Taking OSCE examiner training on the road: reaching the masses.

Science.gov (United States)

Reid, Katharine; Smallwood, David; Collins, Margo; Sutherland, Ruth; Dodds, Agnes

To ensure the rigour of objective structured clinical examinations (OSCEs) in assessing medical students, medical school educators must educate examiners with a view to standardising examiner assessment behaviour. Delivering OSCE examiner training is a necessary yet challenging part of the OSCE process. A novel approach to implementing training for current and potential OSCE examiners was trialled by delivering large-group education sessions at major teaching hospitals. The 'OSCE Roadshow' comprised a short training session delivered in the context of teaching hospital 'Grand Rounds' to current and potential OSCE examiners. The training was developed to educate clinicians about OSCE processes, clarify the examiners' role and required behaviours, and to review marking guides and mark allocation in an effort to standardise OSCE processes and encourage consistency in examiner marking behaviour. A short exercise allowed participants to practise marking a mock OSCE to investigate examiner marking behaviour after the training. OSCE Roadshows at four metropolitan and one rural teaching hospital were well received and well attended by 171 clinicians across six sessions. Unexpectedly, medical students also attended in large numbers ( n= 220). After training, participants' average scores for the mock OSCE clustered closely around the ideal score of 28 (out of 40), and the average scores did not differ according to the levels of clinical experience. The OSCE Roadshow demonstrated the potential of brief familiarisation training in reaching large numbers of current and potential OSCE examiners in a time and cost-effective manner to promote standardisation of OSCE processes.

Does student performance on preclinical OSCEs relate to clerkship grades?

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Chima, Margot; Dallaghan, Gary Beck

2016-01-01

Objective structured clinical examinations (OSCEs) have been used to assess the clinical competence and interpersonal skills of healthcare professional students for decades. However, the relationship between preclinical (second year or M2) OSCE grades and clerkship performance had never been evaluated, until it was explored to provide information to educators at the University of Nebraska Medical Center (UNMC). In addition, the relationship between M2 OSCE communication scores (which is a portion of the total score) and third-year (M3) Internal Medicine (IM) clerkship OSCE scores was also explored. Lastly, conflicting evidence exists about the relationship between the amount of previous clinical experience and OSCE performance. Therefore, the relationship between M3 IM clerkship OSCE scores and the timing of the clerkship in the academic year was explored. Data from UNMC M2 OSCEs and M3 IM clerkship OSCEs were obtained for graduates of the 2013 and 2014 classes. Specifically, the following data points were collected: M2 fall OSCE total, M2 fall OSCE communication; M2 spring OSCE total, M2 spring OSCE communication; and M3 IM clerkship OSCE total percentages. Data were organized by class, M3 IM clerkship OSCE performance, and timing of the clerkship. Microsoft Excel and SPSS were used for data organization and analysis. Of the 245 records, 229 (93.5%) had data points for all metrics of interest. Significant differences between the classes of 2013 and 2014 existed for average M2 spring total, M2 spring communication, and M3 IM clerkship OSCEs. Retrospectively, there were no differences in M2 OSCE performances based on how students scored on the M3 IM clerkship OSCE. M3 IM clerkship OSCE performance improved for those students who completed the clerkship last in the academic year. There were inconsistencies in OSCE performances between the classes of 2013 and 2014, but more information is needed to determine if this is because of testing variability or heterogeneity

Does student performance on preclinical OSCEs relate to clerkship grades?

Directory of Open Access Journals (Sweden)

Margot Chima

2016-06-01

Full Text Available Background: Objective structured clinical examinations (OSCEs have been used to assess the clinical competence and interpersonal skills of healthcare professional students for decades. However, the relationship between preclinical (second year or M2 OSCE grades and clerkship performance had never been evaluated, until it was explored to provide information to educators at the University of Nebraska Medical Center (UNMC. In addition, the relationship between M2 OSCE communication scores (which is a portion of the total score and third-year (M3 Internal Medicine (IM clerkship OSCE scores was also explored. Lastly, conflicting evidence exists about the relationship between the amount of previous clinical experience and OSCE performance. Therefore, the relationship between M3 IM clerkship OSCE scores and the timing of the clerkship in the academic year was explored. Methods: Data from UNMC M2 OSCEs and M3 IM clerkship OSCEs were obtained for graduates of the 2013 and 2014 classes. Specifically, the following data points were collected: M2 fall OSCE total, M2 fall OSCE communication; M2 spring OSCE total, M2 spring OSCE communication; and M3 IM clerkship OSCE total percentages. Data were organized by class, M3 IM clerkship OSCE performance, and timing of the clerkship. Microsoft Excel and SPSS were used for data organization and analysis. Results: Of the 245 records, 229 (93.5% had data points for all metrics of interest. Significant differences between the classes of 2013 and 2014 existed for average M2 spring total, M2 spring communication, and M3 IM clerkship OSCEs. Retrospectively, there were no differences in M2 OSCE performances based on how students scored on the M3 IM clerkship OSCE. M3 IM clerkship OSCE performance improved for those students who completed the clerkship last in the academic year. Conclusions: There were inconsistencies in OSCE performances between the classes of 2013 and 2014, but more information is needed to determine if

Taking OSCE examiner training on the road: reaching the masses

Directory of Open Access Journals (Sweden)

Katharine Reid

2016-09-01

Full Text Available Background: To ensure the rigour of objective structured clinical examinations (OSCEs in assessing medical students, medical school educators must educate examiners with a view to standardising examiner assessment behaviour. Delivering OSCE examiner training is a necessary yet challenging part of the OSCE process. A novel approach to implementing training for current and potential OSCE examiners was trialled by delivering large-group education sessions at major teaching hospitals. Methods: The ‘OSCE Roadshow’ comprised a short training session delivered in the context of teaching hospital ‘Grand Rounds’ to current and potential OSCE examiners. The training was developed to educate clinicians about OSCE processes, clarify the examiners’ role and required behaviours, and to review marking guides and mark allocation in an effort to standardise OSCE processes and encourage consistency in examiner marking behaviour. A short exercise allowed participants to practise marking a mock OSCE to investigate examiner marking behaviour after the training. Results: OSCE Roadshows at four metropolitan and one rural teaching hospital were well received and well attended by 171 clinicians across six sessions. Unexpectedly, medical students also attended in large numbers (n=220. After training, participants’ average scores for the mock OSCE clustered closely around the ideal score of 28 (out of 40, and the average scores did not differ according to the levels of clinical experience. Conclusion: The OSCE Roadshow demonstrated the potential of brief familiarisation training in reaching large numbers of current and potential OSCE examiners in a time and cost-effective manner to promote standardisation of OSCE processes.

Rasch analysis on OSCE data : An illustrative example

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Tor E

2011-06-01

Full Text Available BackgroundThe Objective Structured Clinical Examination (OSCE is awidely used tool for the assessment of clinical competencein health professional education. The goal of the OSCE is tomake reproducible decisions on pass/fail status as well asstudents’ levels of clinical competence according to theirdemonstrated abilities based on the scores. This paperexplores the use of the polytomous Rasch model inevaluating the psychometric properties of OSCE scoresthrough a case study.MethodThe authors analysed an OSCE data set (comprised of 11stations for 80 fourth year medical students based on thepolytomous Rasch model in an effort to answer tworesearch questions: (1 Do the clinical tasks assessed in the11 OSCE stations map on to a common underlyingconstruct, namely clinical competence? (2 What otherinsights can Rasch analysis offer in terms of scaling, itemanalysis and instrument validation over and above theconventional analysis based on classical test theory?ResultsThe OSCE data set has demonstrated a sufficient degree offit to the Rasch model (χ2 = 17.060, DF=22, p=0.76indicating that the 11 OSCE station scores have sufficientpsychometric properties to form a measure for a commonunderlying construct, i.e. clinical competence. IndividualOSCE station scores with good fit to the Rasch model (p >0.1 for all χ2 statistics further corroborated thecharacteristic of unidimensionality of the OSCE scale forclinical competence. A Person Separation Index (PSI of0.704 indicates sufficient level of reliability for the OSCEscores. Other useful findings from the Rasch analysis thatprovide insights, over and above the analysis based onclassical test theory, are also exemplified using the data set.ConclusionThe polytomous Rasch model provides a useful andsupplementary approach to the calibration and analysis ofOSCE examination data.

The use of the OSCE in postgraduate education.

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Arnold, R C; Walmsley, A D

2008-08-01

The Objective Structured Clinical Examination (OSCE) is a method of assessing the clinical skills of undergraduates in medicine, dentistry and other health sciences and is employed increasingly in postgraduate education. To describe the application of the OSCE to the development of Lifelong Learning and Continuing Professional Development (CPD) for General Dental Practitioners (GDPs). A postgraduate course was designed as an OSCE for GDPs. The OSCE comprised 12 stations covering different aspects of general dentistry. After an introductory seminar outlining the aim of the course, the participants spent 7 min at each station. Each question or task required 10 answers and was designed to highlight areas of weakness or interest and to stimulate further study of the presenting topic. Solutions and answers were provided at each station for self-assessment along with a list of locally presented courses related to that subject. Participants were invited to leave contact details and to make suggestions for future postgraduate courses. The final session consisted of a group discussion and participants were invited to complete an evaluation form to express opinions on the course. The evaluation demonstrated that most candidates found participation in the OSCE stimulated their interest in CPD. The OSCE also highlighted areas of weakness in knowledge of certain clinical procedures. Group discussion confirmed that practitioners found the hands-on component valuable and that they were likely to participate in further OSCEs to enhance their CPD. Suggestions received during the discussion were used to modify the course. The OSCE course fulfilled its aim of assisting practitioners to organise their CPD. The reflective nature of the course was helpful in evaluating clinical knowledge and the unique multidisciplinary style fulfilled its objective in promoting thoughts regarding future study.

Assessing third-year medical students' ability to address a patient's spiritual distress using an OSCE case.

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McEvoy, Mimi; Schlair, Sheira; Sidlo, Zsuzsanna; Burton, William; Milan, Felise

2014-01-01

To inform curricular development by assessing the ability of third-year medical students to address a patient's spiritual distress during an acute medical crisis in the context of an objective structured clinical examination (OSCE) case. During March and April 2010, 170 third-year medical students completed an eight-station videotaped OSCE at Albert Einstein College of Medicine of Yeshiva University. One of the standardized patients (SPs) was a 65-year-old man with acute chest pain who mentioned his religious affiliation and fear of dying. If prompted, he revealed his desire to speak with a chaplain. The SP assessed students' history taking, physical examination, and communication skills. In a postencounter written exercise, students reported their responses to the patient's distress via four open-ended questions. Analysis of the postencounter notes was conducted by three coders for emergent themes. Clinical skills performance was compared between students who reported making chaplain referral and those who did not. A total of 108 students (64%) reported making a chaplain referral; 4 (2%) directly addressed the patient's religious/spiritual beliefs. Students' clinical performance scores showed no significant association with whether they made a chaplain referral. Findings suggest that the majority of medical students without robust training in addressing patients' spiritual needs can make a chaplain referral when faced with a patient in spiritual crisis. Yet, few students explicitly engaged the patient in a discussion of his beliefs. Thus, future studies are needed to develop more precise assessment measures that can inform development in spirituality and medicine curricula.

Pabriks denied in OSCE challenge / Lelde Benke

Index Scriptorium Estoniae

Benke, Lelde

2010-01-01

OSCE parlamentaarse assamblee peasekretäriks sai uuesti Spencer Oliver, keda toetas 95% hääletanutest. Läti endine välisminister Artis Pabriks, kes tahtis muuta OSCE PA peasekretäri valimisprotsessi ja hääletussüsteemi, kaotas

Feedback in the OSCE: What Do Residents Remember?

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Humphrey-Murto, Susan; Mihok, Marika; Pugh, Debra; Touchie, Claire; Halman, Samantha; Wood, Timothy J

2016-01-01

The move to competency-based education has heightened the importance of direct observation of clinical skills and effective feedback. The Objective Structured Clinical Examination (OSCE) is widely used for assessment and affords an opportunity for both direct observation and feedback to occur simultaneously. For feedback to be effective, it should include direct observation, assessment of performance, provision of feedback, reflection, decision making, and use of feedback for learning and change. If one of the goals of feedback is to engage students to think about their performance (i.e., reflection), it would seem imperative that they can recall this feedback both immediately and into the future. This study explores recall of feedback in the context of an OSCE. Specifically, the purpose of this study was to (a) determine the amount and the accuracy of feedback that trainees remember immediately after an OSCE, as well as 1 month later, and (b) assess whether prompting immediate recall improved delayed recall. Internal medicine residents received 2 minutes of verbal feedback from physician examiners in the context of an OSCE. The feedback was audio-recorded and later transcribed. Residents were randomly allocated to the immediate recall group (immediate-RG; n = 10) or the delayed recall group (delayed-RG; n = 8). The immediate-RG completed a questionnaire prompting recall of feedback received immediately after the OSCE, and then again 1 month later. The delayed-RG completed a questionnaire only 1 month after the OSCE. The total number and accuracy of feedback points provided by examiners were compared to the points recalled by residents. Results comparing recall at 1 month between the immediate-RG and the delayed-RG were also studied. Physician examiners provided considerably more feedback points (M = 16.3) than the residents recalled immediately after the OSCE (M = 2.61, p feedback points recalled upon completion of the OSCE (2.61) compared to 1 month later (M = 1

Item Analysis to Improve Reliability for an Internal Medicine Undergraduate OSCE

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Auewarakul, Chirayu; Downing, Steven M.; Praditsuwan, Rungnirand; Jaturatamrong, Uapong

2005-01-01

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical…

Kremlin's OSCE Ministerial Council-related demarches / Rokas M. Tracevskis

Index Scriptorium Estoniae

Tracevskis, Rokas M.

2011-01-01

Detsembril alguses Vilniuses toimunud OSCE kohtumisel kritiseeris USA riigisekretär Hillary Clinton Venemaa parlamendivalimiste korraldamist. Venemaa peaminister Vladimir Putin ütles, et USA riigisekretäri kõne saatis Vene opositsioonile tegutsemissignaali. Venemaa välisministri Sergei Lavrovi ja Leedu välisministri Audronius Azubalise ebasõbralikust kohtumisest. Venemaa blokeeris OSCE-s internetivabaduse kaitsele suunatud deklaratsiooni

A core competency-based objective structured clinical examination (OSCE) can predict future resident performance.

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Wallenstein, Joshua; Heron, Sheryl; Santen, Sally; Shayne, Philip; Ander, Douglas

2010-10-01

This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies. Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency. There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p competencies of patient care (R = 0.49, p competencies. An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance. © 2010 by the Society for Academic Emergency Medicine.

