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LoCastro M, Jensen-Battaglia M, Sanapala C, Rodenbach R, Mendler JH, Liesveld J, Huselton E, Loh KP. Exploring the role of the oncologist in promoting shared decision making during treatment planning for older adults with acute myeloid leukemia. J Geriatr Oncol 2024; 15:101793. [PMID: 38735090 DOI: 10.1016/j.jgo.2024.101793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Marissa LoCastro
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Marielle Jensen-Battaglia
- James P. Wilmot Cancer Institute and Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
| | | | - Rachel Rodenbach
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jason H Mendler
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane Liesveld
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
| | - Eric Huselton
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
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Al-Wardat M, Etoom M, Lena F, Pellicciari L, D’Amone F, Kossi O, Brindisino F, Abdullahi A. Exploring Communication Practices in Italian Physiotherapy: Knowledge and Use of Effective Communication Strategies-A National Descriptive Study. Healthcare (Basel) 2023; 11:2247. [PMID: 37628446 PMCID: PMC10454614 DOI: 10.3390/healthcare11162247] [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: 06/17/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to investigate the knowledge and use of effective communication strategies among Italian physiotherapists. We utilized a questionnaire consisting of 19 questions to collect data on the knowledge and use of effective communication strategies among Italian physiotherapists. The results revealed that only 35.8% of the respondents reported being aware of communication strategies related to physiotherapy, with their first exposure occurring during their three-year degree. Despite the majority of respondents agreeing that communication is an effective strategy for improving patient adherence, only about half reported making moderate use of open-ended questions and metaphors during treatment sessions. Furthermore, more than half of the respondents reported being unaware of Motivational Interviewing. The results of this study found that there is a consensus among Italian physiotherapists about the importance of effective communication in clinical practice, though the knowledge and application of some communication strategies remain limited. These findings suggest that there is room for improvement in the training and education of physiotherapists in Italy, with a need for greater emphasis on communication strategies in the university educational curriculum, starting from the bachelor's degree.
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Affiliation(s)
- Mohammad Al-Wardat
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohammad Etoom
- Department of Physical Therapy, Aqaba University of Technology, Aqaba 77110, Jordan;
| | - Francesco Lena
- IRCCS INM Neuromed, Department of Neurology, 86077 Pozzilli, Italy
| | | | - Francesco D’Amone
- Department of Medicine and Health Science, “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (F.D.); (F.B.)
| | - Oyéné Kossi
- ENATSE, National School of Public Health and Epidemiology, University of Parakou, Parakou 03 BP 10, Benin;
- Unit of Neurology and NeuroRehabilitation, University Hospital of Parakou, Parakou 01 BP 02, Benin
| | - Fabrizio Brindisino
- Department of Medicine and Health Science, “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy; (F.D.); (F.B.)
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University, Kano 700271, Nigeria
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Abe T, Nishiyama J, Kushida S, Kawashima M, Oishi N, Ueda K. Tailored opening questions to the context of using medical questionnaires: Qualitative analysis in first-visit consultations. J Gen Fam Med 2023; 24:79-86. [PMID: 36909788 PMCID: PMC10000256 DOI: 10.1002/jgf2.593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Communication skills required for doctors do not consist of simple uses of particular linguistic forms but include uses that are sensitive to the interactional context. In consultations where the doctors have pre-existing information about their patients, this can complicate the context of problem solicitation. We investigated how doctors tailor opening questions to a context in which they get pre-existing information from a medical questionnaire (MQ) filled out by the patients. Methods The data for this study were 87 video recordings of first visits to the department of general medicine at a university hospital in Japan. We qualitatively analyzed doctors' practices in problem solicitation in an opening phase using conversation analysis and triangulated it with quantitative analysis. Results Open-ended questions accounted for 26.4% of opening questions. Among the closed-ended questions, 75.0% were confirming questions about symptoms. In cases with open-ended questions, doctors minimized the relevance of the MQ to problem solicitation by giving license to repeat the description from the MQ. In cases with closed-ended questions, doctors highlighted the relevance of the MQ by sharing the MQ. Through these practices, they avoided patients' possible confusion about problem presentation while simultaneously maximizing the possibility of soliciting the patients' narratives. Conclusions Doctors adjusted the level of relevance of pre-existing information to problem solicitation through both verbal and nonverbal management of the MQ. It will be useful to instruct such context-dependent practices to improve communication skills in medical school curriculum.
