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Ghorbani B, Jackson AC, Dehghan-Nayeri N, Bahramnezhad F. Standardized patients' experience of participating in medical students' education: a qualitative content analysis. BMC MEDICAL EDUCATION 2024; 24:586. [PMID: 38807118 PMCID: PMC11134940 DOI: 10.1186/s12909-024-05531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/07/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Standardized patients are considered a significant educational method in medical sciences and have been successfully employed for many years. This study was conducted with the aim of explaining the experience of standardized patients participating in the education of medical student. METHOD A qualitative content analysis approach was used. This study was conducted at Standardized Patient Center, Tehran University of Medical Sciences, Tehran, Iran, May to February 2022. Fifteen standard patients were selected through purposive sampling with maximum variation. Semi-structured, in-depth, face-to-face interviews were conducted with standard patients. The average duration of the interviews was 60 to 90 min. Data were transcribed and analyzed using the Graneheim and Lundman approach. RESULTS A passport for the future and duality of feelings were the two main themes identified in this study with six subthemes. One of the main themes was passport for the future with subthemes creative, participation in educating future generation, reflection and another theme was duality of feeling with subthemes feeling of value, guilty conscience, and fear of judgment by others. CONCLUSION The participants expressed having mixed feelings about their role as standard patients. They felt conflicted because they were compensated for their participation, which made them worry about being judged by others and feel guilty about taking the fee. Therefore, it is recommended to conduct further studies in this area.
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Affiliation(s)
- Banafsheh Ghorbani
- Nursing department, Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alun C Jackson
- Australian Centre for Heart Health, Melbourne, Australia
- Faculty of Health, Deakin University, Geelong, Australia
- Centre on Behavioural Health, Hong Kong University, Sandy Bay, Hong Kong, China
| | - Nahid Dehghan-Nayeri
- Department of Nursing Management, Nursing and Midwifery Care Research Center,School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat st, Tohid sq, Tehran, I.IRAN141973317, Iran.
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Rogalski D, Barnett N, Bueno de Mesquita A, Jubraj B. The Pharmacist Prescriber: A Psychological Perspective on Complex Conversations about Medicines: Introducing Relational Prescribing and Open Dialogue in Physical Health. PHARMACY 2023; 11:pharmacy11020062. [PMID: 36961040 PMCID: PMC10037595 DOI: 10.3390/pharmacy11020062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to take a more prescriptive role that will allow them to contribute to long-standing prescribing challenges such as poor medication adherence, overprescribing, and the need for shared decision-making and person-centered care. Central to these endeavors are the development and possession of effective consultation skills. University schools of pharmacists in the UK now routinely include consultation skills training, which is also provided by national education bodies. These challenges remain difficult to overcome, even though it is understood, for example, that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments. More recently, a concerted effort has been made to tackle overprescribing and the harm that may occur through the inappropriate use of medication. In routine pharmacy work, these priorities may linger at the bottom of the list due to the busy and complex nature of the work. Solutions to these problems of adherence, optimizing benefits of medication, and overprescribing have typically been pragmatic and structured. However, an arguably reductionist approach to implementation fails to address the complex patient interactions around prescribing and taking medication, and the heterogeneity of the patient's experience, leaving the answers elusive. We suggest that it is essential to explore how person-centered care is perceived and to emphasize the relational aspects of clinical consultations. The development of routine pharmacist prescribing demands building on the core values of person-centered care and shared decision making by introducing the concepts of "relational prescribing" and "open dialogue" to cultivate an essential pharmacotherapeutic alliance to deliver concrete positive patient outcomes. We provide a vignette of how a clinical case can be approached using principles of relational prescribing and open dialogue. We believe these are solutions that are not additional tasks but must be embedded into pharmacy practice. This will improve professional satisfaction and resilience, and encourage curiosity and creativity, particularly with the advent of all pharmacists in Great Britain becoming prescribers at graduation from 2026.