Electronic acquisition of OSCE performance using tablets

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Hochlehnert, Achim

2015-10-01

Full Text Available Background: Objective Structured Clinical Examinations (OSCEs often involve a considerable amount of resources in terms of materials and organization since the scores are often recorded on paper. Computer-assisted administration is an alternative with which the need for material resources can be reduced. In particular, the use of tablets seems sensible because these are easy to transport and flexible to use.Aim: User acceptance concerning the use of tablets during OSCEs has not yet been extensively investigated. The aim of this study was to evaluate tablet-based OSCEs from the perspective of the user (examiner and the student examinee.Method: For two OSCEs in Internal Medicine at the University of Heidelberg, user acceptance was analyzed regarding tablet-based administration (satisfaction with functionality and the subjective amount of effort as perceived by the examiners. Standardized questionnaires and semi-standardized interviews were conducted (complete survey of all participating examiners. In addition, for one OSCE, the subjective evaluation of this mode of assessment was gathered from a random sample of participating students in semi-standardized interviews.Results: Overall, the examiners were very satisfied with using tablets during the assessment. The subjective amount of effort to use the tablet was found on average to be “hardly difficult”. The examiners identified the advantages of this mode of administration as being in particular the ease of use and low rate of error. During the interviews of the examinees, acceptance for the use of tablets during the assessment was also detected.Discussion: Overall, it was found that the use of tablets during OSCEs was well accepted by both examiners and examinees. We expect that this mode of assessment also offers advantages regarding assessment documentation, use of resources, and rate of error in comparison with paper-based assessments; all of these aspects should be followed up on in

Surgical patient selection and counseling.

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Ziegelmann, Matt; Köhler, Tobias S; Bailey, George C; Miest, Tanner; Alom, Manaf; Trost, Landon

2017-08-01

The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures. The process of appropriate patient selection is determined by the integration of patient and surgeon factors, including psychological capacity to handle unsatisfactory results, baseline expectations, complexity of case, and surgeon volume and experience. Using this model, a high-risk scenario includes one in which a low-volume surgeon performs a complex case in a patient with limited psychological capacity and high expectations. In contrast, a high-volume surgeon performing a routine case in a male with low expectations and abundant psychiatric reserve is more likely to achieve a successful outcome. To further help identify patients who are at high risk for dissatisfaction, a previously published mnemonic is recommended: CURSED Patient (compulsive/obsessive, unrealistic, revision, surgeon shopping, entitled, denial, and psychiatric). Appropriate patient counseling includes setting appropriate expectations, reviewing the potential and anticipated risks of surgery, post-operative instruction to limit complications, and long-term follow-up. As thorough counseling is often a time-consuming endeavor, busy practices may elect to utilize various resources including educational materials, advanced practice providers, or group visits, among others. The consequences for poor patient selection and counseling may range from poor surgical outcomes and patient dissatisfaction to lawsuits, loss of

Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings.

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Bernard, Aaron W; Ceccolini, Gabbriel; Feinn, Richard; Rockfeld, Jennifer; Rosenberg, Ilene; Thomas, Listy; Cassese, Todd

2017-01-01

Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings. Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance. Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p<.001). Among 92 first-year students, checklist review was associated with an improved performance on subsequent F-OSCEs (p = 0.038) by 1.07 percentage points on a scale of 0-100. Among 86 second year students, no review modality was associated with improved performance on subsequent F-OSCEs. Medical students review F-OSCE checklists and video recordings less than 50% of the time when not prompted. Student-faculty debriefing meetings increased student data reviews. First-year student's review of checklists on F-OSCEs was associated with increases in performance on subsequent F-OSCEs, however this

Assessing and counseling the obese patient: Improving resident obesity counseling competence.

Science.gov (United States)

Iyer, Shwetha; Jay, Melanie; Southern, William; Schlair, Sheira

To evaluate obesity counseling competence among residents in a primary care training program METHODS: We delivered a 3h obesity curriculum to 28 Primary Care residents and administered a pre-curriculum and post curriculum survey looking specifically at self-assessed obesity counseling competence. Nineteen residents completed both the pre curriculum survey and the post curriculum survey. The curriculum had a positive impact on residents' ability to ascertain patient's stage of change, use different methods to obtain diet history (including 24h recall, food record or food frequency questionnaire), respond to patient's questions regarding treatment options, assist patients in setting realistic goals for weight loss based on making permanent lifestyle changes, and use of motivational interviewing to change behavior. When looking at the 5As domains, there was a significant improvement in the domains of Assess, Advise, and Assist. The proportion of residents with a lower level of self-assessed obesity counseling competence reduced from 75% before the curriculum to 37.5% (p=0.04) after the curriculum. Our curriculum addressing weight loss counseling using the 5As model increased obesity counseling competence among residents in a primary care internal medicine residency program. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

Directory of Open Access Journals (Sweden)

Sherman Scott

2010-06-01

Full Text Available Abstract Background Physicians are encouraged to counsel obese patients to lose weight, but studies measuring the quality of physicians' counseling are rare. We sought to describe the quality of physicians' obesity counseling and to determine associations between the quality of counseling and obese patients' motivation and intentions to lose weight, key predictors of behavior change. Methods We conducted post-visit surveys with obese patients to assess physician's use of 5As counseling techniques and the overall patient-centeredness of the physician.. Patients also reported on their motivation to lose weight and their intentions to eat healthier and exercise. One-way ANOVAs were used to describe mean differences in number of counseling practices across levels of self-rated intention and motivation. Logistic regression analyses were conducted to assess associations between number of 5As counseling practices used and patient intention and motivation. Results 137 patients of 23 physicians were included in the analysis. While 85% of the patients were counseled about obesity, physicians used only a mean of 5.3 (SD = 4.6 of 18 possible 5As counseling practices. Patients with higher levels of motivation and intentions reported receiving more 5As counseling techniques than those with lower levels. Each additional counseling practice was associated with higher odds of being motivated to lose weight (OR 1.31, CI 1.11-1.55, intending to eat better (OR 1.23, CI 1.06-1.44, and intending to exercise regularly (OR 1.14, CI 1.00-1.31. Patient centeredness of the physician was also positively associated with intentions to eat better (OR 2.96, CI 1.03-8.47 and exercise (OR 26.07, CI 3.70-83.93. Conclusions Quality of physician counseling (as measured using the 5As counseling framework and patient-centeredness scales was associated with motivation to lose weight and intentions to change behavior. Future studies should determine whether higher quality obesity

M-OSCE as a method to measure dental hygiene students' critical thinking: a pilot study.

Science.gov (United States)

McComas, Martha J; Wright, Rebecca A; Mann, Nancy K; Cooper, Mary D; Jacks, Mary E

2013-04-01

Educators in all academic disciplines have been encouraged to utilize assessment strategies to evaluate students' critical thinking. The purpose of this study was to assess the viability of the modified objective structured clinical examination (m-OSCE) to evaluate critical thinking in dental hygiene education. This evaluation utilized a convenience sample of senior dental hygiene students. Students participated in the m-OSCE in which portions of a patient case were revealed at four stations. The exam consisted of multiple-choice questions intended to measure students' ability to utilize critical thinking skills. Additionally, there was one fill-in-the-blank question and a treatment plan that was completed at the fifth station. The results of this study revealed that the m-OSCE did not reliably measure dental hygiene students' critical thinking. Statistical analysis found no satisfactory reliability within the multiple-choice questions and moderately reliable results within the treatment planning portion of the examination. In addition, the item analysis found gaps in students' abilities to transfer clinical evidence/data to basic biomedical knowledge as demonstrated through the multiple-choice questioning results. This outcome warrants further investigation of the utility of the m-OSCE, with a focus on modifications to the evaluation questions, grading rubric, and patient case.

How well do second-year students learn physical diagnosis? Observational study of an objective structured clinical examination (OSCE

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Simon Steven R

2002-01-01

Full Text Available Abstract Background Little is known about using the Objective Structured Clinical Examination (OSCE in physical diagnosis courses. The purpose of this study was to describe student performance on an OSCE in a physical diagnosis course. Methods Cross-sectional study at Harvard Medical School, 1997–1999, for 489 second-year students. Results Average total OSCE score was 57% (range 39–75%. Among clinical skills, students scored highest on patient interaction (72%, followed by examination technique (65%, abnormality identification (62%, history-taking (60%, patient presentation (60%, physical examination knowledge (47%, and differential diagnosis (40% (p Conclusions Students scored higher on interpersonal and technical skills than on interpretive or integrative skills. Station scores identified specific content that needs improved teaching.

Enhancing OSCE preparedness with video exemplars in undergraduate nursing students. A mixed method study.

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Massey, D; Byrne, J; Higgins, N; Weeks, B; Shuker, M-A; Coyne, E; Mitchell, M; Johnston, A N B

2017-07-01

Objective structured clinical examinations (OSCEs) are designed to assess clinical skill performance and competency of students in preparation for 'real world' clinical responsibilities. OSCEs are commonly used in health professional education and are typically associated with high levels of student anxiety, which may present a significant barrier to performance. Students, including nursing students, have identified that flexible access to exemplar OSCEs might reduce their anxiety and enable them to better prepare for such examinations. To implement and evaluate an innovative approach to preparing students for OSCEs in an undergraduate (registration) acute care nursing course. A set of digitized OSCE exemplars were prepared and embedded in the University-based course website as part of usual course learning activities. Use of the exemplars was monitored, pre and post OSCE surveys were conducted, and qualitative data were collected to evaluate the approach. OSCE grades were also examined. The online OSCE exemplars increased self-rated student confidence, knowledge, and capacity to prepare and provided clarity around assessment expectations. OSCE exemplars were accessed frequently and positively received; but did not impact on performance. Video exemplars aid student preparation for OSCEs, providing a flexible, innovative and clear example of the assessment process. Video exemplars improved self-rated student confidence and understanding of performance expectations, leading to increased engagement and reduced anxiety when preparing for the OSCE, but not overall OSCE performance. Such OSCE exemplars could be used to increase staff capacity and improve the quality of the student learning experience. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

USA ja Venemaa ristasid piike OSCE tuleviku pärast / Ahto Lobjakas

Index Scriptorium Estoniae

Lobjakas, Ahto, 1970-

2006-01-01

OSCE välisministrite kohtumiselt ei jõutud organisatsiooni tulevikus kokkuleppele. Kui USA nõuab, et OSCE-d tuleb tugevdada demokraatia edendajana ning valimiste aususe tagaja ja inimõiguste kaitsjana, siis Venemaa näeb sellises suunas liigset sekkumist liikmesriikide siseasjadesse

OSCE vs. TEM: Different approaches to assess clinical skills of nursing students

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Prasuna Jelly

2017-01-01

Full Text Available Introduction: Nurses are trained with specific clinical skills, and objective structured clinical examination (OSCE could be a better approach to assess clinical skills of nursing students. Materials and Methods: A comparative study was conducted by observational checklist regarding antenatal care and opinionnaire on the usefulness of OSCE and tradition evaluation method (TEM was used to assess the clinical skills and to get opinion. Results: The mean score of OSCE was more than TEM and the difference was statistically significant (P < 0.001. The opinion of students regarding the usefulness of OSCE was higher than TEM. Conclusions: The study concluded that implementing OSCE will overweigh the advantages of the TEM.

The Dental School Interview As a Predictor of Dental Students' OSCE Performance.

Science.gov (United States)

Park, Sang E; Price, Mirissa D; Karimbux, Nadeem Y

2018-03-01

The aim of this study was to evaluate the use of the dental school admissions interview score as a noncognitive indicator of performance in predoctoral dental education, with specific attention to whether a correlation existed between the admissions interview scores and performance on the objective structured clinical examination (OSCE). The study population consisted of all 175 students in the Harvard School of Dental Medicine (HSDM) DMD Classes of 2012 through 2016. Data on students' gender and age on entering dental school were self-reported using their applications for admission to the HSDM DMD program. Data on students' OSCE scores for three examination sessions were collected from the Office of Dental Education. The results showed that the students' interview scores did not significantly correlate with OSCE performance on any of the three exams. Performance on the first and second OSCEs did, however, correlate with performance on the third OSCE (pinterview score. These results suggest that although the admissions interview scores can serve as an important resource in student selection, with the lack of association between interview and OSCE scores, it is possible that the communication skills required for the interview do not directly overlap with those required for OSCE success.

Nurse counseling of patients with an overconsumption of alcohol

DEFF Research Database (Denmark)

Willaing, Ingrid; Ladelund, Steen

2005-01-01

PURPOSE: To identify the associations between self-reported alcohol-related clinical practice among hospital nurses and their (a) self-rated qualifications for counseling on alcohol, and (b) attitudes toward care of patients with an overconsumption of alcohol. DESIGN AND METHODS: A survey based...... on self-administered questionnaires was undertaken at a Danish University Hospital in the Copenhagen area. Descriptive statistics, chi-square test, and multiple logistic regression analyses were used. Variables were self-reported alcohol-related counseling, self-rated qualifications for counseling...... patients with an overconsumption of alcohol, attitudes toward the priority of counseling on alcohol and other lifestyle issues, and attitudes toward caring for patients with an overconsumption of alcohol. FINDINGS: Self-rated qualifications for counseling and attitudes toward care significantly influenced...

A simple framework for assessing technical skills in a resident observed structured clinical examination (OSCE): vaginal laceration repair.

Science.gov (United States)

Winkel, Abigail Ford; Lerner, Veronica; Zabar, Sondra R; Szyld, Demian

2013-01-01

Educators of trainees in procedure-based specialties need focused assessment tools that are valid, objective, and assess technical skills in a realistic context. A framework for hybrid assessment using standardized patient scenarios and bench skills testing might facilitate evaluation of competency. Seven PGY-1 obstetrics and gynecology residents participated in a hybrid assessment that used observed structured clinical examination (OSCE) by a standardized patient who had sustained a vaginal laceration during vaginal delivery. The residents elicited a history and counseled the patient, and then completed a laceration repair on a pelvic model. The residents were rated on their performance in the scenario, which included issues of cultural competency, rapport-building, patient counseling. The technical skills were videotaped and rated using a modified global assessment form by 2 faculty members on a 3-point scale from "not done" to "partly done" to "well-done." Residents also completed a subjective assessment of the station. Mean technical performance of the residents on the technical skills was 55% "well-done," with a range of 20%-90%. The assessment identified 3 residents as below the mean, and 1 resident with areas of deficiency. Subjective assessment by the residents was that juggling the technical, cognitive, and affective components of the examination was challenging. Technical skills can be included in a case-based assessment using scenarios that address a range of cognitive and affective skills required of physicians. Results may help training programs assess individuals' abilities as well as identify program needs for curricular improvement. This framework might be useful in setting standards for competency and identifying poor performers. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Options Counseling for the Pregnant Adolescent Patient.