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Affiliation(s)
- Tetsuya Abe
- Department of Psychosomatic and General Internal Medicine Kansai Medical University Osaka Japan
| | - Junji Nishiyama
- Department of Psychosomatic and General Internal Medicine Kansai Medical University Osaka Japan.,Clinic of General Medicine Kansai Medical University Hospital Osaka Japan
| | - Shuya Kushida
- Department of Education Osaka Kyoiku University Osaka Japan
| | - Michie Kawashima
- Department of International Relations Kyoto Sangyo University Kyoto Japan
| | - Naoko Oishi
- Department of Psychosomatic and General Internal Medicine Kansai Medical University Osaka Japan
| | - Kento Ueda
- Department of Psychosomatic and General Internal Medicine Kansai Medical University Osaka Japan
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Triantafyllou A, Elia SA, Park C, Climie RE, Mayer CC, Mozos I, Pucci G, Weber T, Panayiotou AG. Developing a Questionnaire on Knowledge, Perceptions and Application of Vascular-Aging Measurements. J Cardiovasc Dev Dis 2023; 10:jcdd10020080. [PMID: 36826576 PMCID: PMC9965266 DOI: 10.3390/jcdd10020080] [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: 12/20/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Vascular age (VA) is independent and chronological age for assessing cardiovascular disease (CVD) risk. However, tools for the implementation of VA are currently lacking. We aimed to develop a questionnaire to assess the current knowledge gaps related to VA and barriers to its implementation in routine practice. METHODS Using a stepwise mixed-method approach, a quantitative questionnaire was constructed in four phases: (1) basic item generation and the development of a semi-qualitative questionnaire (SQQ); (2) dissemination to the VascAgeNet extended network and an analysis of the semi-qualitative questionnaire responses; (3) the development of a quantitative questionnaire (QQ); and (4) an assessment of the content and face validity and internal reliability in an additional sample. RESULTS Based on six main topics initially identified through an expert panel, a SQQ was developed and disseminated. Finally, a 22-item QQ was developed, with questions grouped around three main themes: knowledge of VA and its risk factors; perceptions and beliefs regarding the importance and contribution of VA to risk classification; and the application of VA measurements in clinical and research practice and its potential limitations (Cronbach's alpha between 0.920 and 0.982 for all three categories). CONCLUSION We report the development of a QQ on VA addressed to both clinicians and non-clinicians aiming to assess their knowledge, perceptions and application of VA measurements.
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Affiliation(s)
- Areti Triantafyllou
- 3rd Clinic of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
| | - Stavria-Artemis Elia
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Chloe Park
- MRC Unit for Lifelong Health and Aging, UCL, London WC1E 6BT, UK
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, 1210 Vienna, Austria
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, 05100 Terni, Italy
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Andrie G. Panayiotou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
- Correspondence: ; Tel.: +357-25002131
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Timmermans L, Boeykens D, Sirimsi MM, Decat P, Foulon V, Van Hecke A, Vermandere M, Schoenmakers B, Remmen R, Verté E, Sirimsi MM, Van Bogaert P, De Loof H, Van den Broeck K, Anthierens S, Huybrechts I, Raeymaeckers P, Buffel V, Devroey D, Aertgeerts B, Schoenmakers B, Timmermans L, Foulon V, Declerq A, Van de Velde D, Boeckxstaens P, De Sutter A, De Vriendt P, Lahousse L, Pype P, Boeykens D, Van Hecke A, Decat P, Roose R, Martin S, Rutten E, Pless S, Tuinstra A, Gauwe V, Reynaert D, Van Landschoot L, Hartmann ML, Claeys T, Vandenhoudt H, De Vliegher K, Op de Beeck S. Self-management support in flemish primary care practice: the development of a preliminary conceptual model using a qualitative approach. BMC PRIMARY CARE 2022; 23:63. [PMID: 35361118 PMCID: PMC8968094 DOI: 10.1186/s12875-022-01652-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/25/2022] [Indexed: 12/05/2022]
Abstract
Background Coping with a chronic disease can be really challenging. Self-management represents a promising strategy to improve daily life experiences. The role of primary healthcare professionals cannot be underestimated in supporting self-management. Due to a shortage of theory, implementation of self-management support is hindered in primary care practice. The aim of this study is to create a conceptual model for self-management support by analysing patients’ care experiences towards self-management support. Methods An explorative-descriptive qualitative study was conducted in Flanders, Belgium. Semi-structured interviews were performed with 16 patients and their informal caregiver (dyads) using a purposive sampling strategy and processed by an inductive content analysis, according to Graneheim and Lundman. Results Interviews revealed in-depth insights into patients’ care experiences. A conceptual model was developed for primary care practice, including five fundamental tasks for healthcare professionals - Supporting, Involving, Listening, Coordinating and Questioning (SILCQ) – contributing to the support of self-management of chronic patients. Conclusions This qualitative paper emphasises the use of the SILCQ-model to develop optimal roadmaps and hands-on toolkits for healthcare professionals to support self-management. The model needs to be further explored by all stakeholders to support the development of self-management interventions in primary care practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01652-8.
