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Person-centered integrative

Emily J Rogalski, Becky Khayum
Primary progressive aphasia (PPA) is a clinical neurodegenerative dementia syndrome characterized by deficits in spoken and written word retrieval, word usage, and/or word comprehension. Currently, there are no effective treatments to reverse or halt the underlying disease process; however, speech-language therapy may be helpful. The Communication Bridge Care Model was developed to address the unique communication and quality of life needs of individuals living with PPA. The core elements include person-centered care with dyadic instruction for disease education, and counseling, along with tailored levels of impairment- and compensatory-based communication strategy training...
July 2018: Seminars in Speech and Language
Gro Berntsen, Audhild Høyem, Idar Lettrem, Cornelia Ruland, Markus Rumpsfeld, Deede Gammon
BACKGROUND: Person-Centered Integrated Care (PC-IC) is believed to improve outcomes and experience for persons with multiple long-term and complex conditions. No broad consensus exists regarding how to capture the patient-experienced quality of PC-IC. Most PC-IC evaluation tools focus on care events or care in general. Building on others' and our previous work, we outlined a 4-stage goal-oriented PC-IC process ideal: 1) Personalized goal setting 2) Care planning aligned with goals 3) Care delivery according to plan, and 4) Evaluation of goal attainment...
June 20, 2018: BMC Health Services Research
Kristina Crothers, Carla V Rodriguez, Robin M Nance, Kathleen Akgun, Shahida Shahrir, Joon Kim, Guy W Soo Hoo, Amir Sharafkhaneh, Heidi M Crane, Amy C Justice
PURPOSE: No prior studies have addressed the performance of electronic health record (EHR) data to diagnose chronic obstructive pulmonary disease (COPD) in people living with HIV (PLWH), in whom COPD could be more likely to be underdiagnosed or misdiagnosed, given the higher frequency of respiratory symptoms and smoking compared with HIV-uninfected (uninfected) persons. METHODS: We determined whether EHR data could improve accuracy of ICD-9 codes to define COPD when compared with spirometry in PLWH vs uninfected, and quantified level of discrimination using the area under the receiver-operating curve (AUC)...
June 20, 2018: Pharmacoepidemiology and Drug Safety
(no author information available yet)
The global refugee/migrant crisis of displacement because of persecution and conflict carries staggering implications of ambiguity and loss for the individuals affected. In 2013, approximately 25,000 displaced people sought asylum in the United States; many of whom have experienced state-sponsored physical and psychological torture. With Physicians for Human Rights (PHR), several medical student clinics work closely with immigration attorneys and University and Community based clinicians to assist U.S. asylum seekers in their asylum claims...
June 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Angela M Bengtson, Brian W Pence, Matthew J Mimiaga, Bradley N Gaynes, Richard Moore, Katerina Christopoulos, Conall O'Cleirigh, David Grelotti, Sonia Napravnik, Heidi Crane, Michael Mugavero
Background: The effect of depressive symptoms over time on progression through the HIV treatment cascade is complex and poorly characterized. Methods: We included participants from the Centers for AIDS Research Network of Integrated Clinic Systems Cohort who were ART-naïve, had at least one viral load and HIV appointment measure after ART initiation, and had a depressive symptom measure within 6 months of ART initiation. Recent depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) and categorized using a validated cut-point (PHQ-9 > 10)...
June 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Marie-Eve Poitras, Marie-Eve Maltais, Louisa Bestard-Denommé, Moira Stewart, Martin Fortin
BACKGROUND: Interventions to improve patient-centered care for persons with multimorbidity are in constant growth. To date, the emphasis has been on two separate kinds of interventions, those based on a patient-centered care approach with persons with chronic disease and the other ones created specifically for persons with multimorbidity. Their effectiveness in primary healthcare is well documented. Currently, none of these interventions have synthesized a patient-centered care approach for care for multimorbidity...
June 14, 2018: BMC Health Services Research
Roger Carpenter, Mary Jane Smith
This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge...