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Hornberger, Laurie L

2017-09-01

Each year, more than 500 000 girls and young women younger than 20 years become pregnant. It is important for pediatricians to have the ability and the resources in their offices to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental pregnancy options counseling. Counseling includes an unbiased discussion of the adolescent's legal options to either continue or terminate her pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue. Copyright © 2017 by the American Academy of Pediatrics.

Effect of patient counseling on quality of life of hemodialysis patients in India

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Thomas D

2009-09-01

Full Text Available End stage renal disease (ESRD is a growing problem. The effect of patient counseling is to be defined on health-related quality of life. Objective: The purpose of this study was to find out the impact of patient counseling in health related quality of life (QoL. Methods: In this prospective interventional study, the Karnofsky Performance Status (KPS for QoL questionnaire was used in test and control groups for data collection. The same data collection method was used during six months to study the effect of patient counseling. Results: Health related quality of life in test group showed a consistent improvement of 2% in six months. Improvement of awareness by patient counseling was also improved. Conclusion: As part of medication therapy management (MTM, patient counseling focusing on dialysis compliance, diet and medications are an effective way to improve health-related QoL and awareness in ESRD. Such services should be made mandatory by law in India to improve outcomes in chronic illness.

Application of best practice guidelines for OSCEs-An Australian evaluation of their feasibility and value.

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Mitchell, Marion L; Henderson, Amanda; Jeffrey, Carol; Nulty, Duncan; Groves, Michele; Kelly, Michelle; Knight, Sabina; Glover, Pauline

2015-05-01

Objective Structured Clinical Examinations (OSCEs) are widely used in health professional education and should be based on sound pedagogical foundations. The aim of this study is to evaluate the feasibility and utility of using Best Practice Guidelines (BPGs) within an OSCE format in a broad range of tertiary education settings with under-graduate and post-graduate nursing and midwifery students. We evaluated how feasible it was to apply the BPGs to modify OSCEs in a course; students' perspective of the OSCE; and finally, if the BPG-revised OSCEs better prepared students for clinical practice when compared with the original OSCEs. A mixed method with surveys, focus groups and semi-structured interviews evaluated the BPGs within an OSCE. Four maximally different contexts across four sites in Australia were used. Participants included lecturers and undergraduate nursing students in high and low fidelity simulation settings; under-graduate midwifery students; and post-graduate rural and remote area nursing students. 691 students participated in revised OSCEs. Surveys were completed by 557 students; 91 students gave further feedback through focus groups and 14 lecturers participated in interviews. At all sites the BPGs were successfully used to modify and implement OSCEs. Students valued the realistic nature of the modified OSCEs which contributed to students' confidence and preparation for clinical practice. The lecturers considered the revised OSCEs enhanced student preparedness for their clinical placements. The BPGs have a broad applicability to OSCEs in a wide range of educational contexts with improved student outcomes. Students and lecturers identified the revised OSCEs enhanced student preparation for clinical practice. Subsequent examination of the BPGs saw further refinement to a set of eight BPGs that provide a sequential guide to their application in a way that is consistent with best practice curriculum design principles. Copyright © 2015 Elsevier Ltd

Hubungan Self Assessment-Peer Assessment dengan Nilai Kelulusan OSCE Mahasiswa Fakultas Kedokteran Unisba

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Santun Bhekti Rahimah

2017-02-01

Full Text Available Abstrak Objective structured clinical examination (OSCE adalah cara penilaian kompetensi klinik mahasiswa secara komprehensif dan konsisten serta dapat dijadikan media untuk meningkatkan hasil belajar. Feedback dapat dilakukan oleh mahasiswa itu sendiri (self assessment maupun mahasiswa lain yang satu level (peer assessment. Self dan peer assessment diharapkan akan meningkatkan kemampuan mahasiswa dalam melihat tujuan pembelajaran, meningkatkan rasa percaya diri, kemampuan berpikir kritis, dan bertindak tepat dalam menghadapi ujian. Tujuan penelitian ini melihat hubungan self assessment dan peer assessment dengan nilai kelulusan OSCE mahasiswa tingkat dua dan empat FK Unisba tahun akademik 2012/2013. Nilai hasil ujian OSCE yang dipergunakan adalah pada periode Desember 2012–Juni 2013. Self dan peer assessment dilaksanakan setelah ujian OSCE. Self assessment dilakukan oleh mahasiswa itu sendiri, sedangkan peer assessment didapatkan dari lima orang mahasiswa lain yang pernah berada dalam satu kelompok dengan subjek. Hasil penelitian menunjukkan untuk mahasiswa tingkat dua terdapat korelasi bermakna self assessment dan peer assessment dengan nilai OSCE (p<0,001, arah hubungan antara keduanya positif, serta kekuatan hubungan keduanya sedang (R=0,426. Pada mahasiswa tingkat empat terdapat korelasi bermakna antara self assessment dan nilai OSCE (p<0,001 dengan kekuatan hubungan keduanya sedang (R=0,451, serta terdapat korelasi yang bermakna antara penilaian peer assessment dan nilai OSCE. Simpulan, self assessment mempunyai korelasi positif terhadap nilai kelulusan OSCE pada mahasiswa tingkat dua dan tingkat empat, sedangkan peer assessment mempunyai korelasi positif dengan nilai kelulusan OSCE hanya pada mahasiswa tingkat dua. Self assessment mempunyai korelasi positif dengan peer assessment pada mahasiswa tingkat dua dan tingkat empat FK Unisba tahun akademik 2012/2013. Abstract Objective structured clinical examination (OSCE is a tools to assess

OSCE as a Summative Assessment Tool for Undergraduate Students of Surgery-Our Experience.

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Joshi, M K; Srivastava, A K; Ranjan, P; Singhal, M; Dhar, A; Chumber, S; Parshad, R; Seenu, V

2017-12-01

Traditional examination has inherent deficiencies. Objective Structured Clinical Examination (OSCE) is considered as a method of assessment that may overcome many such deficits. OSCE is being increasingly used worldwide in various medical specialities for formative and summative assessment. Although it is being used in various disciplines in our country as well, its use in the stream of general surgery is scarce. We report our experience of assessment of undergraduate students appearing in their pre-professional examination in the subject of general surgery by conducting OSCE. In our experience, OSCE was considered a better assessment tool as compared to the traditional method of examination by both faculty and students and is acceptable to students and faculty alike. Conducting OSCE is feasible for assessment of students of general surgery.

Detection Learning Style Vark For Out Of School Children (OSC)

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Amran, Ali; Desiani, Anita; Hasibuan, MS

2017-04-01

Learning style is different for every learner especially for out of school children or OSC. They are not like formal students, they are learners but they don’t have a teacher as a guide for learning. E-learning is one of the solutions to help OSC to get education. E-learning should have preferred learning styles of learners. Data for identifying the learning style in this study were collected with a VARK questionnaire from 25 OSC in junior high school level from 5 municipalities in Palembang. The validity of the questionnaire was considered on basis of experts’ views and its reliability was calculated by using Cronbach’s alpha coefficients (α=0.68). Overall, 55% preferred to use a single learning style (Uni-modal). Of these, 27,76% preferred Aural, 20,57% preferred Reading Writing, 33,33% preferred Kinaesthetic and 23,13% preferred Visual. 45% of OSC preferred more than one style, 30% chose two-modes (bimodal), and 15% chose three-modes (tri-modal). The Most preferred Learning style of OSC is kinaesthetic learning. Kinaesthetic learning requires body movements, interactivities, and direct contacts with learning materials, these things can be difficult to implement in eLearning, but E-learning should be able to adopt any learning styles which are flexible in terms of time, period, curriculum, pedagogy, location, and language.

The iOSC3 System: Using Ontologies and SWRL Rules for Intelligent Supervision and Care of Patients with Acute Cardiac Disorders

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Marcos Martínez-Romero

2013-01-01

Full Text Available Physicians in the Intensive Care Unit (ICU are specially trained to deal constantly with very large and complex quantities of clinical data and make quick decisions as they face complications. However, the amount of information generated and the way the data are presented may overload the cognitive skills of even experienced professionals and lead to inaccurate or erroneous actions that put patients’ lives at risk. In this paper, we present the design, development, and validation of iOSC3, an ontology-based system for intelligent supervision and treatment of critical patients with acute cardiac disorders. The system analyzes the patient’s condition and provides a recommendation about the treatment that should be administered to achieve the fastest possible recovery. If the recommendation is accepted by the doctor, the system automatically modifies the quantity of drugs that are being delivered to the patient. The knowledge base is constituted by an OWL ontology and a set of SWRL rules that represent the expert’s knowledge. iOSC3 has been developed in collaboration with experts from the Cardiac Intensive Care Unit (CICU of the Meixoeiro Hospital, one of the most significant hospitals in the northwest region of Spain.

Patient counseling practices in U.S. pharmacies: effects of having pharmacists hand the medication to the patient and state regulations on pharmacist counseling.

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Kimberlin, Carole L; Jamison, Allison Newland; Linden, Stephan; Winterstein, Almut G

2011-01-01

To determine the amount and type of oral counseling given to shoppers posing as new patients with new prescriptions and to determine how state regulations, pharmacy and pharmacist characteristics, and environmental factors affect oral counseling practices. Cross-sectional, observational, correlational study. 41 states and the District of Columbia between January 28 and March 31, 2008. 365 community pharmacy staff members had interactions with shopper-patients. Shoppers presented new prescriptions in community pharmacies and recorded observations related to oral communication with pharmacy staff. Oral provision of medication information and risk information to shoppers by pharmacy staff, as well as questions asked of shoppers by pharmacy staff. Some form of oral communication related to a medication was reported in 68% of encounters. At least one informational item for either medication was provided for approximately 42% of encounters. At least one risk information item was provided in 22% of encounters. Logistic regression findings indicated that the strongest predictor of oral counseling, either providing information or asking questions, was the pharmacist being the pharmacy staff member who handed the medication to the patient, controlling for all other variables in the models. In addition, having strict state regulations specifying that pharmacists must counsel all patients receiving new prescriptions predicted whether patients received counseling. A more private area for prescription pick up also was a significant predictor. The importance of the direct encounter between the pharmacist and patient and strict state regulations mandating that pharmacists counsel patients with new prescriptions were highlighted by these findings.

Communication barriers in counselling foreign-language patients in public pharmacies: threats to patient safety?

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Schwappach, David L B; Meyer Massetti, Carla; Gehring, Katrin

2012-10-01

Foreign-language (FL) patients are at increased risk for adverse drug events. Evidence regarding communication barriers and the safety of pharmaceutical care of FL patients in European countries is scarce despite large migrant populations. To investigate Swiss public pharmacists' experiences and current practices in counselling FL patients with a focus on patient safety. In a cross-sectional study heads of public pharmacies in Switzerland were surveyed using an electronic questionnaire. The survey assessed the frequency of communication barriers encountered in medication counselling of FL patients, perceptions of risks for adverse drug events, satisfaction with the quality of counselling provided to FL patients, current strategies to reduce risks, and preferences towards tools to improve safety for FL patients. 498 pharmacists completed the survey (43 % response rate). More than every second pharmacist reported at least weekly encounters at which they cannot provide good medication counselling to FL patients in the regional Swiss language. Ad-hoc interpreting by minors is also common at a considerable number of pharmacies (26.5 % reported at least one weekly occurrence). Approximately 10 % of pharmacies reported that they fail at least weekly to explain the essentials of drug therapy (e.g. dosing of children's medications) to FL patients. 79.8 % perceived the risk of FL patients for adverse drug events to be somewhat or much higher compared to other patients. 22.5 % of pharmacists reported being concerned at least monthly about medication safety when FL patients leave their pharmacy. However, the majority of pharmacists were satisfied with the quality of care provided to FL patients in their pharmacy [78.6 % (very) satisfied]. The main strategy used to improve counselling for FL patients was the employment of multilingual staff. Participants would use software for printing foreign-language labels (41.2 %) and multilingual package inserts (42.0 %) if these were

Efficacy of Standardized Nursing Fertility Counseling on Sperm Banking Rates in Cancer Patients.

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Rotker, Katherine; Vigneswaran, Hari; Omil-Lima, Danly; Sigman, Mark; Hwang, Kathleen

2017-06-01

To examine the effect of brief nurse counseling on sperm banking rates among patients prior to initiating chemotherapy. A retrospective chart review was performed for men aged 18-50 with newly diagnosed cancer, from 1998 to 2003, prior to initiation of chemotherapy. A standardized nursing education session including brief fertility counseling was implemented at one institution in 2008 (Institution A). Rates of sperm banking among patients who received counseling were compared to those without counseling at institution A and to those at institution B where a counseling program was never initiated. A total of 766 male patients, 402 treated at institution A and 364 at institution B, were included. At institution A, sperm banking rates prior to 2008 were 6.4% and 8.3% after 2008 for those who did not receive counseling. The rate of sperm banking for those patients who did receive counseling was significantly higher at 17.6% (P = .002). The odds of banking increased 2.9 times for those who received counseling compared to those who did not (P = .003). At institution B, where counseling was never initiated, rates of banking remained low before and after 2008. Additional analysis revealed that younger patients and those patients who did not have children were more likely to perform sperm banking. The rates of sperm banking among cancer patients increased with the receipt of a brief, formalized nurse counseling session prior to initiation of chemotherapy. These findings may validate the use of a formalized fertility counseling prior to initiation of chemotherapy. Copyright © 2017 Elsevier Inc. All rights reserved.

Student evaluation of an OSCE in General Medicine at Mamata Medical College, Andhra Pradesh

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Dharma Rao V, Pramod Kumar Reddy M, Rajaneesh Reddy M, HanumiahA, Shyam Sunder P, Narasingha Reddy T, Kishore Babu SPV

2014-04-01

Full Text Available The assessment of student’s clinical competence is of paramount importance, and there are several means of evaluating student performance in medical examinations. The OSCE is an approach to student assessment in which aspects of clinical competence are evaluated in a comprehensive, consistent and structured manner with close attention to the objectivity of the process. The faculty of general medicine in collaboration with other clinical departments, Mamata Medical College, Khammam first implemented the objective structured clinical examination (OSCE in the final MBBS Part-II examination during the internal assessment examination for the 2011-2012 academic years. The study was set out to explore student acceptance of the OSCE as part of an evaluation of final MBBS students. A self-administered questionnaire was completed by successive groups of students immediately after the OSCE. Main outcome measures were student perception of examination attributes, which included the quality of instructions and organization, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other formats. There was an overwhelming acceptance of OSCE in general medicine with respect to comprehensiveness (90% transparency (90% & authenticity of required tasks. Students felt that it was a useful form of examination. Student’s feedback was invaluable in influencing faculty teaching curriculum direction and appreciation of student opinion and overall the students were agreeable with newer form of OSCE. The majority of the students felt that OSCE is a fair assessment tool compared to traditional long and short cases and it covers a wide range of knowledge and clinical skills in general medicine.