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Sikorska K, Gesing M, Olszański R, Roszko-Wysokińska A, Szostakowska B, Van Damme-Ostapowicz K. Misdiagnosis and inappropriate treatment of cutaneous leishmaniasis: a case report. Trop Dis Travel Med Vaccines 2022; 8:18. [PMID: 35909173 PMCID: PMC9341103 DOI: 10.1186/s40794-022-00175-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background Leishmaniasis is a widespread disease in tropical and subtropical countries, except for Australia and Oceania. In Poland, tourists, migrants and travellers from leishmaniasis-endemic countries may carry Leishmania. Case presentation We present a case of undiagnosed cutaneous leishmaniasis in a patient who received many weeks of inadequate antibiotic treatment. Ulceration in the right submandibular region was thought to be a purulent complication after laser surgery. Six weeks before the ulcer developed, the patient had visited the jungle (Guatemala). Cutaneous leishmaniasis was finally diagnosed after nine months based on a proper history and a polymerase chain reaction (PCR) assay. Treatment with antimony derivatives was administered. After three months, the ulcer healed but left a scar. Conclusion A lack of knowledge about tropical diseases among doctors and an incomplete medical history were the reasons for many weeks of erroneous treatment of cutaneous leishmaniasis with antibiotics. This is the first reported case of cutaneous leishmaniasis misdiagnosed as a complication after an aesthetic medical procedure.
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Baumgartner PC, Comment N, Hersberger KE, Arnet I. Development and testing of a framework for defining a strategy to address medication adherence during patient encounters in community pharmacies. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100123. [PMID: 35478506 PMCID: PMC9031683 DOI: 10.1016/j.rcsop.2022.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Counseling patients on medication adherence could be ameliorated in pharmacy practice. There is a lack of simple and practical strategies to address medication adherence with patients in daily practice. The goal was to develop and test a framework that allows pharmacy teams to define and apply a strategy to address medication adherence in community pharmacies. Methods A framework based on the principles of social marketing was developed. It consisted of 3 items: the target patient (“Who”), the target plan (“How”), and the target goal (“How many”). To test the framework, each participating pharmacy team developed their strategy by defining the 3 items and applied them during one pilot day. A master student observed the encounters between patients and pharmacy team members and used a structured checklist to document the patient's characteristics, counseling content, and strategy use. Pharmacy teams answered a feedback questionnaire at the end of the pilot day. Results Ten pharmacy teams were included. During a brainstorming session that lasted on average 31 ± 8 min, unique strategies comprised 18 different target patients and 20 different target plans. The planned target goal was a mean of 31 patients (range: 1 to “all”). A total of 325 encounters were observed, of which 208 patients (64%) corresponded to the predefined target patients. Medication adherence was addressed with 73 patients (22.5%), and adherence counseling was performed with 50 patients (15%). The pharmacy teams accepted the framework and judged it feasible and adaptable to their needs. Conclusion The proposed framework represents a simple tool that enables pharmacy teams to develop a strategy for addressing medication adherence in community pharmacies. Its adoption by pharmacy teams occurred without additional training and its integration into daily practice without difficulties. A further study is now needed to investigate if pharmacy teams can successfully engage patients in discussion on medication adherence and ultimately propose targeted adherence interventions. A 3-item framework to address medication adherence in pharmacies was introduced. The three framework was well received by the pharmacy teams. The adoption of the 3-item framework by the pharmacy teams was simple and quick. The teams chose target patient not according to known factors for poor adherence Patients reacted mainly positively when asked about medication adherence
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Pan PY, Jonsson U, Şahpazoğlu Çakmak SS, Häge A, Hohmann S, Nobel Norrman H, Buitelaar JK, Banaschewski T, Cortese S, Coghill D, Bölte S. Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis. Psychol Med 2022; 52:14-25. [PMID: 34635194 PMCID: PMC8711104 DOI: 10.1017/s0033291721004141] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023]
Abstract
There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63-2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06-1.56), guanfacine (OR = 1.43, 95% CI = 1.12-1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09-1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.