July 2018: Holistic Nursing Practice
Andrea Feldstain, Barry D Bultz, Janet de Groot, Amane Abdul-Razzak, Leonie Herx, Lyle Galloway, Srini Chary, Aynharan Sinnarajah
Background: Palliative care aims to improve suffering and quality of life for patients with life-limiting disease. This study evaluated an interdisciplinary palliative consultation team for outpatients with advanced cancer at the Tom Baker Cancer Centre. This team traditionally offered palliative medicine and recently integrated a specialized psychosocial clinician. Historic patient-reported clinical outcomes were reviewed. There were no a priori hypotheses. Methods: A total of 180 chart reviews were performed in 8 sample months in 2015 and 2016; 114 patients were included...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Xiaoling Xiang, Amanda Leggett, Joseph A Himle, Helen C Kales
OBJECTIVE: This study aims to estimate the prevalence and correlates of major and subthreshold depression and the extent of treatment utilization in older adults receiving home care. METHODS: The study sample included 811 community-dwelling adults aged 60 and over who received paid home care during the 2008-2014 waves of the Health and Retirement Study. Depression was assessed using short forms of the Composite International Diagnostic Interview and the Center for Epidemiologic Studies Depression Scale...
May 8, 2018: American Journal of Geriatric Psychiatry
Anne K Monroe, Sarah M Jabour, Sebastian Peña, Jeanne C Keruly, Richard D Moore, Geetanjali Chander, Kristin A Riekert
BACKGROUND: Inadequate identification and treatment of substance use (SU) and mental health (MH) disorders hinders retention in HIV care. The objective of this study was to elicit stakeholder input on integration of SU/MH screening using computer-assisted patient-reported outcomes (PROs) into clinical practice. METHODS: We conducted semi-structured interviews with HIV-positive patients who self-reported SU/MH symptoms on a computer-assisted PROs (n = 19) and HIV primary care providers (n = 11) recruited from an urban academic HIV clinic...
June 7, 2018: BMC Health Services Research
Haley Moulton, Tor D Tosteson, Wenyan Zhao, Loretta Pearson, Kristina Mycek, Emily Scherer, James N Weinstein, Adam Pearson, William Abdu, Susan Schwarz, Michael Kelly, Kevin McGuire, Alden Milam, Jon D Lurie
STUDY DESIGN: Prospective evaluation of an informational web-based calculator for communicating estimates of personalized treatment outcomes. OBJECTIVE: To evaluate the usability, effectiveness in communicating benefits and risks, and impact on decision quality of a calculator tool for patients with intervertebral disc herniations, spinal stenosis, and degenerative spondylolisthesis who are deciding between surgical and non-surgical treatments. SUMMARY OF BACKGROUND DATA: The decision to have back surgery is preference-sensitive and warrants shared decision-making...
June 5, 2018: Spine
Carmit McMullen, Matthew Nielsen, Alison Firemark, Patricia Merino Price, Denise Nakatani, Jean Tuthill, Ruth McMyn, Anobel Odisho, Michael Meyers, David Shibata, Scott Gilbert
PURPOSE: Complex bladder and colorectal cancer surgeries are associated with significant patient morbidity, yet few resources exist to prepare patients for the high levels of distress and complications they may experience. After ethnographic research to identify design challenges, we held a user-centered design (UCD) workshop to begin to develop patient- and caregiver-centered interventions to support preparation for and recovery after complex cancer surgery. METHODS: Concepts that emerged from brainstorming sessions were visually represented on storyboards and rated...
June 6, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Lisa Garland Baird, Kimberly Fraser
PURPOSE OF STUDY: The purpose of this scoping review was to explore peer-reviewed research and gray literature to examine the extent, range, and nature of available research that describes how home care case managers (HCCMs) provide integrated care for older adults with multiple chronic conditions (MCCs); identify how case management standards of practice correspond with functions of integrated care; identify facilitators and barriers to case management and integrated care delivery; and propose a framework to describe how HCCMs can use case management standards to provide integrated care to older adults with MCCs...
July 2018: Professional Case Management
Krista Revert, Laurence Audran, Jocelyne Pengam, Pascal Lesne, Dominique Pougheon Bertrand
BACKGROUND: The Cystic Fibrosis (CF) center in Roscoff (Brittany) has been involved in therapeutic education programs (TEP) since 2006 and took part in the pilot phase of the French quality improvement program (QIP) since 2011. The aim was to improve the nutritional status of children with cystic fibrosis aged 2-12 years old in order to optimize their health status as they enter adolescence. METHODS: A multidisciplinary quality team was created in order to select and address a specific health problem among our pediatric population...
