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"Physician motivation"

Shannon Ciprut, Erica Sedlander, Kara L Watts, Richard S Matulewicz, Kurt C Stange, Scott E Sherman, Danil V Makarov
Among US men, most new prostate cancer cases are clinically localized and do not require imaging as part of staging workup according to guidelines. Two leading specialty societies promote stewardship of health resources by encouraging guideline-concordant care, thereby limiting inappropriate and obsolete imaging. However, imaging to stage low-risk prostate cancer remains high, as almost half of men with localized prostate cancer undergo wasteful imaging following diagnosis. We employed a theory-based approach, based on current evidence and data on existing practice patterns revealing that providers are the drivers to imaging decisions, to design an intervention to improve guideline -concordant prostate cancer staging imaging across populations...
February 1, 2018: Urologic Oncology
James Heaf, Aivars Petersons, Baiba Vernere, Maija Heiro, Johan V Povlsen, Anette Bagger Sørensen, Mai Rosenberg, Niels Løkkegaard, Fabiola Alonso-Garcia, Jan Dominik Kampmann, Naomi Clyne, Else Randers, Olof Heimburger, Bengt Lindholm
INTRODUCTION: The incidence of unplanned dialysis initiation (DI) with consequent increased comorbidity, mortality and reduced modality choice remains high, but the optimal timing of dialysis initiation (DI) remains controversial, and there is a lack of studies of specific reasons for DI. We investigated why and when physicians prescribe dialysis and hypothesized that physician motivation for DI is an independent factor which may have clinical consequences. METHODS: In the Peridialysis study, an ongoing multicenter prospective study assessing the causes and timing of DI and consequences of unplanned dialysis, physicians in 11 hospitals were asked to describe their primary, secondary and further reasons for prescribing DI...
2017: PloS One
Judith L Bowen, Jonathan S Ilgen, David M Irby, Olle Ten Cate, Bridget C O'Brien
PURPOSE: Physicians routinely transition responsibility for patient care to other physicians. When transitions of responsibility occur before the clinical outcome is known, physicians may lose opportunities to learn from the consequences of their decision making. Sometimes curiosity about patients does not end with the transition and physicians continue to follow them. This study explores physicians' motivations to follow up after transitioning responsibilities. METHOD: Using a constructivist grounded theory approach, the authors conducted 18 semistructured interviews in 2016 with internal medicine hospitalist and resident physicians at a single tertiary care academic medical center...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Maximilian H M Hatz, Tim Sonnenschein, Carl Rudolf Blankart
BACKGROUND: Studies have often stated that individual-level determinants are important drivers for the adoption of medical devices. Empirical evidence supporting this claim is, however, scarce. At the individual level, physicians' adoption motivation was often considered important in the context of adoption decisions, but a clear notion of its dimensions and corresponding measurement scales is not available. OBJECTIVES: To develop and subsequently validate a scale to measure the motivation to adopt medical devices of hospital-based physicians...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
M Ortega-Moreno, N Padilla-Garrido, L Huelva-López, F Aguado-Correa, J Bayo-Calero, E Bayo-Lozano
OBJECTIVE: To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. MATERIAL AND METHODS: A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data...
March 5, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Jeroen Trybou, Paul Gemmel, Sebastian Desmidt, Lieven Annemans
BACKGROUND: To be successful, hospitals must increasingly collaborate with their medical staff. One strategic tool that plays an important role is the mission statement of hospitals. The goal of this research was to study the relationship between the fulfillment of administrative and professional obligations of hospitals on physicians' motivation to contribute to the mission of the hospital. Furthermore the mediating role of the physicians' emotional attachment to the hospital and moderation effect of the exchange with the head physicians were considered...
January 13, 2017: BMC Health Services Research
Paul H Caldron, Ann Impens, Milena Pavlova, Wim Groot
BACKGROUND: Short-term medical missions (STMMs) refer to the provision of direct pro bono medical services in lower and middle income countries for periods ranging from days to a few weeks by physicians from rich countries. Survey data have provided limited information on demographic and professional profiles of physicians as well as monetary and manpower inputs. Understanding why physicians participate, however, remains incomplete. The study's objective was to elicit physicians' motivations directly...
