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https://www.readbyqxmd.com/read/29775994/a-broader-understanding-of-care-managers-attitudes-of-advance-care-planning-a-concurrent-nested-design
#1
Julie Aultman, Kristin R Baughman, Ruth Ludwick
AIMS AND OBJECTIVES: To examine barriers of advance care planning (ACP) experienced by care managers (CMs) through a mixed methods approach. A concurrent nested design was used to acquire a deeper understanding of ACP, and to identify nuances between quantitative and qualitative data. BACKGROUND: Past quantitative studies on providers have identified barriers related to time, culture, knowledge, responsibility, and availability of legal documents. These barriers, and accompanying attitudes and feelings, have been taken at face value without rich qualitative data to identify under what conditions and to what extent a barrier impacts care...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#2
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29772916/home-oxygen-therapy-for-bronchiolitis-an-evaluation-of-the-primary-care-providers-experience-at-sea-level
#3
Erin E Dunbar, Michelle L Macy, James A Cranford, Nicole Sroufe, Marie Lozon, Marisa C Louie
Despite 90% of primary care providers at altitude reporting experience with home oxygen therapy for hypoxemic, otherwise well infants, its use at sea level is not well described. Our objective was to understand experience with home oxygen at sea level and determine potential barriers and benefits of its use. We surveyed all pediatricians and family medicine providers within a 30-mile radius of our pediatric hospital from May 2016 to December 2016. Forty-three percent of providers responded. Few (8%) had any experience with home oxygen therapy for bronchiolitis...
May 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#4
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29771199/narrative-intervention-stories-from-the-front-lines-of-oncology-health-care
#5
Nicole M Saint-Louis, Joretha N Bourjolly
This study examined the experiences of health care professionals who participated in monthly narrative oncology groups. Ten professionals participated in separate, semi-structured, face-to-face interviews. Using a qualitative research design, the transcriptions of the interviews were analyzed using a phenomenological approach. The analysis yielded descriptive information about the professionals' positive experiences of participating in narrative oncology sessions and provides insight into the importance of such a group through five themes: (1) Shared perspectives and bearing witness, (2) Comfort in confidentiality and a safe-space, (3) Group-care becomes self-care, (4) Writing gives structure, and (5) Patient stories...
May 17, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29770101/resources-to-address-stigma-related-to-sexuality-substance-use-and-sexually-transmitted-and-blood-borne-infections
#6
R MacLean
Background: Stigma is widely recognized as a significant barrier to the prevention, management and treatment of sexually transmitted and blood-borne infections (STBBIs) in Canada. Despite major advances in STBBI prevention and treatment, and global efforts to reduce stigma, people living with or affected by STBBIs continue to experience stigma within health and social service settings in Canada. Objective: To describe the development, content and evaluation of knowledge translation resources and training workshops designed to equip health and social service professionals with the knowledge and skills needed to provide more respectful and inclusive sexual health, harm reduction and STBBI services...
February 1, 2018: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29770076/the-use-of-technology-to-improve-health-care-to-saskatchewan-s-first-nations-communities
#7
I Khan, N Ndubuka, K Stewart, V McKinney, I Mendez
Background: Saskatchewan is a province of over one million people and over 13% are Indigenous peoples, many of whom live on reserve lands. Despite continued efforts, access to health care remains a significant challenge for these Indigenous people, especially those in the North. Objective: To address this challenge, Saskatchewan's health care providers have been incorporating the use of technology for various health services. This paper describes various ways technology has been used in First Nations communities in Saskatchewan...
June 1, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29770059/assessing-uptake-of-national-hiv-screening-and-testing-guidance-part-2-knowledge-comfort-and-practice
#8
G P Traversy, T Austin, J Yau, K Timmerman
Background: The Public Health Agency of Canada's (PHAC) HIV Screening and Testing Guide (the Guide) provides guidance to health care providers regarding who, when and how often to screen for HIV. HIV screening and testing is important in meeting the Joint United Nations Programme on HIV/AIDS' (UNAIDS) 90-90-90 targets towards HIV elimination. Objective: To determine health care providers' levels of knowledge about and comfort with aspects of HIV testing, and to determine whether their HIV testing practices are consistent with the recommendations in the Guide...
December 7, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29768418/obgyn-screening-for-environmental-exposures-a-call-for-action
#9
N M Grindler, A A Allshouse, E Jungheim, T L Powell, T Jansson, A J Polotsky
BACKGROUND: Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. OBJECTIVE: Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. STUDY DESIGN: Practicing OBGYNs were approached at the University of Colorado and by social media...
2018: PloS One
https://www.readbyqxmd.com/read/29767725/advancing-the-health-of-women-and-newborns-predictors-of-patient-satisfaction-among-women-attending-antenatal-and-maternity-care-in-rural-rwanda
#10
Christine Mutaganzwa, Leah Wibecan, Hari S Iyer, Evrard Nahimana, Anatole Manzi, Francois Biziyaremye, Merab Nyishime, Fulgence Nkikabahizi, Lisa R Hirschhorn, Hema Magge
Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ≥ 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality...
May 15, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29767578/-death-is-difficult-in-any-language-a-qualitative-study-of-palliative-care-professionals-experiences-when-providing-end-of-life-care-to-patients-from-culturally-and-linguistically-diverse-backgrounds
#11
Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth A Lobb
BACKGROUND: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care. AIM: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture...