February 8, 2018: Orphanet Journal of Rare Diseases
D Marsman, D W Belsky, D Gregori, M A Johnson, T Low Dog, S Meydani, S Pigat, R Sadana, A Shao, J C Griffiths
Many countries are witnessing a marked increase in longevity and with this increased lifespan and the desire for healthy ageing, many, however, suffer from the opposite including mental and physical deterioration, lost productivity and quality of life, and increased medical costs. While adequate nutrition is fundamental for good health, it remains unclear what impact various dietary interventions may have on prolonging good quality of life. Studies which span age, geography and income all suggest that access to quality foods, host immunity and response to inflammation/infections, impaired senses (i...
May 24, 2018: European Journal of Nutrition
Arnold Y L Wong, Katarina Sjögren Forss, Jenny Jakobsson, Veronika Schoeb, Christine Kumlien, Gunilla Borglin
BACKGROUND: Of various chronic diseases, low back pain (LBP) is the most common and debilitating musculoskeletal condition among older adults aged 65 years or older. While more than 17 million older adults in the USA suffer from at least one episode of LBP annually, approximately six million of them experience chronic LBP that significantly affects their quality of life and physical function. Since many older adults with chronic LBP may also have comorbidities and are more sensitive to pain than younger counterparts, these older individuals may face unique age-related physical and psychosocial problems...
May 24, 2018: Systematic Reviews
Laura E Romcevich, Suzanne Reed, Stacy R Flowers, Kathi J Kemper, John D Mahan
Background: Interventions to address burnout include mind-body skills training (MBST), but few studies have evaluated the feasibility of MBST for busy pediatric residents. Objective: In this pilot study, we tested the feasibility of a brief MBST intervention, using in-person peer-led training supported by online modules, to decrease stress and burnout in pediatric resident physicians. Methods: Of 99 (10%) residents, 10 residents at Nationwide Children's Hospital in Ohio participated in up to four 90-minute MBST sessions more than 1 month, led by a co-resident with 5 years of informal training in mind-body skills...
January 2018: Journal of Medical Education and Curricular Development
Melanie Au, Matthew Kehn, Henry Ireys, Crystal Blyler, Jonathan Brown
INTRODUCTION: This study examined burnout risk and job satisfaction reported by care coordinators in three programs integrating physical and behavioral health care; it also assessed the relationship between job support and burnout and the organizational supports helpful to care coordinators. METHODS: As part of an evaluation of the Centers for Medicare & Medicaid Services' Health Care Innovation Awards, the research team performed secondary data analysis of interviews conducted with staff (including care coordinators) in three integrated behavioral health models in 2014 and 2015 (n=88, n=69); focus groups with care coordinators in 2015 (n=3); and a survey of care coordinators in 2015 (n=231) that included the Maslach Burnout Inventory...
June 2018: American Journal of Preventive Medicine
Gregory L Kinney, Stephanie A Santorico, Kendra A Young, Michael H Cho, Peter J Castaldi, Raul San José Estépar, James C Ross, Jennifer G Dy, Barry J Make, Elizabeth A Regan, David A Lynch, Douglas C Everett, Sharon M Lutz, Edwin K Silverman, George R Washko, James D Crapo, John E Hokanson
Chronic Obstructive Pulmonary Disease (COPD) is a syndrome caused by damage to the lungs resulting in decreased pulmonary function and reduced structural integrity. Pulmonary function testing (PFT) is currently used to diagnose and stratify COPD into severity groups and chest computed tomography (CT) imaging is often used to assess structural changes in the lungs. We hypothesized that the combination of PFT and CT phenotypes would provide a more powerful tool for assessing underlying morphologic differences associated with pulmonary function in COPD than PFT alone...
May 16, 2018: American Journal of Epidemiology
Ellen Morrow, Megan Call, Robin Marcus, Amy Locke
DEFINING THE PROBLEM: A growing body of evidence highlights the need for wellness programs to support health care professionals. Although much of the existing literature centers on practicing physicians and physician trainees, there is growing awareness that these challenges are not unique to physicians and affect all members of the health care team. Traumatic and stressful events will always be a part of health care; how these events are addressed on a personal and team level is essential to the success of a health care system...
May 2018: Joint Commission Journal on Quality and Patient Safety
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