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Affiliation(s)
- David Rogalski
- Camden and Islington NHS Foundation Trust, London RG24 9NA, UK
| | - Nina Barnett
- London North West University Healthcare NHS Trust, London HA1 3UJ, UK
- Medicines Use and Safety Division, NHS Specialist Pharmacy Service, London HA1 3UJ, UK
| | | | - Barry Jubraj
- Medicines Use and Safety Division, NHS Specialist Pharmacy Service, London HA1 3UJ, UK
- School of Pharmacy, University College London, London WC1E 6BT, UK
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Reliability and validity testing of the medicines related - consultation assessment tool for assessing pharmacists' consultations. Int J Clin Pharm 2023; 45:201-209. [PMID: 36394786 PMCID: PMC9938801 DOI: 10.1007/s11096-022-01489-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Demonstrating a person-centred approach in a consultation is a key component of delivering high-quality healthcare. To support development of such an approach requires training underpinned by valid assessment tools. Given the lack of a suitable pharmacy-specific tool, a new global consultation skills assessment tool: the medicines related-consultation assessment tool (MR-CAT) was designed and tested. AIM This study aimed to test the validity and reliability of the MR-CAT using psychometric methods. METHOD Psychometric testing involved analysis of participants' (n = 13) assessment of fifteen pre-recorded simulated consultations using the MR-CAT. Analysis included discriminant validity testing, intrarater and interrater reliability testing for each of the five sections of the MR-CAT and for the overall global assessment of the consultation. Analysis also included internal consistency testing for the whole tool. RESULTS Internal consistency for the overall global assessment of the consultation was good (Cronbach's alpha = 0.97). The MR-CAT discriminated well for the overall global assessment of the consultation (p < 0.001). Moderate to high intrarater reliability was observed for the overall global assessment of the consultation and for all five sections of the MR-CAT (rho = 0.64-0.84) in the test-retest analysis. Moderate to good interrater reliability (Kendall's W = 0.68-0.90) was observed for the overall global assessment of the consultation and for all five sections of the MR-CAT. CONCLUSION The MR-CAT is a valid and reliable tool for assessing person-centred pharmacist's consultations. Moreover, its unique design means that the MR-CAT can be used in both formative and summative assessment.
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Murry LT, Reist JC, Fravel MA, Knockel LE, Witry MJ. An Exploratory Mixed Methods Study of Standardized Patient Comments on Empathy and Student Communication Scores. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:ajpe8642. [PMID: 34301573 PMCID: PMC8887057 DOI: 10.5688/ajpe8642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Objective. To quantify student pharmacists' communication ability based on scores from standardized patient (SP) communication rubrics, describe and categorize SP comments about student empathy, and test the relationship between students' communication scores and empathy.Methods. A concurrent mixed methods research design was used to assess a graded performance-based assessment (PBA) of student pharmacists that had been conducted at one college of pharmacy. The PBA rubrics (n=218) completed by SPs contained 20 assessment items and space for open-ended feedback. Scoring categories for communication assessment included: yes, inconsistent, no, and not applicable (N/A). Descriptive statistics were calculated for rubric scores. Feedback from standardized patients was analyzed and used to categorize student interactions during the encounter as reflecting high empathy, mixed empathy, or low empathy. Kruskal-Wallis ANOVA was used to test the relationship between empathy category and communication score.Results. Standardized patients had written comments on 141 of the 218 rubrics (64.7%). The mean communication score was 39.0±1.6 (range, 31-40) out of a maximum 40 points. The total scores for the low, mixed, and high empathy category transformations were 6 (4.3%), 95 (67.4%), and 40 (28.4%), respectively. The results of the Kruskal-Wallis ANOVA were significant, suggesting that communication scores were different between empathy categories.Conclusion. There was a positive association between students' scores on communication rubrics and student empathy categorization, with student pharmacists exhibiting different levels of clinical empathy. While the PBA of interest was not specifically focused on empathy, SPs frequently provided feedback about empathy to students, suggesting that showing empathy during the encounter was important.