January 12, 2017: International Journal of Health Planning and Management
Zhou Ping, Shi Jian-Wei, Zhang Yu, Bai Fei, Wei Xue-Feng, Xue Di
BACKGROUND: Physician motivation to maintain public welfare has become the key for the New Public Hospital Reform in China. This study aimed to apply a different perspective, the psychological contract (a popular concept in business management research) and explore the correlations between physicians' psychological contract and their job satisfaction, intention to leave medical practice, and professionalism. METHODS: A cross-sectional survey was conducted using a stratified sampling method in Shanghai, Hubei, and Gansu in China from June 10 to October 30, 2013...
October 2016: Lancet
Giuliano Russo, Inês Rego, Julian Perelman, Pedro Pita Barros
That the current economic crisis is having an impact on population health and healthcare utilisation across Europe is fairly established; how national health systems and markets are reacting is however still poorly understood. Drawing from the economic literature we conducted 21 interviews with physicians, policy-makers and healthcare managers in Portugal, to explore their perceptions on the impact of the crisis on the country's market medical services, on physicians' motivation, and the ensuing coping strategies...
September 2016: Health Policy
Elizabeth M Schoenfeld, Sarah L Goff, Tala R Elia, Errel R Khordipour, Kye E Poronsky, Kelly A Nault, Peter K Lindenauer, Kathleen M Mazor
BACKGROUND: Shared decision making (SDM) is increasingly recognized as an important facet of patient-centered care. Despite growing interest in SDM in the emergency department (ED), little is known about emergency physicians' (EPs') motivations for using SDM. Understanding current patterns of SDM use and EP's rationale for using SDM is essential for the development of interventions to increase use. OBJECTIVES: Recognizing the EP as an important stakeholder in SDM research, we sought to identify and explore factors that may motivate EPs' engagement in SDM...
December 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Cesare Gridelli, Antonio Rossi, Fortunato Ciardiello, Filippo De Marinis, Lucio Crinò, Alessandro Morabito, Floriana Morgillo, Agnese Montanino, Gennaro Daniele, Maria Carmela Piccirillo, Nicola Normanno, Ciro Gallo, Francesco Perrone
BACKGROUND: About 20% of advanced non-small-cell lung cancer (NSCLC) cases harbor somatic mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene. In these patients, the standard first-line treatments are the EGFR-tyrosine kinase inhibitors, such as gefitinib, erlotinib, or afatinib. Most of these patients develop resistance and relapse within about 1 year of initiation of an EGFR-tyrosine kinase inhibitor. Consequently, it is important to develop new combination strategies to delay this resistance...
September 2016: Clinical Lung Cancer
Kathryn I Pollak, Cynthia J Coffman, James A Tulsky, Stewart C Alexander, Truls Østbye, David Farrell, Pauline Lyna, Rowena J Dolor, Alicia Bilheimer, Pao-Hwa Lin, Michael E Bodner, Terrill D Bravender
PURPOSE: We tested whether an online intervention combined with a patient feedback report improved physicians' use of motivational interviewing (MI) techniques when discussing weight with overweight and obese adolescents. METHODS: We randomized 46 pediatricians and family physicians and audio recorded 527 patient encounters. Half of the physicians received an individually tailored, online intervention. Then, all physicians received a summary report detailing patient's weight-related behaviors...
July 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
C D Reimers, I Reuter, A Straube, B Tettenborn, K M Braumann, A K Reimers
Physical inactivity is a major but modifiable risk factor for morbidity and mortality. Regular physical activity has preventive and therapeutic effects on numerous diseases including neurological disorders. Therefore, it is desirable that physicians motivate their patients to increase their physical and sports activities and that they help them to overcome barriers to exercising. The present study is a survey of neurologists who are members of the German Neurological Society with their own practices; they were asked whether they advised their patients on the benefits of physical activity...
January 2016: Fortschritte der Neurologie-Psychiatrie
Anthony C Waddimba, Howard B Beckman, Thomas L Mahoney, James F Burgess
We examined moderating effects of professional satisfaction on physicians' motivation to adhere to diabetes guidelines associated with pay-for-performance incentives. We merged cross-sectional survey data on attitudes, from 156 primary physicians, with prospective medical record-sourced data on guideline adherence and census data on ambulatory-care population characteristics. We examined moderating effects by testing theory-driven models for satisfied versus discontented physicians, using partial least squares structural equation modeling...