Using modified information delivery to enhance the traditional pharmacy OSCE program at TMU - a pilot study.

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Lin, Che-Wei; Chang, Elizabeth H; Clinciu, Daniel L; Peng, Yun-Ting; Huang, Wen-Chen; Wu, Chien-Chih; Wu, Jen-Chieh; Li, Yu-Chuan

2018-05-01

Objective Structured Clinical Examination (OSCE) has been used in many areas of healthcare training over the years. However, it constantly needs to be upgraded and enhanced due to technological and teaching changes. We aim at implementing an integrative OSCE method which employs informatics via the virtual patient within the pharmacy education curriculum at Taipei Medical University to enhance the pharmacy students' competence for using and disseminating information and to also improve critical thinking and clinical reasoning. We propose an integrated pharmacy OSCE which uses standardized patients and virtual patients (DxR Clinician). To evaluate this method, we designed four simulated stations and pilot tested with 19 students in the first year of the Master in Clinical Pharmacy program. Three stations were simulated as the inpatient pharmacy: 1) History and lab data collection; 2) Prescription review; 3) Calling physician to discuss potential prescription problems. The fourth was simulated as the patient ward station to provide patient education. A satisfaction questionnaire was administered at the end of the study. Students rated their ability of 2.84, 2.37, 2.37, and 3.63 of 5 for each of the four stations, with the second and third being the most difficult stations. The method obtained an average rating of 4.32 of 5 for relevance, 4.16 for improving clinical ability, 4.32 for practicality in future healthcare work, and 4.28 for willing to have another similar learning experience. The integration of Virtual Patient in this study reveals that this assessment method is efficient and practical in many aspects. Most importantly, it provides the test taker with a much closer real-life clinical encounter. Although it is in many ways more difficult, it also provides for better "learning from mistakes" opportunities for test-takers. Copyright © 2017. Published by Elsevier B.V.

Using Item Analysis to Assess Objectively the Quality of the Calgary-Cambridge OSCE Checklist

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Tyrone Donnon

2011-06-01

Full Text Available Background:  The purpose of this study was to investigate the use of item analysis to assess objectively the quality of items on the Calgary-Cambridge Communications OSCE checklist. Methods:  A total of 150 first year medical students were provided with extensive teaching on the use of the Calgary-Cambridge Guidelines for interviewing patients and participated in a final year end 20 minute communication OSCE station.  Grouped into either the upper half (50% or lower half (50% communication skills performance groups, discrimination, difficulty and point biserial values were calculated for each checklist item. Results:  The mean score on the 33 item communication checklist was 24.09 (SD = 4.46 and the internal reliability coefficient was ? = 0.77. Although most of the items were found to have moderate (k = 12, 36% or excellent (k = 10, 30% discrimination values, there were 6 (18% identified as ‘fair’ and 3 (9% as ‘poor’. A post-examination review focused on item analysis findings resulted in an increase in checklist reliability (? = 0.80. Conclusions:  Item analysis has been used with MCQ exams extensively. In this study, it was also found to be an objective and practical approach to use in evaluating the quality of a standardized OSCE checklist.

Practice-level approaches for behavioral counseling and patient health behaviors.

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Balasubramanian, Bijal A; Cohen, Deborah J; Clark, Elizabeth C; Isaacson, Nicole F; Hung, Dorothy Y; Dickinson, L Miriam; Fernald, Douglas H; Green, Larry A; Crabtree, Benjamin F

2008-11-01

There is little empirical evidence to show that a practice-level approach that includes identifying patients in need of health behavior advice and linking them to counseling resources either in the practice or in the community results in improvements in patients' behaviors. This study examined whether patients in primary care practices that had practice-level approaches for physical activity and healthy-diet counseling were more likely to have healthier behaviors than patients in practices without practice-level approaches. A cross-sectional study of 54 primary care practices was conducted from July 2005 to January 2007. Practices were categorized into four groups depending on whether they had both identification tools (health risk assessment, registry) and linking strategies (within practice or to community resources); identification tools but no linking strategies; linking strategies but no identification tools; or neither identification tools nor linking strategies. Controlling for patient and practice characteristics, practices that had both identification tools and linking strategies for physical activity counseling were 80% more likely (95% CI=1.25, 2.59) to have patients who reported exercising regularly compared to practices that lacked both. Also, practices that had either identification tools or linking strategies but not both were approximately 50% more likely to have patients who reported exercising regularly. The use of a greater number of practice-level approaches for physical activity counseling was associated with higher odds of patients' reporting exercising regularly (p for trend=0.0002). Use of identification tools and linking strategies for healthy-eating counseling was not associated with patients' reports of healthy diets. This study suggests that practice-level approaches may enable primary care practices to help patients improve physical activity. However, these approaches may have different effects on different behaviors, and merit further

Student evaluation of an OSCE in paediatrics at the University of the West Indies, Jamaica

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Branday J Michael

2004-10-01

Full Text Available Abstract Background The Faculty of Medical Sciences, University of the West Indies first implemented the Objective Structured Clinical Examination (OSCE in the final MB Examination in Medicine and Therapeutics during the 2000–2001 academic year. Simultaneously, the Child Health Department initiated faculty and student training, and instituted the OSCE as an assessment instrument during the Child Health (Paediatric clerkship in year 5. The study set out to explore student acceptance of the OSCE as part of an evaluation of the Child Health clerkship. Methods A self-administered questionnaire was completed by successive groups of students immediately after the OSCE at the end of each clerkship rotation. Main outcome measures were student perception of examination attributes, which included the quality of instructions and organisation, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other formats. Results There was overwhelming acceptance of the OSCE in Child Health with respect to the comprehensiveness (90%, transparency (87%, fairness (70% and authenticity of the required tasks (58–78%. However, students felt that it was a strong anxiety-producing experience. And concerns were expressed regarding the ambiguity of some questions and inadequacy of time for expected tasks. Conclusion Student feedback was invaluable in influencing faculty teaching, curriculum direction and appreciation of student opinion. Further psychometric evaluation will strengthen the development of the OSCE.

[A survey of willingness about genetic counseling and tests in patients of epithelial ovarian cancer].

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Li, L; Qiu, L; Wu, M

2017-11-21

Objective: To analyze patients' tendency towards genetics counseling and tests based on a prospective cohort study on hereditary ovarian cancer. Methods: From February 2017 to June 2017, among 220 cases of epithelial ovarian cancer in Peking Union Medical College Hospital, we collected epidemiological, pathological and tendency towards genetics counseling and tests via medical records and questionnaire.All patients would get education about hereditary ovarian cancer by pamphlets and WeChat.If they would receive further counseling, a face to face interview and tests will be given. Results: Among all 220 patients, 10 (4.5%) denied further counseling.For 210 patients receiving genetic counseling, 170 (81%) accepted genetic tests.In multivariate analysis, risk factors relevant to acceptance of genetic tests included: being charged by physicians of gynecologic oncology for diagnosis and treatment, receiving counseling in genetic counseling clinics, and having family history of breast cancer.For patients denying genetic tests, there were many subjective reasons, among which, "still not understanding genetic tests" (25%) and "unable bear following expensive targeting medicine" . Conclusions: High proportion patients of epithelial ovarian cancer would accept genetic counseling and tests.Genetic counseling clinics for gynecologic oncology would further improve genetic tests for patients.

Correlation between MMI performance and OSCE performance – a pilot study

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Adetokunbo Oluwasanjo

2015-06-01

Full Text Available Objective: The multiple mini-interview (MMI has been shown to have a positive correlation with early medical school performance, clerkship evaluations, and national licensing examinations. There is limited data on its predictive validity at the postgraduate level. Methods: Six hundred and nineteen internship candidates were interviewed using the MMI format by the internal medicine residency program of The Reading Health System, between September 2011 and February 2014. Fifty-two interns were recruited. Each intern participated in an objective structured clinical examination (OSCE 3–4 months after the start of the program. The OSCE score of each intern was used as the independent variable to test the relationship with both the MMI interpersonal score and the MMI overall score. Results: There was a moderate positive correlation between the average MMI interpersonal score and the communication score on the OSCE, r=0.384, n=52, p=0.005, and a negligible relationship between the average MMI overall score and the communication score on the OSCE, r=0.175, n=52, p=0.214. Conclusion: The MMI is a useful tool for residency programs to assess interpersonal and communication skills prior to matriculation into residency training. This study provides evidence for its validity in assessing these competencies.

Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized controlled trial.

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Ockene, Judith K; Ashe, Karen M; Hayes, Rashelle B; Churchill, Linda C; Crawford, Sybil L; Geller, Alan C; Jolicoeur, Denise; Olendzki, Barbara C; Basco, Maria Theresa; Pendharkar, Jyothi A; Ferguson, Kristi J; Guck, Thomas P; Margo, Katherine L; Okuliar, Catherine A; Shaw, Monica A; Soleymani, Taraneh; Stadler, Diane D; Warrier, Sarita S; Pbert, Lori

2018-01-01

Physicians have an important role addressing the obesity epidemic. Lack of adequate teaching to provide weight management counseling (WMC) is cited as a reason for limited treatment. National guidelines have not been translated into an evidence-supported, competency-based curriculum in medical schools. Weight Management Counseling in Medical Schools: A Randomized Controlled Trial (MSWeight) is designed to determine if a multi-modal theoretically-guided WMC educational intervention improves observed counseling skills and secondarily improve perceived skills and self-efficacy among medical students compared to traditional education (TE). Eight U.S. medical schools were pair-matched and randomized in a group randomized controlled trial to evaluate whether a multi-modal education (MME) intervention compared to traditional education (TE) improves observed WMC skills. The MME intervention includes innovative components in years 1-3: a structured web-course; a role play exercise, WebPatientEncounter, and an enhanced outpatient internal medicine or family medicine clerkship. This evidence-supported curriculum uses the 5As framework to guide treatment and incorporates patient-centered counseling to engage the patient. The primary outcome is a comparison of scores on an Objective Structured Clinical Examination (OSCE) WMC case among third year medical students. The secondary outcome compares changes in scores of medical students from their first to third year on an assessment of perceived WMC skills and self-efficacy. MSWeight is the first RCT in medical schools to evaluate whether interventions integrated into the curriculum improve medical students' WMC skills. If this educational approach for teaching WMC is effective, feasible and acceptable it can affect how medical schools integrate WMC teaching into their curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

Formulation of Genetic Counseling Format for Adult Bangladeshi Patients with Acute Myeloid Leukemia

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M. Z. Rahman

2018-01-01

Full Text Available With the advancement of medical genetics, particular emphasis is given on the genetic counseling worldwide. In Bangladesh, genetic counseling services are not yet developed. Acute myeloid leukemia (AML is a malignant disease of the myeloid cells of bone marrow. Like other malignant diseases, it may result from a mutation in the DNA. A genetic counseling format will educate the AML patients and provide appropriate medical and emotional support. The aim of this descriptive cross-sectional study was to develop a genetic counseling format for adult Bangladeshi patients with AML. Taking this into account, a draft format was prepared by reviewing relevant documents available online which was later analyzed by an expert panel through a group discussion and thus a proposed format was developed. To make the format effective in the perspective of Bangladeshi population, the proposed format was applied in counseling, and thus a final format was developed in the English language. This format will educate the counselors, clinicians, and patients about the utility and importance of the genetic counseling and genetic tests. Also, the patients feel comfort regarding the whole counseling process and going for postcounseling treatments and advice. Though it is written in English, it may be translated into mother tongue for better communication during counseling.

Formulation of Genetic Counseling Format for Adult Bangladeshi Patients with Acute Myeloid Leukemia.

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Rahman, M Z; Nishat, L; Yesmin, Z A; Banu, L A

2018-01-01

With the advancement of medical genetics, particular emphasis is given on the genetic counseling worldwide. In Bangladesh, genetic counseling services are not yet developed. Acute myeloid leukemia (AML) is a malignant disease of the myeloid cells of bone marrow. Like other malignant diseases, it may result from a mutation in the DNA. A genetic counseling format will educate the AML patients and provide appropriate medical and emotional support. The aim of this descriptive cross-sectional study was to develop a genetic counseling format for adult Bangladeshi patients with AML. Taking this into account, a draft format was prepared by reviewing relevant documents available online which was later analyzed by an expert panel through a group discussion and thus a proposed format was developed. To make the format effective in the perspective of Bangladeshi population, the proposed format was applied in counseling, and thus a final format was developed in the English language. This format will educate the counselors, clinicians, and patients about the utility and importance of the genetic counseling and genetic tests. Also, the patients feel comfort regarding the whole counseling process and going for postcounseling treatments and advice. Though it is written in English, it may be translated into mother tongue for better communication during counseling.

Russia coordinates new broadside against OSCE / Liz Fuller

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Fuller, Liz

2004-01-01

SRÜ maade poolt 8. juulil 2004 Viinis tehtud avaldusest, mille kohaselt sekkub Euroopa Julgeoleku- ja Koostööorganisatsioon (OSCE) riikide siseasjadesse ning rakendab topeltstandardeid. Avaldusega ei ühinenud Gruusia ja Aserbaidžaan

Standardised clients as assessors in a veterinary communication OSCE: a reliability and validity study.

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Artemiou, E; Adams, C L; Hecker, K G; Vallevand, A; Violato, C; Coe, J B

2014-11-22

In human medicine, standardised patients (SP) have been shown to reliably and accurately assess learners' communication performance in high-stakes certification Objective Structured Clinical Examinations (OSCE), offering a feasible way to reduce the need for recruitment, time commitment and coordination of faculty assessors. In this study, we evaluated the use of standardised clients (SC) as a viable option for assessing veterinary students' communication performance. We designed a four-station, two-track communication skills OSCE. SC assessors used an adapted nine-item Liverpool Undergraduate Communication Assessment Scale (LUCAS). Faculty used a 21-item checklist derived from the Calgary-Cambridge Guide (CCG) and a five-point global rating scale. Participants were second year veterinary students (n=96). For the four stations, intrastation reliability (α) ranged from 0.63 to 0.82 for the LUCAS, and 0.73 to 0.87 for the CCG. The interstation reliability coefficients were 0.85 for the LUCAS and 0.89 for the CGG. The calculated Generalisability (G) coefficients were 0.62 for the LUCAS and 0.60 for the CGG. Supporting construct validity, SC and faculty assessors showed a significant correlation between the LUCAS and CCG total percent scores (r=0.45, PStudy results support that SC assessors offer a reliable and valid approach for assessing veterinary communication OSCE. British Veterinary Association.

