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https://www.readbyqxmd.com/read/28725863/empathy-in-the-clinician-patient-relationship-the-role-of-reciprocal-adjustments-and-processes-of-synchrony
#1
Arnstein Finset, Knut Ørnes
The clinician-patient relationship is asymmetric in the sense that clinicians and patients have different roles in the medical consultation. Yet, there are qualities of reciprocity and mutuality in many clinician-patient encounters, and we suggest that such reciprocity may be related to the phenomenon of empathy. Empathy is often defined as the capacity to place oneself in another's position, but empathy may also be understood as a sequence of reciprocal turns-of talk, starting with the patient's expression of emotion, followed by the perception, vicarious experience, and empathic response by the clinician...
June 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28705226/continuous-surveillance-of-a-pregnancy-clinical-guideline-an-early-experience
#2
Laura Martínez García, Hector Pardo-Hernández, Andrea Juliana Sanabria, Pablo Alonso-Coello
BACKGROUND: To date there is no consensus about the optimal strategy for keeping clinical guidelines (CGs) up-to-date. The aims of this study were (1) to develop a continuous surveillance and updating strategy for CGs and (2) to test the strategy in a specific CG. METHODS: The main steps were as follows: (1) recruiting members for the CG Updating Working Group, (2) mapping the CG, (3) identifying new evidence from the CG Updating Working Group, (4) designing and running restricted literature searches, (5) reviewing drugs and medical devices alerts, (6) screening and assessing the new evidence, (7) reviewing and, if necessary, modifying clinical questions and recommendations, and (8) updating the CG document...
July 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28698926/diagnosis-of-dementia-by-machine-learning-methods-in-epidemiological-studies-a-pilot-exploratory-study-from-south-india
#3
Sheshadri Iyengar Raghavan Bhagyashree, Kiran Nagaraj, Martin Prince, Caroline H D Fall, Murali Krishna
BACKGROUND: There are limited data on the use of artificial intelligence methods for the diagnosis of dementia in epidemiological studies in low- and middle-income country (LMIC) settings. A culture and education fair battery of cognitive tests was developed and validated for population based studies in low- and middle-income countries including India by the 10/66 Dementia Research Group. AIMS: We explored the machine learning methods based on the 10/66 battery of cognitive tests for the diagnosis of dementia based in a birth cohort study in South India...
July 11, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28695688/opening-pandora-s-box-ethical-issues-in-prenatal-whole-genome-and-exome-sequencing
#4
Ruth Horn, Michael Parker
OBJECTIVE: The development of genomic approaches to prenatal testing such as whole genome and exome sequencing offers the potential for a better understanding of prenatal structural anomalies in the fetus and ultimately for improved patient care and more informed reproductive decision making. In addition to the scientific and clinical challenges of achieving this, the introduction of new reproductive technologies also presents a number of ethical problems. The successful and appropriate development and introduction of prenatal genomics into clinical practice requires these problems to be identified, understood and carefully analysed in the development of models of good ethical practice...
July 10, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28689670/espen-expert-group-recommendations-for-action-against-cancer-related-malnutrition
#5
REVIEW
J Arends, V Baracos, H Bertz, F Bozzetti, P C Calder, N E P Deutz, N Erickson, A Laviano, M P Lisanti, D N Lobo, D C McMillan, M Muscaritoli, J Ockenga, M Pirlich, F Strasser, M de van der Schueren, A Van Gossum, P Vaupel, A Weimann
Patients with cancer are at particularly high risk for malnutrition because both the disease and its treatments threaten their nutritional status. Yet cancer-related nutritional risk is sometimes overlooked or under-treated by clinicians, patients, and their families. The European Society for Clinical Nutrition and Metabolism (ESPEN) recently published evidence-based guidelines for nutritional care in patients with cancer. In further support of these guidelines, an ESPEN oncology expert group met for a Cancer and Nutrition Workshop in Berlin on October 24 and 25, 2016...
June 23, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28686489/adolescent-experiences-of-clinician-patient-hiv-sti-communication-in-primary-care
#6
David Córdova, Frania Mendoza Lua, Lauretta Ovadje, Kathryn Fessler, José A Bauermeister, Christopher P Salas-Wright, Michael G Vaughn, Youth Leadership Council
Effective clinician-patient communication is linked to positive patient health outcomes in adults, yet the research on adolescent populations remains limited. We describe adolescent experiences of clinician-patient HIV/STI communication through qualitative interviews with predominantly African-American adolescent women from a youth-centered primary care clinic. Participants described acknowledging clinicians are professionals, the importance of confidentiality to foster clinician-adolescent communication, and calling for clinician-initiated HIV/STI communication...