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Affiliation(s)
- Logan T Murry
- The University of Iowa, College of Pharmacy, Iowa City, Iowa
| | - Jeffrey C Reist
- The University of Iowa, College of Pharmacy, Iowa City, Iowa
| | | | - Laura E Knockel
- The University of Iowa, College of Pharmacy, Iowa City, Iowa
| | - Mathew J Witry
- The University of Iowa, College of Pharmacy, Iowa City, Iowa
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Why do patients struggle with their medicines?-A phenomenological hermeneutical study of how patients experience medicines in their everyday lives. PLoS One 2021; 16:e0255478. [PMID: 34358258 PMCID: PMC8345846 DOI: 10.1371/journal.pone.0255478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/16/2021] [Indexed: 11/19/2022] Open
Abstract
Why do so many people struggle with their medicines despite decades of research on medicines taking? Research into how people experience medicines in their everyday life remains scarce with the majority of research in this area of focusing on whether or not people take their medicines as prescribed. Hence, this study used a phenomenological hermeneutical qualitative design to gain a deeper understanding of individuals’ perspectives on the lived experience of medicine-taking. Findings from this study highlight five main themes where participants experience medicines as: 1) life-saving and indispensable, 2) normal and a daily routine, 3) confusing and concerning, 4) unsuitable without adjustment, and 5) intrusive and unwelcome. These results can be the basis for mutually agreed prescribing through a co-creative approach that aims at enhancing open and honest dialogues between patients and healthcare professionals in partnership about medicines.
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Howlett N, Bottoms L, Chater A, Clark AB, Clarke T, David L, Irvine K, Jones A, Jones J, Mengoni SE, Murdoch J, Pond M, Sharma S, Sims EJ, Turner DA, Wellsted D, Wilson J, Wyatt S, Trivedi D. A randomised controlled trial of energetic activity for depression in young people (READY): a multi-site feasibility trial protocol. Pilot Feasibility Stud 2021; 7:6. [PMID: 33390189 PMCID: PMC7779325 DOI: 10.1186/s40814-020-00734-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery. METHODS The design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13-17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a 'healthy living' behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness. DISCUSSION UK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression. TRIAL REGISTRATION ISRCTN, ISRCTN66452702 . Registered 9 April 2020.
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Affiliation(s)
- N. Howlett
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - L. Bottoms
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - A. Chater
- Institute for Sport and Physical Activity Research (ISPAR), School of Sport Science and Physical Activity, Faculty of Health, Education, Sport and Social Science, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK
| | - A. B. Clark
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - T. Clarke
- Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE UK
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - L. David
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - K. Irvine
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - A. Jones
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - J. Jones
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - S. E. Mengoni
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - J. Murdoch
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - M. Pond
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - S. Sharma
- Department of Psychology, Sport, and Geography, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - E. J. Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, Norfolk NR4 7TR UK
| | - D. A. Turner
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - D. Wellsted
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - J. Wilson
- Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE UK
- Norwich Medical School, University of East Anglia, Norwich, Norfolk NR4 7TJ UK
| | - S. Wyatt
- Centre for Health Services and Clinical Research, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
| | - D. Trivedi
- Centre for Research in Public Health and Community Care, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB UK
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Lim R, Courtenay M, Deslandes R, Ferriday R, Gillespie D, Hodson K, Reid N, Thomas N, Chater A. Theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers: an acceptability and feasibility experimental study using mixed methods. BMJ Open 2020; 10:e036181. [PMID: 32606061 PMCID: PMC7328741 DOI: 10.1136/bmjopen-2019-036181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To assess the acceptability and feasibility of using a theory-based electronic learning intervention designed to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers for patients presenting with common, acute, uncomplicated self-limiting respiratory tract infections (RTIs). DESIGN Experimental with mixed methods; preintervention and postintervention online surveys and semistructured interviews. SETTING Primary care settings across the UK. PARTICIPANTS 11 nurse and 4 pharmacist prescribers. INTERVENTION A theory-based brief interactive animation electronic learning activity comprised a consultation scenario by a prescriber with an adult presenting with a common, acute, uncomplicated self-limiting RTI to support a 'no antibiotic prescribing strategy'. OUTCOME MEASURES Recruitment, response and attrition rates were assessed. The overall usefulness of the intervention was assessed by analysing prescribers' self-reported confidence and knowledge in treating patients with RTIs before and after undertaking the intervention, and views on the relevance of the intervention to their work. Acceptability of the intervention was assessed in semistructured interviews. The feasibility of data collection methods was assessed by recording the number of study components completed by prescribers. RESULTS 15 prescribers (maximum sample size) consented and completed all four stages of the study. Prescribers reported high to very high levels of confidence and knowledge preintervention and postintervention, with slight postintervention increases in communicating with patients and a slight reduction in building rapport. Qualitative findings supported quantitative findings; prescribers were reassured of their own practice which in turn increased their confidence and knowledge in consultations. The information in the intervention was not new to prescribers but was applicable and useful to consolidate learning and enable self-reflection. Completing the e-learning intervention was acceptable to prescribers. CONCLUSIONS It was feasible to conduct the study. The intervention was acceptable and useful to prescribers. Future work will add complex clinical content in the intervention before conducting a full trial.