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Affiliation(s)
- Pei-Yin Pan
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Sabriye Selin Şahpazoğlu Çakmak
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hjalmar Nobel Norrman
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Samuele Cortese
- Faculty of Environmental and Life sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- New York University Child Study Center, New York, NY, USA
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, and Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia
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Adamczak R, Ukleja-Sokołowska N, Lis K, Bartuzi Z, Dubiel M. Progesterone-induced blocking factor 1 and cytokine profile of follicular fluid of infertile women qualified to in vitro fertilization: The influence on fetus development and pregnancy outcome. Int J Immunopathol Pharmacol 2022; 36:3946320221111134. [PMID: 35861194 PMCID: PMC9310294 DOI: 10.1177/03946320221111134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/14/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction: Progesterone is essential for both the initiation and the maintenance of pregnancy. The immunological effects of progesterone are mediated by the progesterone-induced blocking factor (PIBF), which is an immunomodulatory factor with anti-abortive properties. The aim of the research was to establish the cytokine profile and PIBF1 concentration in follicular fluid (FF) of patients undergoing in vitro fertilization (IVF).Methods: Seventy-eight patients who qualified for IVF underwent a detailed medical interview, including the course of fertility treatment and physical, gynecological, and cytological examinations. The concentration of PIBF1, IL-18, IL-2, IL-4, IL-6, IL-10, interferon-γ (IFN-γ), IL-1α, IL-1β, IL-5, IL-8, and IL-15 in FF during ovarian puncture was measured using commercially available ELISA kits.Results: IL-1 beta concentration was lower in the FF of patients with successful IVF. IL-8 concentration in FF correlated with the number of cumulus-oocyte complexes (COC-1), metaphase II (MII), and top-quality embryos. PIBF1 concentration had a positive correlation with the number of MII and top-quality embryos. IL-2 and IL-6 concentrations were positively correlated with the number of COC-1 and MII. An important parameter in assessing the chances of successful IVF is the number of top-quality embryos achieved.Conclusion: Higher PIBF1 concentration in FF may indicate a greater possibility of successful IVF due to the higher number of top-quality embryos. IL-1 beta concentration was found to be lower in the FF of patients with successful IVF. Therefore, PIBF1 and IL-1 beta in FF could be candidates for a marker of successful IVF.
