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Physician patient e communication

Ralph Poelstra, Ruud W Selles, Harm P Slijper, Mark J W van der Oest, Reinier Feitz, Steven E R Hovius, Jarry T Porsius
This prospective study investigates the extent to which a better experience with healthcare delivery is associated with better postoperative treatment outcomes after surgery for Dupuytren's contracture. Patients undergoing limited fasciectomy or percutaneous needle fasciotomy for Dupuytren's contractures completed the Michigan Hand Outcomes Questionnaire before and 3 months after surgery, together with a patient reported experience measure, while hand therapists assessed the straightness of the finger with a goniometer...
January 1, 2018: Journal of Hand Surgery, European Volume
Jolien J Glaudemans, Anja E de Jong, Bregje D Onwuteaka Philipsen, Jan Wind, Dick L Willems
Background: Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. Objective: To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers...
June 11, 2018: Family Practice
Park Kwang-Ok, Park SungHee, Yu Mi
PURPOSE: This study attempted to understand the core experiences of physicians related to communicating with nurses in Korea. METHODS: Ten physicians who worked at four tertiary university hospitals were interviewed. Data were analyzed using the phenomenological method developed by Colaizzi. RESULTS: The following six categories of participants' experience of communication with nurses were extracted from the analysis: (a) "Complex situations and heavy roles that cannot afford safety," (b) "Forcing a superior position in an authoritative environment," (c) "Different perspectives on patient care and difficulties in establishing relationships," (d) "Communicating key clues and receiving feedback from each other," (e) "Apathetic agreements rather than improvements," and (f) "Gradually developing mutually complementary communication...
June 7, 2018: Asian Nursing Research
Marja Leonhardt, Katja Aschenbrenner, Martin E Kreis, Johannes C Lauscher
BACKGROUND: Although a fifth of the German population has a migration background, health research regarding this population is scarce. The few existing studies on migrant health show that migrants are faced with restrictions regarding health care due to communication problems, a lack of information and distinct health literacy. Colorectal cancer (CRC) is the second most common tumor disease in Germany. The aim of the study is to explore the potential differences in patient characteristics between migrants and non-migrants with CRC and identify possible disparities between migrants and non-migrants regarding their satisfaction and perception with health care...
June 7, 2018: BMC Health Services Research
Emily S Tonorezos, Dana Barnea, Richard J Cohn, Monica S Cypriano, Brice C Fresneau, Riccardo Haupt, Lars Hjorth, Yasushi Ishida, Jarmila Kruseova, Claudia E Kuehni, Purna A Kurkure, Thorsten Langer, Paul C Nathan, Jane E Skeen, Roderick Skinner, Nurdan Tacyildiz, Marry M van den Heuvel-Eibrink, Jeanette F Winther, Melissa M Hudson, Kevin C Oeffinger
With improvements in cancer treatment and supportive care, a growing population of survivors of childhood cancer at risk for significant and potentially life-threatening late effects has been identified. To provide a current snapshot of the models of care from countries with varying levels of resources and health care systems, stakeholders in childhood cancer survivorship clinical care and research were identified from 18 countries across five continents. Stakeholders responded to a survey and provided a brief narrative regarding the current state of survivorship care...
June 6, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Arpita Mehrotra, Allison Kennedy Fisher, Jennifer Mullen, Leslie Rodriguez, Angela J Jiles, Alison P Albert, Laura A Randall, Paula M Frew
Background: Pertussis, or "whooping cough," is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27-36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16-61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women...
May 2018: Heliyon
Robert Klitzman
BACKGROUND: Infertility patients generally see provider-patient communication and relationships as important, but as often insufficient, raising critical questions regarding why these gaps persist, and how they might best be addressed. METHODS: Semi-structured interviews of approximately one hour each were conducted with 37 ART providers and patients (17 physicians, 10 other health providers, and 10 patients) and were thematically analyzed. RESULTS: Patients see clinicians' interactions as ranging widely from good to bad, related to several specific barriers and factors...
June 5, 2018: BMC Women's Health
Bujung Hong, Manolis Polemikos, Hans E Heissler, Christian Hartmann, Makoto Nakamura, Joachim K Krauss
BACKGROUND: Cerebrospinal fluid (CSF) circulation disturbances may occur during the course of disease in patients with glioblastoma. Ventriculoperitoneal shunting has generally been recommended to improve symptoms in glioblastoma patients. Shunt implantation for patients with glioblastoma, however, presents as a complex situation and produces different problems to shunting in other contexts. Information on complications of shunting glioma patients has rarely been the subject of investigation...
June 4, 2018: Fluids and Barriers of the CNS
Justin A Chen, Leah B Rosenberg, Brian J Schulman, Jonathan E Alpert, Robert J Waldinger
Although healthy physician-patient boundaries are essential to medical practice, published research on how to teach this important topic to medical students is lacking. Physician-patient boundaries, the interpersonal limits placed on behavior within a clinical relationship, protect providers and patients alike, and they represent a key component of professionalism. However, these boundaries may be difficult to teach and frequently are not presented as part of the formal curriculum, except in communication-focused specialties such as psychiatry and palliative care...
May 29, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Faranak Esmaeilbeigi, Janet E Pope
OBJECTIVES: To determine practices regarding cardiovascular (CV) risk assessment in systemic lupus erythematosus (SLE) amongst rheumatologists. METHODS: A questionnaire assessing preventative strategies, risk assessment, and beliefs regarding SLE and CV disease was sent electronically to 425 members of the Canadian Rheumatology Association. Questions were based on published recommendations for CV risk management. Responses were stratified based practitioner's characteristics...