July 7, 2017: Health Communication
https://www.readbyqxmd.com/read/28678426/using-collaborate-a-brief-patient-reported-measure-of-shared-decision-making-results-from-three-clinical-settings-in-the-united-states
#7
Rachel C Forcino, Paul J Barr, A James O'Malley, Roger Arend, Molly G Castaldo, Elissa M Ozanne, Sanja Percac-Lima, Cheryl D Stults, Ming Tai-Seale, Rachel Thompson, Glyn Elwyn
INTRODUCTION: CollaboRATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate CollaboRATE scores and response rates across multiple clinical settings with varied patient populations. METHOD: All adult patients at three United States primary care practices were eligible to complete CollaboRATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications...
July 5, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28632020/are-patients-with-hemiplegic-stroke-really-walking-with-a-cane-fitted-at-the-greater-trochanter
#8
Yong-Jun Cha
The purpose of this study was to determine the cane lengths currently used by patients with hemiplegic stroke for ambulatory assistance. The sample consisted of 116 adults with hemiplegic stroke. Descriptive statistics and Chi-square test for trend were conducted to examine the distributions of cane lengths, which were classified as follows: reaching >2 cm below the greater trochanter (GT), reaching from <2 cm below to <2 cm above the GT, or reaching >2 cm above the GT. Cane lengths reaching >2 cm above the GT were most common (range 62%-88%)...
February 26, 2017: Assistive Technology: the Official Journal of RESNA
https://www.readbyqxmd.com/read/28619273/the-many-disguises-of-patient-centered-communication-problems-of-conceptualization-and-measurement
#9
Richard L Street
OBJECTIVE: To critically examine different approaches to the measurement of patient-centered communication. METHODS: Provides a critique of 7 different measures of patient-centered communication with respect to differences in their assumptions about what constitutes patient-centeredness and in their approaches to measurement. RESULTS: The measures differed significantly with regard to whether the measure captured behavior (what the interactants did) or judgment (how well the behavior was performed), focused on the individual clinician or on the interaction as a whole, and on who makes the assessment (participant or observer)...
May 5, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28602566/dis-integration-of-communication-in-healthcare-education-workplace-learning-challenges-and-opportunities
#10
Marcy E Rosenbaum
The purpose of this paper, based on a 2016 Heidelberg International Conference on Communication in Healthcare (ICCH) plenary presentation, is to examine a key problem in communication skills training for health professional learners. Studies have pointed to a decline in medical students' communication skills and attitudes as they proceed through their education, particularly during their clinical workplace training experiences. This paper explores some of the key factors in this disintegration, drawing on selected literature and highlighting some curriculum efforts and research conducted at the University of Iowa Carver College of Medicine as a case study of these issues...
June 3, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28599142/opioid-pharmacovigilance-a-clinical-social-history-of-the-changes-in-opioid-prescribing-for-patients-with-co-occurring-chronic-non-cancer-pain-and-substance-use
#11
Kelly R Knight, Margot Kushel, Jamie S Chang, Kara Zamora, Rachel Ceasar, Emily Hurstak, Christine Miaskowski
There is growing concern among US-based clinicians, patients, policy makers, and in the media about the personal and community health risks associated with opioids. Perceptions about the efficacy and appropriateness of opioids for the management of chronic non-cancer pain (CNCP) have dramatically transformed in recent decades. Yet, there is very little social scientific research identifying the factors that have informed this transformation from the perspectives of prescribing clinicians. As part of an on-going ethnographic study of CNCP management among clinicians and their patients with co-occurring substance use, we interviewed 23 primary care clinicians who practice in safety-net clinical settings...
August 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28590895/a-qualitative-case-study-of-smartphone-connected-hearing-aids-influences-on-patients-clinicians-and-patient-clinician-interactions
#12
Stella L Ng, Shanon Phelan, MaryAnn Leonard, Jason Galster
BACKGROUND: Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence...
June 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/28582256/internet-based-exercise-therapy-using-algorithms-for-conservative-treatment-of-anterior-knee-pain-a-pragmatic-randomized-controlled-trial
#13
Tae Won Benjamin Kim, Nic Gay, Arpit Khemka, Jonathan Garino
BACKGROUND: Conservative treatment remains the first-line option, and there is significant medical evidence showing that home-based exercise therapy for the treatment of common causes of knee pain is effective. SimpleTherapy created an online platform that delivers Internet-based exercise therapy for common causes of knee pain. The system is driven by an algorithm that can process the user's feedback to provide an adaptive exercise regimen. This triple-armed, pragmatic randomized pilot was designed to evaluate if this telerehabilitation platform is safe and effective...