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Affiliation(s)
- Rosemary Lim
- Reading School of Pharmacy, University of Reading, Reading, UK
| | - Molly Courtenay
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Rhian Deslandes
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, UK
| | | | | | - Karen Hodson
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, UK
| | | | - Neil Thomas
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Luton, UK
- University College London School of Pharmacy, London, UK
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Xu X, Zhang Y, Wang W, Zhang Y, Yang N. Effects of Patients' Perceptions of Physician-Patient Relational Empathy on an Inflammation Marker in Patients with Crohn's Disease: The Intermediary Roles of Anxiety, Self-Efficacy, and Sleep Quality. Psychol Res Behav Manag 2020; 13:363-371. [PMID: 32425624 PMCID: PMC7196771 DOI: 10.2147/prbm.s221435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/11/2020] [Indexed: 01/14/2023] Open
Abstract
Background Physician-patient empathy is inextricably linked with outcomes of patients. The purpose of this study was to test whether anxiety, self-efficacy, and sleep quality played intermediary roles in relationships between patients' perceptions of physician-patient relational empathy and an inflammation marker in Crohn's disease patients. Methods The study included 187 patients. At admission (T1) and 3 months after admission (T2), anxiety, self-efficacy, sleep, and the inflammatory marker IL6 of patients were tested and compared. Patients' perceptions of physician-patient relational empathy (CARE scale) was measured at T2. Correlations among patients' anxiety, self-efficacy, sleep quality, IL6, and CARE scores were explored by Pearson's correlation analysis and a structural equation model. Results Compared with T1, patients showed higher self-efficacy and sleep quality and lower anxiety and IL6 at T2. Patients' perceptions of physician-patient relational empathy were negatively related to anxiety and IL6 and connected to self-efficacy and sleep quality positively. Patients' anxiety, self-efficacy, and sleep quality played intermediary roles incorrelations between empathy and IL6. Conclusion In correlations of patients' perceptions of physician-patient relational empathy and IL6 in patients with Crohn's disease, patients' anxiety, self-efficacy, and sleep quality acted as intermediary effects. Therefore, medical staff should empathize with patients.
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Affiliation(s)
- Xianlin Xu
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, People's Republic of China
| | - Yan Zhang
- College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, People's Republic of China
| | - Wei Wang
- School of Health Sciences, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yin Zhang
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, People's Republic of China
| | - Ningxi Yang
- College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, People's Republic of China
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Williams CR, Rodgers PT, McLaughlin JE, Angelo TA, Shepherd G. Comparing Empathy Levels in Doctor of Pharmacy Students and Exemplary Pharmacist Preceptors. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7497. [PMID: 32313275 PMCID: PMC7159009 DOI: 10.5688/ajpe7497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/04/2019] [Indexed: 05/22/2023]
Abstract
Objective. To determine how student pharmacists' empathy compares to that of exemplary pharmacist preceptors. Methods. First- through third-year Doctor of Pharmacy students and nominated preceptors demonstrating a model level of empathy in patient care were invited to take the Jefferson Scale of Empathy (JSE) and answer demographic questions. A comparison of total JSE scores was made between students and preceptors. Comparisons of total JSE scores were performed between male and female students, students with and without direct patient care experience, students with and without chronic care experience, and among students based on class year. A factor analysis was completed. Results. The response rate for students and preceptors was 70.3% (n=318) and 73.7% (n=14), respectively. No significant differences in median JSE scores were identified for any of the comparisons. Factor analysis revealed two factors as underlying constructs: "compassionate care" and "perspective taking." Seven of 20 items on the JSE had mean scores >6.0 (possible range 1-7). Conclusion. The majority of students had moderately high cognitive empathy not related to class year that was similar to that of exemplary pharmacist preceptors. A possible ceiling effect was found in several items on the JSE, potentially limiting its use for measuring changes in empathy longitudinally in students with baseline high empathy.