May 28, 2018: Clinical and Experimental Rheumatology
E Girard, Q Jegousso, B Boussat, P François, F-X Ageron, C Letoublon, P Bouzat
BACKGROUND: Analyzing mortality in a mature trauma system is useful to improve quality of care of severe trauma patients. Standardization of error reporting can be done using the classification of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The aim of our study was to describe preventable deaths in our trauma system and to classify errors according to the JCAHO taxonomy. METHODS: We performed a six-year retrospective study using the registry of the Northern French Alps trauma network (TRENAU)...
May 25, 2018: Journal of Visceral Surgery
Nicole E M Jaspers, Frank L J Visseren, Mattijs E Numans, Yvo M Smulders, Fere A van Loenen Martinet, Yolanda van der Graaf, Jannick A N Dorresteijn
OBJECTIVE: Expressing therapy benefit from a lifetime perspective, instead of only a 10-year perspective, is both more intuitive and of growing importance in doctor-patient communication. In cardiovascular disease (CVD) prevention, lifetime estimates are increasingly accessible via online decision tools. However, it is unclear what gain in life expectancy is considered meaningful by those who would use the estimates in clinical practice. We therefore quantified lifetime and 10-year benefit thresholds at which physicians and patients perceive statin and antihypertensive therapy as meaningful, and compared the thresholds with clinically attainable benefit...
May 26, 2018: BMJ Open
Yulia A Strekalova, Kimberly E Hawkins, Leylah M Drusbosky, Cristopher R Cogle
Care coordination has been shown to have a positive effect on the management of chronic disease. Specific to the management of leukemia, coordination may occur between primary care physician, medical and radiation oncologists, surgeons, cardiologists, and genetics specialists. Experiencing gaps in communication and care coordination, many health consumers seek instrumental support in their social circles, including online forums and networks. The goal of this theory-guided study was to provide an in-depth assessment of how individuals use online forums to deliberate about their goals and plans for leukemia care coordination...
May 23, 2018: Translational Behavioral Medicine
Colin W O'Brien, Jessica Y Breland, Cindie Slightam, Andrea Nevedal, Donna M Zulman
Intensive outpatient care programs (IOCPs) have shown promise for high-risk patients who account for disproportionate acute care utilization and costs. These programs typically address medical, behavioral, and social needs through intensive case management, health care navigation, coordination, and access to a range of social and community services. However, the value of these programs is often limited by patient engagement challenges (i.e., difficulty engaging patients in self-care, decision-making, and follow-up with recommended services)...
May 23, 2018: Translational Behavioral Medicine
Andrea N Leep Hunderfund, Stephanie R Starr, Liselotte N Dyrbye, Jed D Gonzalo, Paul George, Bonnie M Miller, Helen K Morgan, Ari Hoffman, Elizabeth G Baxley, Bradley L Allen, Tonya L Fancher, Jay Mandrekar, Susan E Skochelak, Darcy A Reed
PURPOSE: To describe attitudes of first- and second-year U.S. medical students toward value-added medical education, assess their self-reported desire to participate in various value-added activities, and identify potentially modifiable factors influencing their engagement. METHOD: The authors conducted a cross-sectional survey of first- and second-year students at nine U.S. medical schools in 2017. Survey items measured students' attitudes toward value-added medical education (n = 7), desire to participate in value-added activities (n = 20), and factors influencing potential engagement (n = 18)...
May 22, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Martin Müller, Dana Khamis, David Srivastava, Aristomenis K Exadaktylos, Carmen Andrea Pfortmueller
According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide. Several factors have a major influence on asylum seekers' health; so, their health profile is markedly different from that of the population in the country of asylum. The aim of this study is to review the major issues physicians need to be aware of when treating asylum seekers, with a special focus on the neurological problems of asylum seekers and refugees. The major impact factors on refugees' health are linked to experiences and exposure (1) in the country of origin, (2) in refugee camps and en route to Europe, and (3) in the process of immigration into the host country and living in European asylum centers...
April 2018: Seminars in Neurology
Chad D Meyerhoefer, Susan A Sherer, Mary E Deily, Shin-Yi Chou, Xiaohui Guo, Jie Chen, Michael Sheinberg, Donald Levick
Objective: The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. Methods: We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR...
May 16, 2018: Journal of the American Medical Informatics Association: JAMIA
Carmen E Gonzalez, Norman Brito-Dellan, Srinivas R Banala, David Rubio, Mohamed Ait Aiss, Terry W Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Todd Sweberg, Anita I Sen, Paul C Mullan, Adam Cheng, Lynda Knight, Jimena Del Castillo, Takanari Ikeyama, Roopa Seshadri, Mary Fran Hazinski, Tia Raymond, Dana E Niles, Vinay Nadkarni, Heather Wolfe
BACKGROUND: The American Heart Association recommends debriefing after attempted resuscitation from in-hospital cardiac arrest (IHCA) to improve resuscitation quality and outcomes. This is the first published study detailing the utilization, process and content of hot debriefings after pediatric IHCA. METHODS: Using prospective data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q), we analyzed data from 227 arrests occurring between February 1, 2016, and August 31, 2017...
May 13, 2018: Resuscitation
Scott Edwards, Patricia E Molina, Kathleen H McDonough, Donald E Mercante, Tina Patel Gunaldo
Incorporating active interprofessional education (IPE) opportunities into the classroom setting is a potentially effective mechanism to enhance student learning both in the basic sciences and for future interprofessional collaboration. We integrated an IPE exercise into a graduate-level human physiology course at our health sciences center that enrolled physician assistant (PA), physical therapy (PT), and graduate studies students. Our activity adopted and targeted the four Interprofessional Education Collaborative (IPEC) competency domains of values/ethics (VE), roles/responsibilities, interprofessional communication, and teams and teamwork (TT)...
June 1, 2018: Advances in Physiology Education
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