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Affiliation(s)
- Rafał Adamczak
- Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Natalia Ukleja-Sokołowska
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Kinga Lis
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zbigniew Bartuzi
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Mariusz Dubiel
- Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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Youn I, Cheong MJ, Kim J, Kim SI, Kim HK, Kwon M, Seo J, Nam D, Leem J. Understanding the experiences and perception of people living with HIV on integrative traditional East Asian medicine management in Korea: an interview protocol for qualitative research. BMJ Open 2021; 11:e051880. [PMID: 34887276 PMCID: PMC8663099 DOI: 10.1136/bmjopen-2021-051880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/19/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patients with HIV/AIDS have been able to experience the average life expectancy of the general population due to medical advancements. However, they face physical, emotional and social difficulties that worsen their quality of life. The pharmacological approach is often the first choice to address these issues, but it involves some limitations. Integrative traditional East Asian medicine (ITEAM) can compensate for the limitations of drugs and can be applied to treat physiological and psychiatric problems. In Korea, ITEAM interventions are easily accessible under the government insurance. However, the experiences, perceptions and barriers to the use of ITEAM in patients with HIV/AIDS are less studied. Therefore, we will interview them to explore their experiences and examine the strengths, limitations, barriers and improvements in the use of ITEAM. METHODS AND ANALYSIS This is a qualitative study using a phenomenological framework. We will conduct one-to-one interviews with 3-10 patients with HIV/AIDS who have been treated with ITEAM from March 2021 to January 2022. We will present semistructured open-ended questions and analyse them using experiential phenomenological research methods. The results will be reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies. ETHICS AND DISSEMINATION This research was approved by the Institutional Review Board of the National Medical Center (IRB number, NMC-2101-008). The results of this study will be disseminated through journal articles, newspapers and conference proceedings. TRIAL REGISTRATION NUMBER Clinical Research Information Service: KCT0005855; Pre-results.
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Affiliation(s)
- Inae Youn
- Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Department of Acupuncture & Moxibustion, National Medical Center, Seoul, Republic of Korea
| | - Moon Joo Cheong
- Rare Disease Integrated Treatment Research Center, Wankwang University Jangheung Integrative Medical Hospital, Jangheung, Jeollanam-do, Republic of Korea
| | - Jinwon Kim
- Department of Internal Korean Medicine, National Medical Center, Seoul, Republic of Korea
| | - Soo Im Kim
- Department of Counseling, Dankook University, Yongin, Gyeonggi-do, Republic of Korea
| | - Hye Kyung Kim
- Psychological Counseling Office, LG Electronics Gasan Research and Development Campus, Geumcheon-gu, Seoul, Republic of Korea
| | - Miri Kwon
- Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Joohee Seo
- Department of Korean Neuropsychiatry, National Medical Center, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan, Jeollabuk-do, Republic of Korea
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Kemp MT, Williams AM, Brown CS, Liesman DR, Sharma SB, Wakam GK, Biesterveld BE, Wilson JK, Cohen MS, Alam HB. Practical Guidance for Early Identification of Barriers in Surgical Telehealth Clinics. Ann Surg 2021; 273:e268-e270. [PMID: 33214474 PMCID: PMC8119297 DOI: 10.1097/sla.0000000000004633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Early identification of and response to barriers in telehealth settings will help patients receive optimal care. Here, the authors, based on institutional experience, provide advice on such strategies. This guidance focuses on standardizing expectations, assessing technological knowledge and resource access, evaluating understanding and comfort with telehealth, and assessing social support.
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Affiliation(s)
- Michael T. Kemp
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | | | - Craig S. Brown
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | | | | | - Glenn K. Wakam
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | | | - Jesse K. Wilson
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Mark S. Cohen
- Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Hasan B. Alam
- Department of Surgery, University of Michigan, Ann Arbor, MI
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12
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Montgomery B, Corrie O. The practice of breaking bad news. TRENDS IN UROLOGY & MEN'S HEALTH 2021. [DOI: 10.1002/tre.785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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Abstract
Susceptibility to atrial fibrillation (AF) is determined by well-recognized risk factors such as diabetes mellitus or hypertension, emerging risk factors such as sleep apnea or inflammation, and increasingly well-defined genetic variants. As discussed in detail in a companion article in this series, studies in families and in large populations have identified multiple genetic loci, specific genes, and specific variants increasing susceptibility to AF. Since it is becoming increasingly inexpensive to obtain genotype data and indeed whole genome sequence data, the question then becomes to define whether using emerging new genetics knowledge can improve care for patients both before and after development of AF. Examples of improvements in care could include identifying patients at increased risk for AF (and thus deploying increased surveillance or even low-risk preventive therapies should these be available), identifying patient subsets in whom specific therapies are likely to be effective or ineffective or in whom the driving biology could motivate the development of new mechanism-based therapies or identifying an underlying susceptibility to comorbid cardiovascular disease. While current guidelines for the care of patients with AF do not recommend routine genetic testing, this rapidly increasing knowledge base suggests that testing may now or soon have a place in the management of select patients. The opportunity is to generate, validate, and deploy clinical predictors (including family history) of AF risk, to assess the utility of incorporating genomic variants into those predictors, and to identify and validate interventions such as wearable or implantable device-based monitoring ultimately to intervene in patients with AF before they present with catastrophic complications like heart failure or stroke.