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Affiliation(s)
- Charlene R Williams
- University of North Carolina, UNC Eshelman School of Pharmacy, Asheville, North Carolina
| | - Philip T Rodgers
- University of North Carolina, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | | | - Thomas A Angelo
- University of North Carolina, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Greene Shepherd
- University of North Carolina, UNC Eshelman School of Pharmacy, Asheville, North Carolina
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Chen X, Zhang Y, Xu X, Wang W, Yan H, Li S, Yang N. Mediating Roles of Anxiety, Self-Efficacy, and Sleep Quality on the Relationship Between Patient-Reported Physician Empathy and Inflammatory Markers in Ulcerative Colitis Patients. Med Sci Monit 2019; 25:7889-7897. [PMID: 31634896 PMCID: PMC6820358 DOI: 10.12659/msm.917552] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/15/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Empathy between doctor and patient has an important bearing on patient health. The purpose of this study was to assess whether anxiety, sleep quality, and self-efficacy of patients have mediating effects in the relationship of patient-reported physician empathy and inflammatory factor in ulcerative colitis (UC) patients. MATERIAL AND METHODS This study included 242 patients attended by 45 doctors. Self-reported doctors' empathy ability was measured at patient admission (T1), and patient-reported physician empathy was measured 3 months later (T2). Patient anxiety, general self-efficacy, sleep, and inflammatory factor (IL-6) were measured on T1 and T2. Pearson correlation analysis was used to assess the relationships between self-reported doctor empathy ability and patient indices on T1 and T2. The relationships between anxiety, sleep quality, self-efficacy, IL-6, and patient-reported physician empathy were measured by Pearson correlation analysis and structural equation modeling. RESULTS On T1, no significant correlation was reported between self-reported doctors' empathy ability and indices of the patients (P>0.05). On T2, self-reported doctors' empathy ability was significantly positively correlated with patient sleep and self-efficacy (P<0.01), and significantly negatively correlated with patient anxiety and IL-6 (P<0.01). Moreover, on T2, patient-reported physician empathy was negatively correlated with anxiety and IL-6 and was positively correlated with self-efficacy and sleep quality. The effect of patient-reported physician empathy on IL-6 was mediated by anxiety, sleep quality, and self-efficacy. CONCLUSIONS The anxiety, self-efficacy, and sleep quality of UC patients had mediating effects in the relationship between patient-reported physician empathy and IL-6.
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Affiliation(s)
- Xiangfan Chen
- School of Health Science, Wuhan University, Wuhan, Hubei, P.R. China
| | - Yin Zhang
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, P.R. China
| | - Xianlin Xu
- Department of Gastroenterology, Huiyang Sanhe Hospital, Huizhou, Guangdong, P.R. China
| | - Wei Wang
- School of Health Science, Wuhan University, Wuhan, Hubei, P.R. China
| | - Hong Yan
- School of Health Science, Wuhan University, Wuhan, Hubei, P.R. China
| | - Shiyue Li
- School of Health Science, Wuhan University, Wuhan, Hubei, P.R. China
| | - Ningxi Yang
- College of Humanities and Social Sciences, Harbin Engineering University, Harbin, Heilongjiang, P.R. China
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Babin M, Folliard C, Robert J, Sorrieul J, Kieffer H, Augereau P, Devys C. Consultations pharmaceutiques en oncologie : mise en place, bilan à un an et perspectives. ANNALES PHARMACEUTIQUES FRANÇAISES 2019; 77:426-434. [DOI: 10.1016/j.pharma.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 11/16/2022]
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Chater A, Courtenay M. Community nursing and antibiotic stewardship: the importance of communication and training. Br J Community Nurs 2019; 24:338-342. [PMID: 31265341 DOI: 10.12968/bjcn.2019.24.7.338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Antimicrobial stewardship (using antimicrobials responsibly) can reduce the risk of antimicrobial resistance (AMR). Many health professionals identify themselves as 'antibiotic guardians', but patient expectations, time constraints, and a lack of confidence or underdeveloped communication skills can influence decisions to prescribe. Nurse prescribers have an important role to play in antibiotic stewardship, and their numbers continue to grow. While nurse prescribers welcome this extension to their traditional role, they are often faced with barriers to antibiotic stewardship activities. These barriers may relate to their Capability (knowledge/skill), Opportunity (norms of practice, influence of patients, environmental factors), and Motivation (attitudes and beliefs, concern over outcome, emotion and habit) [COM-B]. Education, training and enablement can help to overcome these barriers, and the development of knowledge, confidence and effective communication skills should be of priority. Further, communication skills can help nurse prescribers understand patient expectations, with the use of open-ended questions, active listening and creation of a patient-centred consultation that leads to a mutually agreed end goal and way forward.