February 9, 2016: Medical Care Research and Review: MCRR
Douglas S Krakower, Susan E Beekmann, Philip M Polgreen, Kenneth H Mayer
BACKGROUND: US Public Health Service guidelines recommend early initiation of antiretroviral treatment (ART) for human immunodeficiency virus infection (HIV)-infected patients and preexposure prophylaxis (PrEP) as a prevention option for persons at risk for HIV acquisition. Before issuance of these guidelines, few clinicians reported prescribing early ART or PrEP. METHODS: The Emerging Infections Network, a national network of infectious diseases physicians in the United States and Canada, was surveyed in September 2014 to assess practices of adult HIV-care providers with early ART, PrEP, and other guideline-recommended HIV prevention methods...
January 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Daniel J Mullin, Lisa Forsberg, Judith A Savageau, Barry Saver
INTRODUCTION: Motivational interviewing (MI) skills are relevant for primary care providers (PCPs) who are responsible for caring for patients with diseases affected by behavior. There are significant challenges associated with developing PCP's MI skills. We report on an effort to document the acquisition of MI skills by PCPs using an objective measure of MI competence, the Motivational Interviewing Treatment Integrity (MITI) coding system. METHOD: Eleven PCPs volunteered to participate in 6 MI workshops over a period of 6 months and to submit work samples between each of these workshops to be assessed with the MITI coding system...
December 2015: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Rolf P Engelberger, Georg Noll, Dominique Schmidt, Adriano Alatri, Benedikt Frei, Walter E Kaiser, Nils Kucher
BACKGROUND: Rivaroxaban has become an alternative to vitamin-K antagonists (VKA) for stroke prevention in non-valvular atrial fibrillation (AF) patients due to its favourable risk-benefit profile in the restrictive setting of a large randomized trial. However in the primary care setting, physician's motivation to begin with rivaroxaban, treatment satisfaction and the clinical event rate after the initiation of rivaroxaban are not known. METHODS: Prospective data collection by 115 primary care physicians in Switzerland on consecutive nonvalvular AF patients with newly established rivaroxaban anticoagulation with 3-month follow-up...
September 2015: European Journal of Internal Medicine
Martina Moick, Ralf Terlutter
BACKGROUND: Physicians have differing motives for using the Internet and Internet-related services in their professional work. These motives may affect their evaluation of patients who bring with them health-related information from the Internet. Differing motives may also affect physician-patient communication and subsequent prescribing behavior. OBJECTIVES: to segment physicians into types based on their motives for using the internet in connection with professional activities and to analyze how those segments differ in their attitudes in three areas: toward patients who bring along Internet-sourced information; in their own subsequent prescribing behavior; and in their attitudes toward using the Internet to communicate with patients in future...
July 2012: Medicine 2.0
S Lee Ridner, Michael Ostapchuk, Richard N Cloud, John Myers, Anna Jorayeva, Jiying Ling
OBJECTIVES: To compare the effects of resident physician motivational interviewing (MI), resident physician MI plus registered nurse (RN), and the standard of care counseling approach--ask, advise, assess, assist, and arrange follow-up (5 As)--on current smokers' behaviors (readiness to quit, cigarettes smoked per day, current smoking rates), self-efficacy to quit smoking, and nicotine dependence. METHODS: The study design was quasi-experimental pretest/posttest with a comparison group...
May 2014: Southern Medical Journal
Steven A Trankle
BACKGROUND: In Australian end-of-life care, practicing euthanasia or physician-assisted suicide is illegal. Despite this, death hastening practices are common across medical settings. Practices can be clandestine or overt but in many instances physicians are forced to seek protection behind ambiguous medico-legal imperatives such as the Principle of Double Effect. Moreover, the way they conceptualise and experience such practices is inconsistent. To complement the available statistical data, the purpose of this study was to understand the reasoning behind how and why physicians in Australia will hasten death...
2014: BMC Medical Ethics
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