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Affiliation(s)
- M. Benjamin Shoemaker
- Department of Medicine (Cardiovascular Medicine), Vanderbilt University Medical Center, Nashville, TN
| | - Rajan L. Shah
- Department of Medicine (Cardiovascular Medicine), Stanford University Medical Center, Palo Alto, CA
| | - Dan M. Roden
- Departments of Medicine (Cardiovascular Medicine and Clinical Pharmacology), Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Marco V. Perez
- Stanford Center for Inherited Cardiovascular Diseases, Stanford University, Palo Alto, CA
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Chen AH, Bakar NFA, Lam CSY. Comparison of open-ended and close-ended questions to determine signs and symptoms of eye problems among children. JOURNAL OF OPTOMETRY 2020; 13:81-87. [PMID: 31629682 PMCID: PMC7182780 DOI: 10.1016/j.optom.2019.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Parents play important role in providing information regarding their children's health status to healthcare providers. However, parents' ability in reporting signs and symptoms of eye problems among their children required more in-depth investigation. Our study aimed to compare the differences of parental report regarding eye problems among their children using two different question approaches. METHODS A total of 416 parents with children aged between two months old and 17 years old were participated in this cross-sectional survey. The responses of parents' observation on signs and symptoms of eye problems were compared between one open-ended question and ten close-ended questions. We also examined the demographic contributing factors that could influence parental responses. RESULTS The total count of reported signs and symptoms through open-ended and close-ended question was 164 and 529 reports, respectively. Parents reported more diverse (70% higher) categories of signs and symptoms in open-ended compared to close-ended questions. Parent's ability to report eye problems using open-ended question was associated with their gender (p<0.05), but no similar significant association was found in close-ended questions. CONCLUSION Parents reported more signs and symptoms of eye problems among their children through close-ended questions (regardless of gender) and more diversified categories through open-ended question in this study suggested that different communication approaches might be needed in clinical practice between those who requested specific appointment and those attending screening or routine assessment. The discrepancy might imply the importance to enhance the parent's role in preventive eye care. Effective communication between eyecare providers and parents has the potential to improve paediatric eyecare delivery.
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Affiliation(s)
- Ai-Hong Chen
- Optometry, Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Malaysia.
| | - Nurul-Farhana Abu Bakar
- Optometry, Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Selangor, Kampus Puncak Alam, Malaysia.
| | - Carly Siu-Yin Lam
- Centre of Myopia, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
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Zulman DM, Haverfield MC, Shaw JG, Brown-Johnson CG, Schwartz R, Tierney AA, Zionts DL, Safaeinili N, Fischer M, Thadaney Israni S, Asch SM, Verghese A. Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter. JAMA 2020; 323:70-81. [PMID: 31910284 DOI: 10.1001/jama.2019.19003] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction. OBJECTIVE To identify evidence and narrative-based practices that promote clinician presence, a state of awareness, focus, and attention with the intent to understand patients. EVIDENCE REVIEW Preliminary practices were derived through a systematic literature review (from January 1997 to August 2017, with a subsequent bridge search to September 2019) of effective interpersonal interventions; observations of primary care encounters in 3 diverse clinics (n = 27 encounters); and qualitative interviews with physicians (n = 10), patients (n = 27), and nonmedical professionals whose occupations involve intense interpersonal interactions (eg, firefighter, chaplain, social worker; n = 30). After evidence synthesis, promising practices were reviewed in a 3-round modified Delphi process by a panel of 14 researchers, clinicians, patients, caregivers, and health system leaders. Panelists rated each practice using 9-point Likert scales (-4 to +4) that reflected the potential effect on patient and clinician experience and feasibility of implementation; after the third round, panelists selected their "top 5" practices from among those with median ratings of at least +2 for all 3 criteria. Final recommendations incorporate elements from all highly rated practices and emphasize the practices with the greatest number of panelist votes. FINDINGS The systematic literature review (n = 73 studies) and qualitative research activities yielded 31 preliminary practices. Following evidence synthesis, 13 distinct practices were reviewed by the Delphi panel, 8 of which met criteria for inclusion and were combined into a final set of 5 recommendations: (1) prepare with intention (take a moment to prepare and focus before greeting a patient); (2) listen intently and completely (sit down, lean forward, avoid interruptions); (3) agree on what matters most (find out what the patient cares about and incorporate these priorities into the visit agenda); (4) connect with the patient's story (consider life circumstances that influence the patient's health; acknowledge positive efforts; celebrate successes); and (5) explore emotional cues (notice, name, and validate the patient's emotions). CONCLUSIONS AND RELEVANCE This mixed-methods study identified 5 practices that have the potential to enhance physician presence and meaningful connection with patients in the clinical encounter. Evaluation and validation of the outcomes associated with implementing the 5 practices is needed, along with system-level interventions to create a supportive environment for implementation.