December 14, 2016: JMIR Rehabil Assist Technol
https://www.readbyqxmd.com/read/28572917/mobilizing-for-a-war-on-the-home-front-against-sugar-related-morbidity-and-mortality
#14
Dean Schillinger, James G Kahn
In Israel today, there are 420,200 Israelis diagnosed with diabetes, and every year, Israelis sustain thousands of diabetes-related deaths and tens of thousands of diabetes-related amputations. As such, in Israel, as in much of the world, there is a silent and deadly public health war against obesity and diabetes taking place on the home front -- one in which clinicians, patients, and families fight thousands of life- and limb-threatening battles daily, involving preventable heart disease, diabetes, strokes and amputations...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28570424/adherence-to-hepatitis-b-antiviral-therapy-a-qualitative-study
#15
Suzanne Polis, Iryna Zablotska-Manos, Amany Zekry, Lisa Maher
Hepatitis B virus (HBV) antiviral therapies potentially suppress HBV viral load to an undetectable level reducing the risk of progressive liver disease and the development of HBV-related hepatocellular carcinoma. Adherence to antiviral therapies is imperative to achieve and maintain viral suppression. To date, there has been limited research on adherence to HBV therapies. Our study aimed to explore factors influencing adherence to antiviral therapy. A total of 29 participants consented to in-depth qualitative interviews at three outpatient clinics in Sydney, New South Wales, Australia...
May 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28553806/perspectives-of-patients-clinicians-and-health-system-leaders-on-changes-needed-to-improve-the-health-care-and-outcomes-of-older-adults-with-multiple-chronic-conditions
#16
Rosie Ferris, Caroline Blaum, Eliza Kiwak, Janet Austin, Jessica Esterson, Gene Harkless, Gary Oftedahl, Michael Parchman, Peter H Van Ness, Mary E Tinetti
OBJECTIVE: To ascertain perspectives of multiple stakeholders on contributors to inappropriate care for older adults with multiple chronic conditions. METHOD: Perspectives of 36 purposively sampled patients, clinicians, health systems, and payers were elicited. Data analysis followed a constant comparative method. RESULTS: Structural factors triggering burden and fragmentation include disease-based quality metrics and need to interact with multiple clinicians...
February 1, 2017: Journal of Aging and Health
https://www.readbyqxmd.com/read/28546055/the-long-way-of-implementing-patient-centered-care-and-shared-decision-making-in-germany
#17
Martin Härter, Jörg Dirmaier, Isabelle Scholl, Norbert Donner-Banzhoff, Marie-Luise Dierks, Wolfgang Eich, Hardy Müller, David Klemperer, Klaus Koch, Christiane Bieber
The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision-making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Law on Patients' Rights" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28535105/the-importance-of-economic-perspective-and-quantitative-approaches-in-oncology-value-frameworks-of-drug-selection-and-shared-decision-making
#18
A Reginald Waldeck, Marc F Botteman, Richard E White, Ben A van Hout
The debate around value in oncology drug selection has been prominent in recent years, and several professional bodies have furthered this debate by advocating for so-called value frameworks. Herein, we provide a viewpoint on these value frameworks, emphasizing the need to consider 4 key aspects: (1) the economic underpinnings of value; (2) the importance of the perspective adopted in the valuation; (3) the importance of the difference between absolute and relative measures of risk and measuring patient preferences; and (4) the recognition of multiple quality-of-life (QoL) domains, and the aggregation and valuation of those domains, through utilities within a multicriteria decision analysis, may allow prioritization of QoL above the tallying of safety events, particularly in a value framework focusing on the individual patient...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28532629/shared-decision-making-in-the-uk-moving-towards-wider-uptake
#19
Angela Coulter, Adrian Edwards, Vikki Entwistle, Graham Kramer, Alan Nye, Richard Thomson, Emma Walker
Shared decision making (SDM) is firmly on the policy agenda in the UK and a recent legal ruling has confirmed its importance. Policymakers, ethicists, professional regulators and societies, patient organisations and now the courts are committed to ensuring that SDM becomes the norm throughout the NHS, but an unfavourable economic climate makes this especially challenging. Considerable progress has been made over the last few years, with new learning from demonstration sites, various initiatives in capacity building and training, wider availability of patient decision aids, and important leadership initiatives...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532611/hijacked-evidence-based-medicine-stay-the-course-and-throw-the-pirates-overboard
#20
John P A Ioannidis
The article discusses a number of criticisms that have been raised against evidence-based medicine, such as focusing on benefits and ignoring adverse events; being interested in averages and ignoring the wide variability in individual risks and responsiveness; ignoring clinician-patient interaction and clinical judgement; leading to some sort of reductionism; and falling prey to corruption from conflicts of interest. I argue that none of these deficiencies are necessarily inherent to evidence-based medicine...
April 2017: Journal of Clinical Epidemiology
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