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Affiliation(s)
- Angel Chater
- Reader in Health Psychology and Behaviour Change, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford; Honorary Senior Lecturer in Health Psychology and Behavioural Medicine, Centre for Behavioural Medicine, University College London School of Pharmacy, London
| | - Molly Courtenay
- Professor, School of Healthcare Sciences, Cardiff University, Cardiff
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Makdessi CJ, Day C, Chaar BB. Challenges faced with opioid prescriptions in the community setting - Australian pharmacists' perspectives. Res Social Adm Pharm 2019; 15:966-973. [PMID: 30819418 DOI: 10.1016/j.sapharm.2019.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Prescription opioids (POs) are well recognised for their role in pain management. However over recent years, use of POs has become an increasingly complex public health issue, with the emergence of increasing quantities of POs being misused and abused. Pharmacists represent the 'gatekeepers' of medicines, which can be a challenging role, relating in particular to POs. OBJECTIVE This study aimed to gain insight into the challenges Australian community pharmacists experience in the dispensation of POs. SETTING Sydney Australia. METHOD Twenty-five pharmacists were recruited from suburbs in and around Sydney, Australia. Pharmacists were interviewed using an in-depth, semi-structured protocol. All interviews were audio-recorded, transcribed and thematically analysed. MAIN OUTCOME MEASURE Identification of issues/factors that may influence the dispensing of POs. RESULTS Pharmacists were reportedly confronted with several issues in the dispensing of POs, particularly in relation to the patient and prescriber. Pharmacists reported some individuals becoming increasingly more "creative" in the methods used to obtain POs, rendering detection of potential abuse/misuse increasingly difficult. Poor professional relationships with prescribers-an apparent power dynamic between the two professions, and limited engagement with patients were issues also identified. The majority of participants suggested that an electronic monitoring database would help in the identification of PO abuse/misuse. CONCLUSION Education is required to emphasise the importance of inter-professional collaboration between pharmacists and prescribers, as is empathy in the pharmacist-patient relationship. Prescription drug monitoring programs and prescribers sending electronic prescriptions directly to the pharmacist were perceived as helpful initiatives to undertake.
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Affiliation(s)
- Clarissa J Makdessi
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Carolyn Day
- Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Australia
| | - Betty B Chaar
- Pharmacy Practice and Professional Ethics, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.
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Steed L, Sohanpal R, James WY, Rivas C, Jumbe S, Chater A, Todd A, Edwards E, Macneil V, Macfarlane F, Greenhalgh T, Griffiths C, Eldridge S, Taylor S, Walton R. Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention. BMJ Open 2017; 7:e015637. [PMID: 28801403 PMCID: PMC5724215 DOI: 10.1136/bmjopen-2016-015637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/14/2017] [Accepted: 03/22/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. DESIGN Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. METHODS Phase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II: We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III: We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. SETTING Eight community pharmacies in three inner east London boroughs. PARTICIPANTS 12 Stop Smoking Advisers. INTERVENTION Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. RESULTS The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. CONCLUSIONS We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. TRIAL REGISTRATION NUMBER UKCRN ID 18446, Pilot.
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Affiliation(s)
- Liz Steed
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ratna Sohanpal
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Wai-Yee James
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, UK
| | - Sandra Jumbe
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Angel Chater
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- University of Bedfordshire, Luton, UK
| | - Adam Todd
- Centre for Health and Inequalities Research (CHIR), University of Durham
| | - Elizabeth Edwards
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Fraser Macfarlane
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Chris Griffiths
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sandra Eldridge
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stephanie Taylor
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Robert Walton
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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