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Affiliation(s)
- Donna M Zulman
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, California
| | - Marie C Haverfield
- VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, California
- Stanford University Center for Primary Care and Outcomes Research (PCOR) and Center for Health Research and Policy (CHRP), Stanford, California
| | - Jonathan G Shaw
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Cati G Brown-Johnson
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Rachel Schwartz
- VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, California
- Stanford University Center for Primary Care and Outcomes Research (PCOR) and Center for Health Research and Policy (CHRP), Stanford, California
| | - Aaron A Tierney
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, California
| | - Dani L Zionts
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Nadia Safaeinili
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | - Meredith Fischer
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
| | | | - Steven M Asch
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California
- VA Palo Alto Health Care System Center for Innovation to Implementation (Ci2i), Menlo Park, California
| | - Abraham Verghese
- Department of Medicine, Stanford University, Stanford, California
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Sexual and Gender Minority Adolescents: Meeting the Needs of Our LGBTQ Patients and Their Families. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2019. [DOI: 10.1016/j.cpem.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Tam NT, Huy NT, Thoa LTB, Long NP, Trang NTH, Hirayama K, Karbwang J. Participants' understanding of informed consent in clinical trials over three decades: systematic review and meta-analysis. Bull World Health Organ 2015; 93:186-98H. [PMID: 25883410 PMCID: PMC4371493 DOI: 10.2471/blt.14.141390] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 10/29/2014] [Accepted: 11/26/2014] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To estimate the proportion of participants in clinical trials who understand different components of informed consent. METHODS Relevant studies were identified by a systematic review of PubMed, Scopus and Google Scholar and by manually reviewing reference lists for publications up to October 2013. A meta-analysis of study results was performed using a random-effects model to take account of heterogeneity. FINDINGS The analysis included 103 studies evaluating 135 cohorts of participants. The pooled proportion of participants who understood components of informed consent was 75.8% for freedom to withdraw at any time, 74.7% for the nature of study, 74.7% for the voluntary nature of participation, 74.0% for potential benefits, 69.6% for the study's purpose, 67.0% for potential risks and side-effects, 66.2% for confidentiality, 64.1% for the availability of alternative treatment if withdrawn, 62.9% for knowing that treatments were being compared, 53.3% for placebo and 52.1% for randomization. Most participants, 62.4%, had no therapeutic misconceptions and 54.9% could name at least one risk. Subgroup and meta-regression analyses identified covariates, such as age, educational level, critical illness, the study phase and location, that significantly affected understanding and indicated that the proportion of participants who understood informed consent had not increased over 30 years. CONCLUSION The proportion of participants in clinical trials who understood different components of informed consent varied from 52.1% to 75.8%. Investigators could do more to help participants achieve a complete understanding.
