purpose of our investigation was to elucidate the optimal decision between ORIF and IMN for acute traumatic operative humeral shaft fractures through an expected value decision analysis. METHODS: We performed an expected value decision analysis and sensitivity analysis to elucidate the difference between ORIF and IMN fixation for patients with acute traumatic humeral shaft fractures...
October 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28985348/elbow-room-for-best-practice-montgomery-patients-values-and-balanced-decision-making-in-person-centred-clinical-care
#9
Jonathan Herring, K M W Fulford, Michael Dunn, Ashok I Handa
The UK Supreme Court Montgomery judgment marks a decisive shift in the legal test of duty of care in the context of consent to treatment, from the perspective of the clinician (as represented by Bolam rules) to that of the patient. A majority of commentators on Montgomery have focused on the implications of the judgment for disclosure of risk. In this article, we set risk disclosure in context with three further elements of the judgment: benefits, options, and dialogue. These elements, we argue, taken together with risk disclosure, reflect the origins of the Montgomery ruling in a model of consent based on autonomy of patient choice through shared decision-making with their doctor...
July 19, 2017: Medical Law Review
https://www.readbyqxmd.com/read/28985192/incorporating-supportive-care-into-the-hemodialysis-unit
#10
Rebecca J Schmidt
PURPOSE OF REVIEW: Advance care planning is underutilized in patients with dialysis-dependent kidney failure and the provision of high intensity rather than supportive care is a standard practice in most hemodialysis units wherever challenges to incorporating palliative or supportive care into unit processes remain formidable. RECENT FINDINGS: The practice of advance care planning empowers patients, families and physicians and drives decisions about future treatment that align with patients' values, wishes and changing clinical circumstances...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28983741/what-do-high-risk-patients-value-perspectives-on-a-care-management-program
#11
Ishani Ganguli, E John Orav, Eric Weil, Timothy G Ferris, Christine Vogeli
BACKGROUND: There is growing interest in coordinating care for high-risk patients through care management programs despite inconsistent results on cost reduction. Early evidence suggests patient-centered benefits, but we know little about how participants engage with the programs and what aspects they value. OBJECTIVE: To explore care management program participants' awareness and perceived utility of program offerings. DESIGN: Cross-sectional telephone survey administered December 2015-January 2016...
October 5, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28981229/-clinical-care-pathway-for-chronic-kidney-disease-development-and-perspectives
#12
J Nortier, V Plennevaux, A Nolf, J M Hougardy, A D Petit
Because of the significant costs related to the treatment of end-stage kidney disease by dialysis, Belgian Health Care Authorities proposed in June 2009 to launch an early multidisciplinary care plan for chronic kidney disease (CKD) patients in the form of a clinical care pathway (CCP) focusing on a combined follow-up by the general practitioner and the nephrologist. The objective was to increase nephro-protection measures, reduce patient morbidity and mortality, and delay admission on dialysis. Our Nephrology Department at Erasme Hospital took the opportunity of CCP to set up workshops on therapy education which promote CKD patients' compliance and autonomy regarding their treatment (" empowerment ")...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28977277/-reflections-on-ethnography-in-the-emergency-department
#13
Janaína de Souza Aredes, Josélia Oliveira Araújo Firmo, Annette Leibing, Karla Cristina Giacomin
: Ethnography is the principal research method in Anthropology. With a broad scope, it allows using different data collection techniques and incorporates elements observed and obtained in the field into the analysis. In Public Health, it can contribute to understanding the health/disease process and health professionals' and patients' values and attitudes in different healthcare settings. The aim of this article is to present and discuss the ethnographic method based on an empirical study of physicians' hospital work in the face of the limits between life and death...
September 28, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28972652/shared-decision-making-for-people-with-asthma
#14
REVIEW
Kayleigh M Kew, Poonam Malik, Krishnan Aniruddhan, Rebecca Normansell
BACKGROUND: Asthma is a chronic inflammatory disease that affects the airways and is common in both adults and children. It is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. People with asthma may be helped to manage their condition through shared decision-making (SDM). SDM involves at least two participants (the medical practitioner and the patient) and mutual sharing of information, including the patient's values and preferences, to build consensus about favoured treatment that culminates in an agreed action...
October 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28972523/shared-decision-making-interventions-theoretical-and-empirical-evidence-with-implications-for-health-literacy
#15
Dawn Stacey, Sophie Hill, Kirsten McCaffery, Laura Boland, Krystina B Lewis, Lidia Horvat
Basic health literacy is required for making health decisions. The aim of this chapter is to discuss the use of shared decision making interventions for supporting patient involvement in making health decisions. The chapter provides a definition of shared decision making and discusses the link between shared decision making and the three levels of health literacy: functional, communicative/interactive, and critical. The Interprofessional Shared Decision Making Model is used to identify the various players involved: the patient, the family/surrogate/significant others, decision coach, and health care professionals...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28963833/-home-daily-hemodialysis-with-nxstage-system-one-monocentric-italian-casistic-results
#16
Chiara Brunati, Franca Cassaro, Laura Cretti, Michela Izzo, Marisa Pegoraro, Daniela Negri, Francesca Gervasi, Giacomo Colussi
NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate...
September 28, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28962816/shared-decision-making-in-neurocritical-care
#17
REVIEW
Muhammad Waqas Khan, Susanne Muehlschlegel
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28959495/shared-decision-making-in-stroke-an-evolving-approach-to-improved-patient-care
#18
REVIEW
Melissa J Armstrong
Shared decision-making (SDM) occurs when patients, families and clinicians consider patients' values and preferences alongside the best medical evidence and partner to make the best decision for a given patient in a specific scenario. SDM is increasingly promoted within Western contexts and is also being explored outside such settings, including in China. SDM and tools to promote SDM can improve patients' knowledge/understanding, participation in the decision-making process, satisfaction and trust in the healthcare team...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28953814/service-users-perspectives-in-promise-and-research
#19
Sarah Rae
Since its inception in 2013, PROMISE (PROactive Management of Integrated Services and Environments) has been supporting service users and staff at the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) on a journey to reduce reliance on force. The author's own personal experiences led to the founding of PROMISE and illustrates how individual experiences can influence a patient to lead change. Coproduction is actively embedded in PROMISE. Patients have been meaningfully involved because they are innovators and problem solvers who bring an alternative viewpoint by the very nature of their condition...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28940536/patient-value-perspectives-from-the-advocacy-community
#20
REVIEW
Bonnie J Addario, Ana Fadich, Jesme Fox, Linda Krebs, Deborah Maskens, Kathy Oliver, Erin Schwartz, Gilliosa Spurrier-Bernard, Timothy Turnham
All health-care systems are under financial pressure and many have therefore developed value frameworks to assist decision making regarding access to treatment. Unfortunately, many frameworks simply reflect the clinically focused values held by health-care professionals rather than outcomes that also matter to patients. It is difficult to define one single homogeneous set of patient values as these are shaped by social, religious and cultural factors, and health-care environment, as well as many factors such as age, gender, education, family and friends and personal finances...
September 20, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
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