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29767220/patients-perceptions-of-bedside-rounding
#12
Allen F Shih, Nana O Addo-Tabiri, Andre N Sofair
OBJECTIVES: Concerns regarding lack of privacy, poor patient understanding, and physician discomfort have led to a decline in rounding at the bedside. Our project explored patient perceptions of the implementation and value of bedside rounding. METHODS: This mixed-methods study used semi-structured qualitative interviews and a five-item Likert survey, which included questions about patients' experiences with rounds, their comfort level with the rounding process, and their understanding of care after rounds...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29766400/social-media-in-the-rei-clinic-what-do-patients-want
#13
Darcy E Broughton, Allison Schelble, Kristina Cipolla, Michele Cho, Jason Franasiak, Kenan R Omurtag
PURPOSE: To elicit patient preferences for social media utilization and content in the infertility clinic. METHODS: This was a cross-sectional survey study conducted in three US fertility practices. Women presenting to the infertility clinic for an initial or return visit were offered an anonymous voluntary social media survey. The survey elicited patient perception of whether social media use in the infertility clinic is beneficial, and preferences regarding topics of interest...
May 15, 2018: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29764988/you-ve-made-the-diagnosis-of-functional-neurological-disorder-now-what
#14
EDITORIAL
Caitlin Adams, Jordan Anderson, Elizabeth N Madva, W Curt LaFrance, David L Perez
Patients with functional neurological disorders (FND)/conversion disorder commonly present to outpatient clinics. FND is now a 'rule in' diagnosis based on neurological examination findings and semiological features. While neurologists may be more comfortable diagnosing patients with FND, there is only limited guidance as to how to conduct follow-up outpatient visits. Using clinical vignettes, we provide practical suggestions that may help guide clinical encounters including how to: (1) explore illness beliefs openly; (2) enquire longitudinally about predisposing vulnerabilities, acute precipitants and perpetuating factors that may be further elucidated over time; (3) facilitate psychotherapy engagement by actively listening for potentially unhelpful or maladaptive patterns of thoughts, behaviours, fears or psychosocial stressors that can be reflected back to the patient and (4) enquire about the fidelity of individual treatments and educate other providers who may be less familiar with FND...
May 15, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29764715/the-state-of-adherence-to-hiv-care-in-black-women
#15
Crystal Chapman Lambert, Michael J Mugavero, Yaseen S Najjar, Comfort Enah, Barbara J Guthrie
The purpose of this systematic review was to assess the state of adherence to HIV care such as HIV medication and appointment adherence among Black women in the United States. After a systematic search of CINAHL, PubMed, EMBASE, and clinicialtrials.gov, 26 studies and two ongoing trials met inclusion criteria. Psychosocial factors such as intersectional stigmas and depression were among the salient factors associated with adherence-to-care behaviors in women living with HIV (WLWH). In addition, interpersonal factors such as social support and the patient-provider relationship were frequently associated with adherence-to-care behaviors...
February 21, 2018: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/29764406/women-s-experiences-of-continuous-support-during-childbirth-a-meta-synthesis
#16
Petronellah Lunda, Catharina Susanna Minnie, Petronella Benadé
BACKGROUND: Despite the known benefits of continuous support during childbirth, the practice is still not routinely implemented in all maternity settings and women's views and experiences might not be considered. The purpose of the study was to integrate individual studies' findings related to women's experiences of continuous support during childbirth in order to expand the understanding of the phenomenon. The review question was: What were the views and experiences of women regarding continuous support during childbirth as reported in studies that adopted qualitative or mixed research methods (with a qualitative component) using semi-structured, in-depth or focus group interviews or case studies? METHODS: A detailed search was executed on electronic data bases: EBSCOhost: Medline, CINAHL, PsychINFO, SocINDEX, OAlster, Scopus, SciELO, Science Direct, PubMED and Google Scholar, using a predetermined search strategy...
May 15, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#17
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29757917/nurse-practitioners-completion-of-physician-orders-for-scope-of-treatment-forms-in-west-virginia-a-secondary-analysis-of-12-months-of-data-from-the-state-registry
#18
Lori Anne Constantine, Toni Dichiacchio, Evan C Falkenstine, Alvin H Moss
BACKGROUND AND PURPOSE: Advanced care planning documents, such as the Physician Orders for Life-Sustaining Treatment (POLST), require authorized medical provider signatures; only recently have nurse practitioners (NPs) been authorized to sign these forms. Recent legislation in West Virginia (WV) granting NPs signatory authority on POLST forms and the creation of a statewide registry provides an opportunity to examine the completion rates. The aim of this study was to investigate how recent legislation allowing NPs signatory authority for POLST forms has affected POLST completion...
January 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757787/screening-for-childhood-adversity-among-adult-primary-care-patients
#19
Karen A Kalmakis, Mary B Shafer, Genevieve E Chandler, Elizabeth V Aponte, Susan J Roberts
BACKGROUND AND PURPOSE: Over half of Americans reports a history of adverse childhood experiences (ACEs), which have been associated with many chronic health conditions. Yet primary care providers infrequently screen patients for ACEs and fail to consider the relationship between ACEs and adult health. Therefore, the purposes of this study were to test the effectiveness and feasibility of a screening interview for ACEs and to confirm the prevalence of ACEs among individuals with chronic health conditions...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757074/differences-in-screening-and-treatment-for-antepartum-versus-postpartum-patients-are-providers-implementing-the-guidelines-of-care-for-perinatal-depression
#20
Gina L Fedock, Carmen Alvarez
BACKGROUND: National guidelines recommend universal depression screening for perinatal patients and provide treatment recommendations to prevent adverse maternal/child health outcomes. However, providers rarely screen all patients, and most women with perinatal depression remain undertreated. This study investigated predictors of universal screening and guideline-congruent care for perinatal depression by obstetrician-gynecologists and examined differences in practices with pregnant and postpartum patients...
May 14, 2018: Journal of Women's Health
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