Counseling Is Effective for Smoking Cessation in Head and Neck Cancer Patients

DEFF Research Database (Denmark)

Klemp, Ingrid; Wangsmo Steffenssen, Mia Charlotte; Bakholdt, Vivi T.

2016-01-01

PURPOSE: The purpose of this systematic review was to describe the efficacy of smoking cessation counseling and the resulting quit rate in patients with head and neck cancer. MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed, Embase, and Cochrane databases. Predictor...... variables were smoking cessation counseling and smoking cessation interventions. The outcome was smoking cessation. Data collection and quality assessment were performed independently by 2 of the authors. Selected publications were assessed for potential risk of bias, and the level of evidence was evaluated...... in patients who received smoking cessation counseling compared with those who received usual care. CONCLUSIONS: This review shows that counseling supplemented with nicotine replacement therapy increases the possibility for smoking cessation in patients with head and neck cancer....

Evaluation of the OSC-TV iterative reconstruction algorithm for cone-beam optical CT.

Science.gov (United States)

Matenine, Dmitri; Mascolo-Fortin, Julia; Goussard, Yves; Després, Philippe

2015-11-01

The present work evaluates an iterative reconstruction approach, namely, the ordered subsets convex (OSC) algorithm with regularization via total variation (TV) minimization in the field of cone-beam optical computed tomography (optical CT). One of the uses of optical CT is gel-based 3D dosimetry for radiation therapy, where it is employed to map dose distributions in radiosensitive gels. Model-based iterative reconstruction may improve optical CT image quality and contribute to a wider use of optical CT in clinical gel dosimetry. This algorithm was evaluated using experimental data acquired by a cone-beam optical CT system, as well as complementary numerical simulations. A fast GPU implementation of OSC-TV was used to achieve reconstruction times comparable to those of conventional filtered backprojection. Images obtained via OSC-TV were compared with the corresponding filtered backprojections. Spatial resolution and uniformity phantoms were scanned and respective reconstructions were subject to evaluation of the modulation transfer function, image uniformity, and accuracy. The artifacts due to refraction and total signal loss from opaque objects were also studied. The cone-beam optical CT data reconstructions showed that OSC-TV outperforms filtered backprojection in terms of image quality, thanks to a model-based simulation of the photon attenuation process. It was shown to significantly improve the image spatial resolution and reduce image noise. The accuracy of the estimation of linear attenuation coefficients remained similar to that obtained via filtered backprojection. Certain image artifacts due to opaque objects were reduced. Nevertheless, the common artifact due to the gel container walls could not be eliminated. The use of iterative reconstruction improves cone-beam optical CT image quality in many ways. The comparisons between OSC-TV and filtered backprojection presented in this paper demonstrate that OSC-TV can potentially improve the rendering of

Introduction of new guidelines for emergency patients: motivational counselling among smokers

DEFF Research Database (Denmark)

Backer, Vibeke; Nelbom, Bente Munkholm; Duus, Benn Rønnow

2007-01-01

Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate the implem...... the implementation of motivational counselling in a department of acute surgery....

Forging Consensus for Atrocity Prevention: Assessing the Record of the OSCE

Directory of Open Access Journals (Sweden)

Matthew Levinger

2018-03-01

Full Text Available This essay examines the record of the Organization for Security and Cooperation in Europe (OSCE in fostering norms and collaborative practices for preventing mass atrocities in Eurasia. Comprising fifty-seven participating states “from Vancouver to Vladivostok,” the OSCE is the sole regional security organization spanning all of the members of NATO and the former Warsaw Pact. Its consensus-based approach to advancing “common and comprehensive security” has proved successful in preventing escalation or containing levels of violence in various conflicts in the Baltic states, Ukraine, Southeastern Europe, and the Caucasus. Since the late 1990s, however, rising geopolitical tensions between NATO and the Russian Federation have undermined the effectiveness of the OSCE’s conflict prevention initiatives. In order for the OSCE to play a more robust role in enhancing human security in Eurasia, it will need to find a path toward rebuilding the normative consensus between Russia and its Western participating states.

Objective Structured Clinical Examinations (OSCEs, psychiatry and the Clinical assessment of Skills and Competencies (CASCSame Evidence, Different Judgement

Directory of Open Access Journals (Sweden)

Marwaha Steven

2011-05-01

Full Text Available Abstract Background The Objective Structured Clinical Examination (OSCE, originally developed in the 1970's, has been hailed as the "gold standard" of clinical assessments for medical students and is used within medical schools throughout the world. The Clinical assessment of Skills and Competencies (CASC is an OSCE used as a clinical examination gateway, granting access to becoming a senior Psychiatrist in the UK. Discussion Van der Vleuten's utility model is used to examine the CASC from the viewpoint of a senior psychiatrist. Reliability may be equivalent to more traditional examinations. Whilst the CASC is likely to have content validity, other forms of validity are untested and authenticity is poor. Educational impact has the potential to change facets of psychiatric professionalism and influence future patient care. There are doubts about acceptability from candidates and more senior psychiatrists. Summary Whilst OSCEs may be the best choice for medical student examinations, their use in post graduate psychiatric examination in the UK is subject to challenge on the grounds of validity, authenticity and educational impact.

Counseling Patients Exposed to Ionizing Radiation in Diagnostic Radiology During Pregnancy

International Nuclear Information System (INIS)

Brnic, Z.; Leder, N.I.; Popic Ramac, J.; Vidjak, V.; Knezevic, Z.

2013-01-01

There are many false assumptions regarding influence of radiation on pregnant patients and fetus during diagnostic procedures in spite of scientific facts based on studies (both in general population and among physicians). These false assumptions are mostly based on the idea that every diagnostic procedure that uses ionizing radiation is a cause for serious concern and consideration for artificial abortion as a possible solution. We have analysed the data of counselling of pregnant patients exposed to ionizing radiation during diagnostic procedures in University Hospital Merkur, during a period of four years. In this period we had 26 patients come in counselling due to exposure to ionizing radiation during pregnancy. Results show that most of these patients have been exposed to radiation between 2nd and 3rd week of gestation (36 %), between 4th and 5th week - 32 %; before 2nd week - 24%; and after 6th week of gestation less than 8 %. Average doses were: up to 0.01 cGy in 46.2 % patients; 0.01 - 0.15 cGy in 19.2 % patients; 0.2 - 1 cGy in 26.9 % and 1 cGy or more in 7.7 % of patients. No one of the counselled patients had a medical indication for abortion, even though in a small percentage of patients abortion was a personal subjective decision. Considering that there are no Croatian guidelines for counselling patients exposed to ionizing radiation during pregnancy, recommendation is to use International Commission on Radiological Protection (ICRP) guidelines for management of pregnant patients exposed to ionizing radiation.(author)

Calibration of communication skills items in OSCE checklists according to the MAAS-Global.

Science.gov (United States)

Setyonugroho, Winny; Kropmans, Thomas; Kennedy, Kieran M; Stewart, Brian; van Dalen, Jan

2016-01-01

Communication skills (CS) are commonly assessed using 'communication items' in Objective Structured Clinical Examination (OSCE) station checklists. Our aim is to calibrate the communication component of OSCE station checklists according to the MAAS-Global which is a valid and reliable standard to assess CS in undergraduate medical education. Three raters independently compared 280 checklists from 4 disciplines contributing to the undergraduate year 4 OSCE against the 17 items of the MAAS-Global standard. G-theory was used to analyze the reliability of this calibration procedure. G-Kappa was 0.8. For two raters G-Kappa is 0.72 and it fell to 0.57 for one rater. 46% of the checklist items corresponded to section three of the MAAS-Global (i.e. medical content of the consultation), whilst 12% corresponded to section two (i.e. general CS), and 8.2% to section one (i.e. CS for each separate phase of the consultation). 34% of the items were not considered to be CS. A G-Kappa of 0.8 confirms a reliable and valid procedure for calibrating OSCE CS checklist items using the MAAS-Global. We strongly suggest that such a procedure is more widely employed to arrive at a stable (valid and reliable) judgment of the communication component in existing checklists for medical students' communication behaviours. It is possible to measure the 'true' caliber of CS in OSCE stations. Students' results are thereby comparable between and across stations, students and institutions. A reliable calibration procedure requires only two raters. Copyright © 2015. Published by Elsevier Ireland Ltd.

Breast cancer genetic counseling among Dutch patients from Turkish and Moroccan descent: participation determinants and perspectives of patients and healthcare professionals.

Science.gov (United States)

Baars, J E; van Dulmen, A M; Velthuizen, M E; van Riel, E; Ausems, M G E M

2017-04-01

Lower participation rates in cancer genetic counseling are observed among different ethnic minorities. The goal of our study is to gain insight into determinants of Turkish and Moroccan patients' participation in breast cancer genetic counseling and DNA testing, from the point of view of healthcare professionals and patients. Questionnaire-based telephone interviews about awareness, perceptions, and reasons for (non-) participation in cancer genetic counseling were conducted with 78 Dutch breast cancer patients from Turkish and Moroccan descent. The interviews were held in Arabic, Berber, Turkish, or Dutch by bilingual research assistants. Additionally, 14 breast cancer patients participated in one of two focus group meetings, and two focus groups were held with 11 healthcare professionals. SPSS and QSR Nvivo were used to examine the quantitative and qualitative data, respectively. Half of the total group of patients (N = 78) and 79% of patients eligible for genetic counseling and testing (N = 33) were aware of the possibility of genetic counseling. The most important determinants for nonparticipation in genetic counseling were experienced difficulties in patient-doctor communication, cultural factors (e.g., social norms), limited health literacy, limited knowledge of the family cancer history, and anxiety about cancer. Religious beliefs and knowing personal and family members' breast cancer risks were motives to obtain genetic counseling. Despite the fact that our study showed that Moroccan and Turkish women reported several personal motives to obtain genetic counseling and testing (GCT), patients and healthcare professionals experience significant language and health literacy difficulties, which make it harder to fully access health care such as genetic counseling and testing.

Randomized trial of teaching brief motivational interviewing to pediatric trainees to promote healthy behaviors in families.

Science.gov (United States)

Lozano, Paula; McPhillips, Heather A; Hartzler, Bryan; Robertson, Andrea S; Runkle, Cecilia; Scholz, Kelley A; Stout, James W; Kieckhefer, Gail M

2010-06-01

That pediatric resident trainees would demonstrate increased counseling skill following training in brief motivational interviewing (MI). Randomized controlled trial. University of Washington Pediatric Residency. Pediatric residents (N = 18), including residents in postgraduate years 1, 2, 3, and 4. Collaborative Management in Pediatrics, a 9-hour behavior change curriculum based on brief MI plus written feedback on communication skills (based on a 3-month Objective Standardized Clinical Evaluation [OSCE]). The percentage of MI-consistent behavior (%MICO), a summary score for MI skill, was assessed via OSCEs in which standardized patients portray parents of children with asthma in 3 clinical scenarios (stations). The OSCEs were conducted at baseline and 3 and 7 months. Blinded coders rated videotaped OSCEs using a validated tool to tally communication behaviors. Training effects were assessed using linear regression controlling for baseline %MICO. Global ratings of counseling style served as secondary outcome measures. Trained residents demonstrated a trend toward increased skill (%MICO score) at 3 months compared with control residents. At 7 months, %MICO scores increased 16% to 20% (P < .02) across all OSCE stations after the combined intervention of Collaborative Management in Pediatrics training plus written feedback. The effect of training on global ratings supported the main findings. Pediatric trainees' skills in behavior change counseling improved following the combination of training in brief MI plus personalized feedback.

Interactions of oversulfated chondroitin sulfate (OSCS) from different sources with unfractionated heparin.

Science.gov (United States)

Gray, Angel; Litinas, Evangelos; Jeske, Walter; Fareed, Jawed; Hoppensteadt, Debra

2012-01-01

In 2008, oversulfated chondroitin sulfate (OSCS) was identified as the main contaminant in recalled heparin. Oversulfated chondroitin sulfate can be prepared from bovine (B), porcine (P), shark (Sh), or skate (S) origin and may produce changes in the antithrombotic, bleeding, and hemodynamic profile of heparins. This study examines the interactions of various OSCSs on heparin in animal models of thrombosis and bleeding, as well as on the anticoagulant and antiprotease effects in in vitro assays. Mixtures of 70% unfractionated heparin (UFH) with 30% OSCS from different sources were tested. In the in vitro activated partial thromboplastin time (aPTT) assay, all contaminant mixtures showed a decrease in clotting times. In addition, a significant increase in bleeding time compared to the control (UFH/saline) was observed. In the thrombosis model, no significant differences were observed. The OSCSs significantly increased anti-Xa activity in ex vivo blood samples. These results indicate that various sources of OSCS affect the hemostatic properties of heparin.

Factors influencing quality of patient interaction at community pharmacy drive-through and walk-in counselling areas.

Science.gov (United States)

Odukoya, Olufunmilola K; Chui, Michelle A; Pu, Jia

2014-08-01

To examine factors influencing the amount of time and information pharmacy personnel provide to patients at drive-through and walk-in counselling areas. On-site observational data collection in 22 community pharmacies by pharmacy students. Information included observable patient characteristics such as gender, age range, English proficiency and mobility impairment; encounter characteristics included type of prescription and whether the patient was acknowledged; and counselling characteristics included types of counselling information conveyed and length of time for each encounter. Patient-pharmacist encounters were documented at the drive-through and walk-in counselling areas 961 and 1098 times respectively. Pharmacists spent less time, and technicians more time, with patients at the drive-through counselling area. The amount of information provided to patients was significantly affected by whether the patient was receiving new versus refill prescriptions. Patients with a new prescription were twice as likely to receive more information from pharmacy personnel. There was a significant difference between the amount of counselling provided to patients at the drive-through and walk-in counselling area (rate ratio (RR) 0.92, 95% confidence interval (CI): 0.86-1.00). Patients at the drive-through received a lower amount of information relative to patients using the walk-in. Amount of information provided to patients was affected by the level of pharmacy busyness (RR 0.96, 95% CI: 0.95-0.99). Providing patient care at the drive-through counselling area may negatively influence quality of patient care. To improve quality of pharmacy drive-through services, standardization of drive-through services in pharmacies may be needed. © 2013 Royal Pharmaceutical Society.

Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar.

Science.gov (United States)

Paravattil, Bridget; Kheir, Nadir; Yousif, Adil

2017-08-01

Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist's counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community

Patient and Physician Characteristics Associated with the Provision of Weight Loss Counseling in Primary Care

Science.gov (United States)

Dutton, Gareth R.; Herman, Katharine G.; Tan, Fei; Goble, Mary; Dancer-Brown, Melissa; Van Vessem, Nancy; Ard, Jamy D.

2013-01-01

Background A variety of physician and patient characteristics may influence whether weight loss counseling occurs in primary care encounters. Objectives This study utilized a cross-sectional survey of primary care patients, which examined patient characteristics, physician characteristics, and characteristics of the physician-patient relationship associated with weight loss counseling and recommendations provided by physicians. Participants Participants (N=143, mean age=46.8 years, mean BMI=36.9 kg/m2, 65% Caucasian) were overweight and obese primary care patients participating in a managed care weight loss program. Measures Participants completed self-report surveys in the clinic prior to the initial weight loss session. Surveys included items assessing demographic/background characteristics, weight, height, and a health care questionnaire evaluating whether their physician had recommended weight loss, the frequency of their physicians’ weight loss counseling, and whether their physician had referred them for obesity treatment. Results Patient BMI and physician sex were most consistently associated with physicians’ weight loss counseling practices. Patients seen by female physicians were more likely to be told that they should lose weight, received more frequent obesity counseling, and were more likely to have been referred for obesity treatment by their physician. Length and frequency of physician-patient contacts were unrelated to the likelihood of counseling. Conclusions These findings add to previous evidence suggesting possible differences in the weight loss counseling practices of male and female physicians, although further research is needed to understand this potential difference between physicians. PMID:24743007

Assessing the Organizational Social Context (OSC) of Child Welfare Systems: Implications for Research and Practice

Science.gov (United States)

Glisson, Charles; Green, Philip; Williams, Nathaniel J.

2012-01-01

Objective: The study: (1) provides the first assessment of the a "priori" measurement model and psychometric properties of the Organizational Social Context (OSC) measurement system in a US nationwide probability sample of child welfare systems; (2) illustrates the use of the OSC in constructing norm-based organizational culture and climate…

A group approach to genetic counselling of cardiomyopathy patients: satisfaction and psychological outcomes sufficient for further implementation.

Science.gov (United States)

Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Tintelen, J Peter; van Langen, Irene M

2015-11-01

The introduction of next-generation sequencing in everyday clinical genetics practise is increasing the number of genetic disorders that can be confirmed at DNA-level, and consequently increases the possibilities for cascade screening. This leads to a greater need for genetic counselling, whereas the number of professionals available to provide this is limited. We therefore piloted group genetic counselling for symptomatic cardiomyopathy patients at regional hospitals, to assess whether this could be an acceptable alternative to individual counselling. We performed a cohort study with pre- and post-counselling patient measurements using questionnaires, supplemented with evaluations of the group counselling format by the professionals involved. Patients from eight regional hospitals in the northern part of the Netherlands were included. Questionnaires comprised patient characteristics, psychological measures (personal perceived control (PPC), state and trait anxiety inventory (STAI)), and satisfaction with counsellors, counselling content and design. In total, 82 patients (mean age 57.5 year) attended one of 13 group sessions. Median PPC and STAI scores showed significantly higher control and lower anxiety after the counselling. Patients reported they were satisfied with the counsellors, and almost 75% of patients were satisfied with the group counselling. Regional professionals were also, overall, satisfied with the group sessions. The genetics professionals were less satisfied, mainly because of their perceived large time investment and less-than-expected group interaction. Hence, a group approach to cardiogenetic counselling is feasible, accessible, and psychologically effective, and could be one possible approach to counselling the increasing patient numbers in cardiogenetics.

Theoretical Study on the Rational Design of Cyano-Substituted P3HT Materials for OSCs

DEFF Research Database (Denmark)

Qiu, Meng; Brandt, Rasmus Guldbæk; Niu, Yingli

2015-01-01

Calculations have been made regarding the strong electron-withdrawing cyano (-CN) group, which was introduced onto the backbone of poly(3-hexylthiophene) (P3HT), as an effective way to improve the parameters essential for the photovoltaic performance of organic solar cells (OSCs). The substitution...... useful information for better design strategy for OSCs....

An evidence-based approach to pre-pregnancy counselling for patients with systemic lupus erythematosus.

Science.gov (United States)

Teng, Y K Onno; Bredewold, Edwin O W; Rabelink, Ton J; Huizinga, Tom W J; Eikenboom, H C Jeroen; Limper, Maarten; Fritsch-Stork, Ruth D E; Bloemenkamp, Kitty W M; Sueters, Marieke

2017-11-20

Patients with SLE are often young females of childbearing age and a pregnancy wish in this patient group is common. However, SLE patients are at high risk for adverse pregnancy outcomes that require adequate guidance. It is widely acknowledged that pre-pregnancy counselling is the pivotal first step in the management of SLE patients with a wish to become pregnant. Next, management of these patients is usually multidisciplinary and often requires specific expertise from the different physicians involved. Very recently a EULAR recommendation was published emphasizing the need for adequate preconception counselling and risk stratification. Therefore the present review specifically addresses the issue of pre-pregnancy counselling for SLE patients with an evidence-based approach. The review summarizes data retrieved from recently published, high-quality cohort studies that have contributed to a better understanding and estimation of pregnancy-related risks for SLE patients. The present review categorizes risks from a patient-oriented point of view, that is, the influence of pregnancy on SLE, of SLE on pregnancy, of SLE on the foetus/neonate and of SLE-related medication. Lastly, pre-pregnancy counselling of SLE patients with additional secondary APS is reviewed. Collectively these data can guide clinicians to formulate appropriate preventive strategies and patient-tailored monitoring plans during pre-pregnancy counselling of SLE patients. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessing the Organizational Social Context (OSC) of child welfare systems: implications for research and practice.

Science.gov (United States)

Glisson, Charles; Green, Philip; Williams, Nathaniel J

2012-09-01

The study: (1) provides the first assessment of the a priori measurement model and psychometric properties of the Organizational Social Context (OSC) measurement system in a US nationwide probability sample of child welfare systems; (2) illustrates the use of the OSC in constructing norm-based organizational culture and climate profiles for child welfare systems; and (3) estimates the association of child welfare system-level organizational culture and climate profiles with individual caseworker-level job satisfaction and organizational commitment. The study applies confirmatory factor analysis (CFA) and hierarchical linear models (HLM) analysis to a US nationwide sample of 1,740 caseworkers from 81 child welfare systems participating in the second National Survey of Child and Adolescent Wellbeing (NSCAW II). The participating child welfare systems were selected using a national probability procedure reflecting the number of children served by child welfare systems nationwide. The a priori OSC measurement model is confirmed in this nationwide sample of child welfare systems. In addition, caseworker responses to the OSC scales generate acceptable to high scale reliabilities, moderate to high within-system agreement, and significant between-system differences. Caseworkers in the child welfare systems with the best organizational culture and climate profiles report higher levels of job satisfaction and organizational commitment. Organizational climates characterized by high engagement and functionality, and organizational cultures characterized by low rigidity are associated with the most positive work attitudes. The OSC is the first valid and reliable measure of organizational culture and climate with US national norms for child welfare systems. The OSC provides a useful measure of Organizational Social Context for child welfare service improvement and implementation research efforts which include a focus on child welfare system culture and climate. Copyright © 2012

OSCEs for undergraduate clinical examination in orthopaedics: inter ...

African Journals Online (AJOL)

... D (Group 2) was 8.625. The p-value was 0.001148 (95% confidence interval). Conclusion: There was statistically significant inter-examiner variability. We recommend that for all OSCE exams, examiners be paired with a deliberate attempt to pair a “Hawk” with a “Dove”. Statistical correction of biases is also recommended.

[Shared decision-making based on equal information. Patient guidelines as a tool for patient counseling].

Science.gov (United States)

Sänger, Sylvia; Kopp, Ina; Englert, Gerhard; Brunsmann, Frank; Quadder, Bernd; Ollenschläger, Günter

2007-06-15

In discussions on the quality of cross-sectorial health-care services high importance is attributed to patient education and patient counseling, with guideline-based patient information being considered a crucial tool. Guideline-based patient information is supposed to serve patients as a decision-making basis and, in addition, to also support the implementation of the guidelines themselves. The article highlights how patient guidelines for National Disease Management Guidelines in Germany--within the scope of patient education and patient counseling--may provide a uniform information platform for physicians and patients aiming to promote shared decision-making. The authors will also address the issue which contents should be included in patient guidelines in order to meet these requirements and which measures are required to review their quality. The present paper continues the series of articles on the Program for German National Disease Management Guidelines.

Fertility Preservation Counseling for Pediatric and Adolescent Cancer Patients.

Science.gov (United States)

Campbell, Jessica E; Assanasen, Chatchawin; Robinson, Randal D; Knudtson, Jennifer F

2016-03-01

Fertility preservation for children and young adults with cancer is an important part of comprehensive patient care. In 2013, the American Society of Clinical Oncology (ASCO) released updated clinical practice guidelines addressing fertility preservation. This study aimed to evaluate if pediatric oncologists were performing fertility preservation counseling, if the new guidelines were being adopted, and how reproductive endocrinologists can educate this patient population and their providers. A cross-sectional study was performed from May 26, 2014, to August 26, 2014. An online survey addressing fertility preservation practice patterns was created and provided to the members of the Children's Oncology Group (COG). Thirty-five percent of the 234 respondents reported reading the new 2013 ASCO guidelines. Ninety-five percent of providers reported mentioning fertility preservation options prior to treatment, most commonly including referral to a reproductive endocrinologist (28%), and sperm banking (57%). The most commonly reported barrier to fertility preservation counseling was the cost of treatment. Fertility preservation counseling is being performed by pediatric oncology providers. Familiarity of the ASCO guidelines is limited, revealing that the established methods for fertility preservation in women--embryo and oocyte cryopreservation--may be offered less than experimental methods in this younger patient population. Such differences in apparent practice patterns highlight the need for more education for providers.

Low back pain patients' beliefs about effective/ineffective constituents of a counseling intervention

DEFF Research Database (Denmark)

Buus, Niels; Jensen, Lone Donbæk; Maribo, Thomas

2014-01-01

PURPOSE: Everyday activities are important factors for avoiding the development of chronic low back pain (LBP). The purpose this study was to explore LBP patients' perspective on long-term effects of participating in a counseling intervention designed to motivate them to change work routines...... models". RESULTS: For the individual participant the beliefs about the illness were internally coherent, but most often they were idiosyncratic and fitted to the particular participants' overall explanatory model. Participation in the counseling intervention had created a sense of certainty and potential......, is an important factor in low back pain rehabilitation. Counselling on low back pain rehabilitation must be aligned with people's beliefs about their illness. A counselling intervention made patients adopt exercising into their long-term management of low back pain....

Intensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients

Directory of Open Access Journals (Sweden)

Alessio Molfino

2012-06-01

In conclusion, in HD patients, nutritional counselling and nutritional support positively affect nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to non-anorexic.

Dietary counselling and nutritional support in oropharyngeal cancer patients treated with radiotherapy

NARCIS (Netherlands)

Vlooswijk, C.P.; Rooij, Van P.H.E.; Kruize, J.C.; Schuring, H.A.; Al-Mamgani, A.; Roos, De N.M.

2016-01-01

Background/Objectives:The need for dietary counselling and nutritional support in oropharyngeal cancer patients is generally accepted. However, evidence for the effectiveness is sparse. The aim of this study was to describe dietary counselling, nutritional support, body weight and toxicity during

Sexual counselling of cardiac patients : Nurses' perception of practice, responsibility and confidence

NARCIS (Netherlands)

Jaarsma, T.; Stromberg, A.; Fridlund, B.; De Geest, S.; Martensson, J.; Moons, P.; Norekval, T. M.; Smith, K.; Steinke, E.; Thompson, D. R.

Background: Cardiac patients may experience problems with sexual activity as a result of their disease, medications or anxiety and nurses play an important role in sexual counselling. We studied the practice, responsibility and confidence of cardiac nurses in the sexual counselling of these

Content of Spiritual Counselling for Cancer Patients Undergoing Chemotherapy in Iran: A Qualitative Content Analysis

Science.gov (United States)

Memaryan, Nadereh; Ghaempanah, Zeinab; Saeedi, Mir Majid; Aryankhesal, Aidin; Ansarinejad, Nafiseh; Seddigh, Ruohollah

2017-07-27

Background: Cancer is one of the leading causes of human death. Besides clinical treatment, cancer patients may need emotional and spiritual counselling to overcome their mental and morale problems. Such counselling sessions have been reported influential by many patients. We aimed to explore the structure of spiritual counselling sessions and their content as one of services provided to patients who experience chemotherapy in Iranian hospitals. Methods: Through a qualitative content analysis study, we recorded the discussions between a counsellor, who was a cleric as well, and cancer cases who were undergoing chemotherapy in a hospital in Tehran. The sessions were only recorded if the patient consented to attend at the study. All consideration were taken to avoid release of patients’ identity. The recorded discussions were transcribed verbatim and analyzed thematically after each session, until no new theme was emerged. Result: Twenty two sessions were held. The patients aged 53 years old on average. The content of discussions were analyzed along which 165 codes emerged. Four general themes or phases were recognized through counseling as (i) history-Taking (including demographic, disease-related and spiritual history and characteristics), (ii) general advice, (iii) spiritual-religious advice, and (iv) dealing with patients’ spiritual or religious ambiguities and paradoxes. Conclusion: Counselling of cancer patients needs special and in depth knowledge on spiritual and religious issues. The counsellor should be able to motivate patients, among whom many are disappointed, to follow the curative instructions well and stay hopeful about their treatment and life. Exploring and understanding what happens during a spiritual counselling session can counselling to the conformity and standardization of such interventions. Creative Commons Attribution License

Telegenetics use in presymptomatic genetic counselling : patient evaluations on satisfaction and quality of care

NARCIS (Netherlands)

Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V.; van Langen, Irene M.