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Affiliation(s)
- Nguyen Thanh Tam
- Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Nguyen Tien Huy
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Le Thi Bich Thoa
- Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Nguyen Phuoc Long
- Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | | | - Kenji Hirayama
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki, Japan
| | - Juntra Karbwang
- Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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Opsommer E, Schoeb V. 'Tell me about your troubles': description of patient-physiotherapist interaction during initial encounters. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2014; 19:205-21. [PMID: 24711174 DOI: 10.1002/pri.1585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 11/29/2013] [Accepted: 02/13/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND PURPOSE Communication skills are essential for physiotherapy practice. It has been shown that patients, especially those with chronic pain problems, are more satisfied with services when therapists communicate adequately. The objective of this study was to explore how French-speaking physiotherapists and patients with low back pain explore and assess the patient's pain experience during initial encounters. METHODS The initial consultation of six consenting patients with low back pain and two physiotherapists was videotaped. Conversation analysis was used to describe and analyse the communication practices related to pain assessment. RESULTS When physiotherapists explored patients' pain experience, they specifically focused on the impact of pain on function. The observed physiotherapists used the following communication strategies: 1) using yes/no questions and 'okay' as a resource to shift to a new topic; 2) following documentation quite stringently without allowing digression; 3) building the next question on the basis of the patient's discourse; 4) inviting the patient to talk using formulations such as 'tell me about your troubles?'; and 5) using gaze and nodding as continuers. The physiotherapists used two different approaches to close the encounter. While one therapist chose to summarize the consultation, including a prognostic assessment, the other one ended the consultation by organizing the follow-up consultation. CONCLUSION This exploratory study examines the interaction between patients and physiotherapists during initial encounters and identifies assumptions underlying pain assessment that shape the therapists' exploration of patients' pain experience. It also shows evidence of the physiotherapists' difficulties to inquire about the patient's perspective.
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Affiliation(s)
- Emmanuelle Opsommer
- University of Applied Sciences and Arts Western Switzerland (HES-SO), University of Health Sciences (HESAV), Avenue Beaumont, Lausanne, Switzerland
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Rouse RA, Al-Maqbali M. Identifying nurse managers' essential communication skills: an analysis of nurses' perceptions in Oman. J Nurs Manag 2014; 22:192-200. [PMID: 24529216 DOI: 10.1111/jonm.12222] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2014] [Indexed: 11/28/2022]
Abstract
AIM(S) The aim of the present study was to analyse nurses' perceptions of the communication qualities that are essential for nurse managers to carry out their jobs effectively. BACKGROUND An examination of effective communication may help to identify nurse manager behaviours that promote dignity and respect. METHOD(S) A paper-and-pencil survey collected open-ended data from 1526 nursing professionals (RNs) representing 22 hospitals in Oman. Qualitative content analysis was conducted first, followed by a quantitative descriptive analysis. RESULTS The participants reported frustration with nurse managers who seemed overly focused on mistakes. Many participants felt there was little to no appreciation for tasks that were well done. Nurses also disliked being disciplined openly in front of colleagues or patients. CONCLUSION(S) The participants stressed that nurse manager feedback should be shared privately and framed in a positive and constructive tone. Active listening, team collaboration and the avoidance of discrimination/favouritism were also emphasised. IMPLICATIONS FOR NURSING MANAGEMENT A supportive and communicative work environment promotes nurses' dignity and respect. Embarrassing nurses in front of other health care professionals may be counterproductive. Instead, the study results suggested privately discussing concerns in a positive, constructive tone is more likely to foster nurse trust and dignity.
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Affiliation(s)
- Ruby A Rouse
- School of Advanced Studies, University of Phoenix, San Antonio, Texas, USA
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Ziółkowska J. Positions in doctors' questions during psychiatric interviews. QUALITATIVE HEALTH RESEARCH 2009; 19:1621-1631. [PMID: 19843970 DOI: 10.1177/1049732309350685] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this article I apply the concept of positioning to the analysis of 15 initial psychiatric interviews. I argue that through their questions the psychiatrists-in-training impose positions requiring the patients to gaze at themselves and their actual problems from particular perspectives. I point to three such positions: (a) the position of the observing assessor, from which it is expected that the patients will make a detached assessment of themselves or their problems, (b) the position of the informing witness, which requires the patients only to verify the information about themselves, and (c) the marginal one, the position of the experiencing narrator, from which talk about experiences and problems is expected. I explore the roots and consequences of the positions, with particular attention toward objectivization of the patients' experiences in the dominant witness and assessor positions. I conclude with a discussion about the medical model in psychiatry.
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