In recent years, online counselling has been introduced in clinical genetics to increase patients' access to care and to reduce time and cost for both patients and professionals. Most telegenetics reports so far evaluated online oncogenetic counselling at remote health centres in regions with large

The Knowledge, Attitude and Behavior of HIV/AIDS Patients’ Family toward Their Patients before and after Counseling

Directory of Open Access Journals (Sweden)

Behnam Honarvar

2010-12-01

Full Text Available Background: Acquired immunodeficiency may impose considerableconsequences on patients’ family behaviors towardthem. The objective of the present study was to investigatewhether a counseling program at Behavioral Counseling Centerin the city of Shiraz, Iran could change the attitude, knowledgeand behavior of patients' family members.Methods: 125 HIV/AIDS patients’ family members were interviewed,using a valid and reliable questionnaire before andafter performing counseling sessions at Behavioral CounselingCenter. The findings were analyzed using nonparametric tests.Results: The age of the participants was 40±13 years. Sixty fivepercent were female, 63% married and 79% educated. Forty fourpercent of participants had spousal relationships with their patients.Their knowledge about the main routes of HIV transmissionwere 9.76 ± 2.59 and10.64±0.88 before and after counseling,respectively (P=0.028. Supportive behaviors of families towardtheir patients reached to 79% after counseling compared with 44% before that (P=0.004. Belief to isolate the patients and thepractice of this approach at home dropped from 71% to 15% andfrom 29% to 7% after counseling, respectively (P0.05.Conclusion: Ongoing counseling for HIV/AIDS patients’ familiesat Behavioral Counseling Center of Shiraz did advance theirknowledge about AIDS and improved their attitude and behaviortoward their patients However, the counseling program didnot show remarkable success in some aspects such as the removalof fear about HIV spread in the family or the change ofthe patients’ wives attitude to have protected sex with their HIVinfected husbands.Iran J Med Sci 2010; 35(4: 287-292.

Impact Of Patient Counseling And Education Of Diabetic Patients In Improving Their Quality Of Life

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Nalini Pais

2010-12-01

Full Text Available Objectives: The current study which is randomized comparative intervention (concurrent control attempts to study the effect of counseling and education provided by clinical pharmacist regarding the disease and related issues to achieve glycemic control and ultimately better quality of life of Diabetic patients; which was carried out for a period of 6months in the out-patient medicine department of St.Martha’sHospital, Bangalore.Materials and Method: A total of 98 (53 intervention, 45control patients were randomized into intervention and control group by chit method. Intervention group received counseling and education along with the information leaflet;follow up was done at intervals of 2nd, 4th & 6th month after baseline. Pre-validated questionnaires for KAP & QoL were administered at the baseline and last follow up. In a group of25 patients HbA1c was recorded at baseline & last follow-up.All the parameters (FBS, PPBS, HbA1c and scores were compared between intervention & control group postcounseling. Significant improvement (P<0.05 was observed inthe intervention group in terms of glycemic control and HbA1cvalues in comparison with the control group.Results: In the intervention group; Knowledge about the disease improved (P<0.05 along with better compliance to diet, however change in attitude towards need for exercise and regular checkups could not be achieved but significant improvement (p<0.05 in Quality of Life (QoL was achieved with education and counseling.Conclusion: The findings revealed that the clinical pharmacist can contribute to the better management of diabetes through patient education and counseling.

The quality of feedback during formative OSCEs depends on the tutors’ profile

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Noelle Junod Perron

2016-11-01

Full Text Available Abstract Background During their pre-clinical years, medical students are given the opportunity to practice clinical skills with simulated patients. During these formative objective structured clinical encounters (OSCEs, tutors from various backgrounds give feedback on students’ history taking, physical exam, and communication skills. The aim of the study was to evaluate whether the content and process of feedback varied according to the tutors’ profile. Methods During 2013, all 2nd and 3rd year medical students and tutors involved in three formative OSCEs were asked to fill in questionnaires, and their feedback sessions were audiotaped. Tutors were divided into two groups: 1 generalists: primary care, general internist and educationalist physicians 2 specialists involved in the OSCE related to their field of expertise. Outcome measures included the students’ perceptions of feedback quality and utility and objective assessment of feedback quality. Results Participants included 251 medical students and 38 tutors (22 generalists and 16 specialists. Students self-reported that feedback was useful to improve history taking, physical exam and communication skills. Objective assessment showed that feedback content essentially focused on history taking and physical exam skills, and that elaboration on clinical reasoning or communication/professionalism issues was uncommon. Multivariate analyses showed that generalist tutors used more learner-centered feedback skills than specialist tutors (stimulating student’s self-assessment (p < .001; making the student active in finding solutions, p < .001; checking student’s understanding, p < .001 and elaborated more on communication and professionalism issues (p < 0.001. Specialists reported less training in how to provide feedback than generalists. Conclusion These findings suggest that generalist tutors are more learner-centered and pay more attention to communication and

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

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Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically

Experiences of patients with multiple sclerosis from group counseling

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Mazaheri, Mina; Fanian, Nasrin; Zargham-Boroujeni, Ali

2011-01-01

BACKGROUND: Group counseling is one of the most important methods in somatic and psychological rehabilitation of the multiple sclerosis (M.S.) patients. Knowing these patients? experiences, feelings, believes and emotion based on learning in group is necessary to indicate the importance of group discussion on quality of life of the patients. This study was done to achieve experiences of M.S. patients from group training. METHODS: This was a qualitative study using phenomenological method. The...

[Group counselling for the second trimester ultrasound: can group counselling be an alternative for individual counselling?].

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de Lau, Hinke; Depmann, Martine; Laeven, Yvo J M; Stoutenbeek, Philip H; Pistorius, Lou R; van Beek, Erik; Schuitemaker, Nico W E

2013-01-01

To compare group counselling to individual counselling with respect to the second trimester ultrasound. A prospective cohort study at two hospitals. At one hospital, 100 pregnant women were counselled on the risks and benefits of the second trimester ultrasound in groups of up to 15 patients. Shortly before the ultrasound they were asked to fill out a questionnaire. Results were compared to 100 women who were counselled individually at another hospital. The primary outcome was the level of informed choice whether or not to undergo the ultrasound, defined as sufficient knowledge and a value-consistent decision. The secondary outcome measures were level of understanding of the second trimester ultrasound and the degree of satisfaction with the counselling. The resulting level of informed choice was 87.0% after group counselling compared to 79.4% after individual counselling (p = 0.47). The mean knowledge score was 8.8 for the women who attended group counselling; women who were individually counselled had a mean score of 7.4 (p counselling was 7.0 for group counselling and 6.2 for individual counselling (p group counselling was associated with higher post-counselling knowledge and satisfaction scores. Group counselling should therefore be considered as an alternative counselling method.

Student´s self-assessment of clinical competence and objective clinical performance in OSCE evaluation

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Jünger, J; Schellberg, D; Nikendei, C

2006-01-01

[english] Overestimating one's clinical competence can be dangerous to patient's safety. Therefore the goal of this study was to identify students with high confidence in their own clinical competence but low performance in objective assessment. 171 students in the 14 week course in internal medicine completed the clinical skills-related self-assessment expectations (SE) and were tested in a 12 station OSCE. Both measures were obtained within three days. In total we identified 16% of students...

Development, implementation, and evaluation of an integrated multidisciplinary Objective Structured Clinical Examination (OSCE) in primary health care settings within limited resources.

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Abdelaziz, Adel; Hany, Mohamed; Atwa, Hani; Talaat, Wagdy; Hosny, Somaya

2016-01-01

In ordinary circumstances, objective structured clinical examination (OSCE) is a resource-intensive assessment method. In case of developing and implementing multidisciplinary OSCE, there is no doubt that the cost will be greater. Through this study a research project was conducted to develop, implement and evaluate a multidisciplinary OSCE model within limited resources. This research project went through the steps of blueprinting, station writing, resources reallocation, implementation and finally evaluation. The developed model was implemented in the Primary Health Care (PHC) program which is one of the pillars of the Community-Based undergraduate curriculum of the Faculty of Medicine, Suez Canal University (FOM-SCU). Data for evaluation of the implemented OSCE model were derived from two resources. First, feedback of the students and assessors through self-administered questionnaires was obtained. Second, evaluation of the OSCE psychometrics was done. The deliverables of this research project included a set of validated integrated multi-disciplinary and low cost OSCE stations with an estimated reliability index of 0.6. After having this experience, we have a critical mass of faculty members trained on blueprinting and station writing and a group of trained assessors, facilitators and role players. Also there is a state of awareness among students on how to proceed in this type of OSCE which renders future implementation more feasible.

A fast 4D cone beam CT reconstruction method based on the OSC-TV algorithm.

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Mascolo-Fortin, Julia; Matenine, Dmitri; Archambault, Louis; Després, Philippe

2018-01-01

Four-dimensional cone beam computed tomography allows for temporally resolved imaging with useful applications in radiotherapy, but raises particular challenges in terms of image quality and computation time. The purpose of this work is to develop a fast and accurate 4D algorithm by adapting a GPU-accelerated ordered subsets convex algorithm (OSC), combined with the total variation minimization regularization technique (TV). Different initialization schemes were studied to adapt the OSC-TV algorithm to 4D reconstruction: each respiratory phase was initialized either with a 3D reconstruction or a blank image. Reconstruction algorithms were tested on a dynamic numerical phantom and on a clinical dataset. 4D iterations were implemented for a cluster of 8 GPUs. All developed methods allowed for an adequate visualization of the respiratory movement and compared favorably to the McKinnon-Bates and adaptive steepest descent projection onto convex sets algorithms, while the 4D reconstructions initialized from a prior 3D reconstruction led to better overall image quality. The most suitable adaptation of OSC-TV to 4D CBCT was found to be a combination of a prior FDK reconstruction and a 4D OSC-TV reconstruction with a reconstruction time of 4.5 minutes. This relatively short reconstruction time could facilitate a clinical use.

A cluster-randomized trial of provider-initiated (opt-out) HIV counseling and testing of tuberculosis patients in South Africa.

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Pope, Diana S; Deluca, Andrea N; Kali, Paula; Hausler, Harry; Sheard, Carol; Hoosain, Ebrahim; Chaudhary, Mohammad A; Celentano, David D; Chaisson, Richard E

2008-06-01

To determine whether implementation of provider-initiated human immunodeficiency virus (HIV) counseling would increase the proportion of tuberculosis (TB) patients who received HIV counseling and testing. Cluster-randomized trial with clinic as the unit of randomization. Twenty, medium-sized primary care TB clinics in the Nelson Mandela Metropolitan Municipality, Port Elizabeth, Eastern Cape Province, South Africa. A total of 754 adults (18 years and older) newly registered as TB patients in the 20 study clinics. Implementation of provider-initiated HIV counseling and testing. Percentage of TB patients HIV counseled and tested. SECONDARY: Percentage of patients with HIV test positive, and percentage of those who received cotrimoxazole and who were referred for HIV care. : A total of 754 adults newly registered as TB patients were enrolled. In clinics randomly assigned to implement provider-initiated HIV counseling and testing, 20.7% (73/352) patients were counseled versus 7.7% (31/402) in the control clinics (P = 0.011), and 20.2% (n = 71) versus 6.5% (n = 26) underwent HIV testing (P = 0.009). Of those patients counseled, 97% in the intervention clinics accepted testing versus 79% in control clinics (P = 0.12). The proportion of patients identified as HIV infected in intervention clinics was 8.5% versus 2.5% in control clinics (P = 0.044). Fewer than 40% of patients with a positive HIV test were prescribed cotrimoxazole or referred for HIV care in either study arm. Provider-initiated HIV counseling significantly increased the proportion of adult TB patients who received HIV counseling and testing, but the magnitude of the effect was small. Additional interventions to optimize HIV testing for TB patients urgently need to be evaluated.

Nurse educators’ perceptions of OSCE as a clinical evaluation method

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MM Chabeli

2001-09-01

Full Text Available The South African Qualifications Authority, and the South African Nursing Council are in pursuit of quality nursing education to enable the learners to practise as independent and autonomous practitioners. The educational programme should focus on the facilitation of critical and reflective thinking skills that will help the learner to make rational decisions and solve problems. A way of achieving this level of functioning is the use of assessment and evaluation methods that measure the learners’ clinical competence holistically. This article is focused on the perceptions of twenty nurse educators, purposively selected from three Nursing Colleges affiliated to a university in Gauteng, regarding the use of OSCE (Objective Structured Clinical Examination as a clinical evaluation method within a qualitative and descriptive research strategy. Three focus group interviews were conducted in different sessions. A descriptive content analysis was used. Trustworthiness was ensured by using Lincoln and Guba’s model (1985. The results revealed both positive and negative aspects of OSCE as a clinical evaluation method with regard to: administrative aspects; evaluators; learners; procedures/instruments and evaluation. The conclusion drawn from the related findings is that OSCE does not measure the learners’ clinical competence holistically. It is therefore recommended that the identified negative perception be taken as challenges faced by nurse educators and that the positive aspects be strengthened. One way of meeting these recommendations is the use of varied alternative methods for clinical assessment and evaluation that focus on the holistic measurement of the learners’ clinical competence.

Risk perception after genetic counseling in patients with increased risk of cancer

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Rantala Johanna

2009-08-01

Full Text Available Abstract Background Counselees are more aware of genetics and seek information, reassurance, screening and genetic testing. Risk counseling is a key component of genetic counseling process helping patients to achieve a realistic view for their own personal risk and therefore adapt to the medical, psychological and familial implications of disease and to encourage the patient to make informed choices 12. The aim of this study was to conceptualize risk perception and anxiety about cancer in individuals attending to genetic counseling. Methods The questionnaire study measured risk perception and anxiety about cancer at three time points: before and one week after initial genetic counseling and one year after completed genetic investigations. Eligibility criteria were designed to include only index patients without a previous genetic consultation in the family. A total of 215 individuals were included. Data was collected during three years period. Results Before genetic counseling all of the unaffected participants subjectively estimated their risk as higher than their objective risk. Participants with a similar risk as the population overestimated their risk most. All risk groups estimated the risk for children's/siblings to be lower than their own. The benefits of preventive surveillance program were well understood among unaffected participants. The difference in subjective risk perception before and directly after genetic counseling was statistically significantly lower in all risk groups. Difference in risk perception for children as well as for population was also statistically significant. Experienced anxiety about developing cancer in the unaffected subjects was lower after genetic counseling compared to baseline in all groups. Anxiety about cancer had clear correlation to perceived risk of cancer before and one year after genetic investigations. The affected participants overestimated their children's risk as well as risk for anyone in

[Fall prevention counselling for patients with hearing and balance disorders].

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Ptok, M; Ptok, A; Jungheim, M; Kühn, D; Miller, S

2014-09-01

Otolaryngologists caring for patients with hearing and balance disorders are also responsible for advising patients about their increased risk of falling and informing them of fall prevention measures. This review will give a brief overview of appropriate programs. This systematic review is based on a selective literature search. Intrinsic and extrinsic fall risk factors can be distinguished. The former include not only hearing and balance disorders, but also increasing age, nocturia, dementia, limited mobility and poor nutritional status. Extrinsic factors include, for example, unfixed carpet edges, poor lighting and poor footwear. Fall prevention can be achieved through appropriate counselling about risk factors and fall prevention courses. The frequency of falls--with potentially very adverse consequences--increases continuously beyond the age of 60 years. Furthermore, the risk of falling is significantly increased in patients with hearing and balance disorders. Otolaryngologists caring for this patient group should inform them about their fall risk and advise appropriate countermeasures during counselling. A basal knowledge of fall prevention measures is therefore helpful.

Counseling, quality of life, and acute postoperative pain in elderly patients with hip fracture

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Gambatesa M

2013-09-01

Full Text Available Maria Gambatesa,1 Alessandro D'Ambrosio,1 Davide D'Antini,1 Lucia Mirabella,1 Antonella De Capraris,1 Salvatore Iuso,2 Antonello Bellomo,2 Antonio Macchiarola,3 Michele Dambrosio,1 Gilda Cinnella1 1Department of Anesthesiology and Intensive Care, 2Department of Psychology and Psychiatry, University of Foggia, Foggia, Italy; 3Department of Orthopedic and Trauma Surgery, Riuniti Hospital, Foggia, Italy Introduction: Hip fractures represent one of the most important causes of morbidity and mortality in elderly people. Anxiety and depression affect their quality of life and increase pain severity, and have adverse effects on functional recovery. Recent World Health Organization guidelines emphasize that therapeutic regimes need to be individualized and combined with psychological support. This study was launched with the primary endpoint of assessing if and to what extent client-centered therapy affects the perception of pain, reduces anxiety and depression, and increases the quality of life of elderly patients with hip fracture. Materials and methods: Forty patients were admitted to the Orthopedic and Trauma Surgery ward for hip fracture. Patients were randomly divided into two subgroups: (1 case (group C, had to receive patient-centered counseling throughout the hospitalization; and (2 control (group NC, receiving the analgesic treatment without receiving counseling. Short Form-36-item Health Survey Questionnaire, State–Trait Anxiety Inventory, and Hamilton Rating Scale for Depression scores were recorded before any treatment, at discharge, and after 30 days. Pain levels were evaluated by means of Visual Analog Scale every 12 hours during the hospitalization from the day of surgery until day 5. Results: The hierarchical clustering analysis identified before any treatment were two clusters based on different physical functioning perceptions and role limitations, which were due to physical and emotional problems. Counseling did have a positive

Healthcare provider counseling to quit smoking and patient desire to quit: The role of negative smoking outcome expectancies.

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Tucker, Joan S; Stucky, Brian D; Edelen, Maria Orlando; Shadel, William G; Klein, David J

2018-05-21

The U.S. Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends providing advice to quit to every tobacco user seen in a healthcare setting. However, the mechanism through which counseling encourages patients to quit has not been adequately studied. This study tests whether the association between receiving healthcare provider counseling and desire to quit is accounted for by negative health and psychosocial outcome expectancies of smoking. Data were collected online from 721 adult smokers who had seen a healthcare provider in the past 12 months. Associations between counseling to quit, negative outcome expectancies of smoking, and desire to quit were tested, as well as whether outcome expectancies and desire to quit differed by type of counseling (counseling only vs. counseling plus assistance) and level of smoking. Bivariate associations indicated a stronger desire to quit among patients receiving counseling, particularly when it included healthcare provider assistance to quit. SEM results indicated that the association between counseling and desire to quit was fully accounted for by patients' negative health and psychosocial outcome expectancies for smoking. These associations were found across levels of smoking in the case of health expectancies, but were limited to moderate and heavy smokers in the case of psychosocial expectancies. Results suggest that the time devoted to counseling patients about smoking should include providing some assistance to quit, such as recommending a product, prescription or program. Regardless of smoking level, this counseling should incorporate techniques to elicit patients' negative health and psychosocial expectancies of smoking. Copyright © 2018. Published by Elsevier Ltd.

Randomized trial of proactive rapid genetic counseling versus usual care for newly diagnosed breast cancer patients.

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Schwartz, Marc D; Peshkin, Beth N; Isaacs, Claudine; Willey, Shawna; Valdimarsdottir, Heiddis B; Nusbaum, Rachel; Hooker, Gillian; O'Neill, Suzanne; Jandorf, Lina; Kelly, Scott P; Heinzmann, Jessica; Zidell, Aliza; Khoury, Katia

2018-04-02

Breast cancer patients who carry BRCA1/BRCA2 gene mutations may consider bilateral mastectomy. Having bilateral mastectomy at the time of diagnosis not only reduces risk of a contralateral breast cancer, but can eliminate the need for radiation therapy and yield improved reconstruction options. However, most patients do not receive genetic counseling or testing at the time of their diagnosis. In this trial, we tested proactive rapid genetic counseling and testing (RGCT) in newly diagnosed breast cancer patients in order to facilitate pre-surgical genetic counseling and testing. We recruited newly diagnosed breast cancer patients at increased risk for carrying a BRCA1/2 mutation. Of 379 eligible patients who completed a baseline survey, 330 agreed to randomization in a 2:1 ratio to RGCT (n = 220) versus UC (n = 108). Primary outcomes were genetic counseling and testing uptake and breast cancer surgical decisions. RGCT led to higher overall (83.8% vs. 54.6%; p genetic counseling uptake compared to UC. Despite higher rates of genetic counseling, RGCT did not differ from UC in overall (54.1% vs. 49.1%, p > 0.10) or pre-surgical (30.6% vs. 27.4%, p > 0.10) receipt of genetic test results nor did they differ in uptake of bilateral mastectomy (26.6% vs. 21.8%, p > 0.10). Although RGCT yielded increased genetic counseling participation, this did not result in increased rates of pre-surgical genetic testing or impact surgical decisions. These data suggest that those patients most likely to opt for genetic testing at the time of diagnosis are being effectively identified by their surgeons.

Wahlfach Teamarbeit: Ergebnisse eines Pilotprojektes zur interprofessionellen und interdisziplinären Ausbildung mit formativem Team-OSCE (TOSCE [Teamwork elective: Results of a German pilot project on interprofessional and interdisciplinary education with formative team OSCE

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Schmidt, Anita

2010-08-01

Full Text Available [english] Aims: There is a growing need to implement teamworking in medical education. In reality, interdisciplinary and interprofessional education is often absent. Here we describe a pilot trial developed jointly by the nursing college and the medical faculty in Erlangen (Germany in which nursing students and undergraduate medical students formed interprofessional teams and were confronted with interprofessional cases using simulated patients (SPs and phantoms. The elective was planned using standard curriculum planning instruments and finally evaluated with a novel formative team OSCE (Objective Structured Clinical Evaluation instrument.Methods: During one year, 20 nursing students participated voluntarily in the project and 10 medical students took the course as an elective. Results: The pilot project was first performed with two tutors, one from the medical school and one from the nursing school, as well as one to two SPs. During the second course, there was only one tutor. Overall evaluation of the voluntary students was good, with some elements (acute stroke, factual knowledge, and general organizational problems that needed to be improved. Performance of a four-station team OSCE was feasible, but raters reported problems in assessing individuals and the team at the same time. Interobserver agreement was satisfactory (kappa 0.35.Conclusions: Interdisciplinary and interprofessional education between a nursing school and a medical school is feasible within an elective, but requires substantial personnel resources. Design and performance of a team OSCE is possible. The validity of the test has to be shown on follow-up.[german] Zielsetzung: Das Lernziel „Fähigkeit zur interprofessionellen und interdisziplinären Teamarbeit“ wird sowohl in der aktuellen Approbationsordnung für Ärzte als auch im Krankenpflegegesetz gefordert. In der Realität gibt es in beiden Ausbildungen kaum gemeinsame Lehreinheiten. Wir beschreiben ein Pilotprojekt

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

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Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

A cluster randomized trial of provider-initiated (Opt-out) HIV counseling and testing of tuberculosis patients in South Africa

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Pope, Diana S.; DeLuca, Andrea N.; Kali, Paula; Hausler, Harry; Sheard, Carol; Hoosain, Ebrahim; Chaudhary, Mohammed A.; Celentano, David D.; Chaisson, Richard E.

2008-01-01

Objective To determine whether implementation of provider-initiated HIV counseling would increase the proportion of tuberculosis patients that received HIV counseling and testing. Design Cluster-randomized trial with clinic as unit of randomization Setting Twenty, medium-sized primary care TB clinics in the Nelson Mandela Metropolitan Municipality, Port Elizabeth, Eastern Cape Province, South Africa Subjects A total of 754 adults (≥ 18 years) newly registered as tuberculosis patients the twenty study clinics Intervention Implementation of provider-initiated HIV counseling and testing. Main outcome measures Percentage of TB patients HIV counseled and tested. Secondary Percentage of patients HIV test positive and percentage of those that received cotrimoxazole and who were referred for HIV care. Results A total of 754 adults newly registered as tuberculosis patients were enrolled. In clinics randomly assigned to implement provider-initiated HIV counseling and testing, 20.7% (73/352) patients were counseled versus 7.7% (31/402) in the control clinics (p = 0.011), and 20.2 % (n = 71) versus 6.5% (n = 26) underwent HIV testing (p = 0.009). Of those patients counseled, 97% in the intervention clinics accepted testing versus 79% in control clinics (p =0.12). The proportion of patients identified as HIV-infected in intervention clinics was 8.5% versus 2.5% in control clinics (p=0.044). Fewer than 40% of patients with a positive HIV test were prescribed cotrimoxazole or referred for HIV care in either study arm. Conclusions Provider-initiated HIV counseling significantly increased the proportion of adult TB patients that received HIV counseling and testing, but the magnitude of the effect was small. Additional interventions to optimize HIV testing for TB patients urgently need to be evaluated. PMID:18520677

Counseling Spanish-speaking patients: Atlanta pharmacists' cultural sensitivity, use of language-assistance services, and attitudes.

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Muzyk, Andrew J; Muzyk, Tara L; Barnett, Candace W

2004-01-01

To document the types of language-assistance services available in pharmacies and the perceptions of pharmacists regarding the effectiveness of these services, and to measure the attitudes toward counseling Spanish-speaking patients and cultural sensitivity of pharmacists. Cross-sectional assessment. Metropolitan Atlanta, Ga. Registered Georgia pharmacists residing in metropolitan Atlanta. Mailed survey, with repeat mailing 2 weeks later. 38 survey items measuring demographic and practice-site characteristics, types of language-assistance services available with an assessment of the effectiveness of each measured on a nominal scale, and attitudinal items concerning counseling of Spanish-speaking patients and pharmacists' cultural sensitivity using a 5-point Likert-type response scale. Of 1,975 questionnaires mailed, 608 were returned, a 30.8% response rate. Nearly two thirds of the pharmacists had recently counseled a Spanish-speaking patient, but only one fourth of those respondents considered their interactions effective. Nearly all pharmacists, 88.0%, worked in pharmacies with language-assistance services. Of seven types of these services, a mean of 2.19 were available in pharmacies, and the majority of pharmacists (84.4% or more) identifying a service considered it to be effective. The pharmacists were neutral about counseling Spanish-speaking patients (mean = 2.94) and indifferent toward other cultures (mean = 3.28); however, they agreed they had a responsibility to counsel Spanish-speaking patients, and they believed that use of language-assistance services would constitute a reasonable effort to counsel these patients. Pharmacists have an opportunity to address barriers to communication with the Spanish-speaking population through use of language-assistance services and educational measures within the profession.

Counseling patients on facial volume replacement and adherence with posttreatment instructions

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Doris Day

2010-07-01

Full Text Available Doris DayDay Dermatology and Aesthetics New York, USAAbstract: Use of injectable volume replacement products has increased dramatically in the US in recent years. An optimal outcome with volume replacement depends on a thorough ­knowledge of the products on the part of the dermatologic/aesthetic physician specialist, identification of patients with a likelihood of benefiting from volume replacement procedures, selection of an appropriate product for the individual patient, and effective patient counseling to ensure adherence to posttreatment care instructions. Adherence to physician instructions in the field of dermatology appears limited, and there is very little published information on adherence to physician instructions following facial volume replacement procedures. The purpose of this review is to provide strategies for understanding and overcoming the barriers to adherence with the widely used dermal fillers. Strategies include using patient-centered techniques, such as a motivational interview encouraging the patient to follow postprocedure care instructions, eg, massage. In this case, demonstrating massage techniques while the patient is still in the office, with patient participation and detailed feedback, also contributes to good adherence with posttreatment care instructions. Telephone counseling, reminder postcards, and text messages may help improve clinic attendance for follow-up. Motivated patients who demonstrate good ­adherence to physician instructions generally respond well to volume replacement treatments, and usually experience fewer adverse events than patients who do not follow instructions. Although promoting adherence to pretreatment and posttreatment protocols remains a challenge, patient counseling throughout the treatment process can lead to successful results.Keywords: improving adherence, injectable volume replacement, product selection, ­rejuvenation procedure, soft tissue augmentation

Testing clinical competencies in undergraduate nursing education using Objective Structured Clinical Examination (OSCE) – a literature review of international practice

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Beyer, Angelika; Dreier, Adina; Kirschner, Stefanie; Hoffmann, Wolfgang

2016-07-01

Background: In response to demographic trends in Germany nursing competencies are currently reevaluated. Since these have to be taught and trained in nursing education programs, efficient verification of the success is necessary. OSCEs are internationally well-recognized as a comprehensive tool for that. Aim: In this analysis we identified competencies worldwide, which are tested by OSCEs in undergraduate nursing education programs. Method: An international literature research was conducted. The selection criterion for an article was the specification of at least one verifiable competency. Afterwards the competencies were categorized into knowledge, skills and attitudes according to the German “Fachqualifikationsrahmen Pflege für die hochschulische Bildung”. Results: A total of 36 publications fulfilled all inclusion criteria. Relevant studies were predominantly initiated in the UK, Canada and Australia. Within all categories a total of n = 166 different competencies are mentioned. OSCEs are developed and performed in a broad range of methods. Most frequently skills were verified. The most common topic was sure handling of medication. Other important themes were communicative competencies in relation to patients and the ability of self-evaluation. Discussion/Conclusions: A variation in examination methods is appropriate as different competencies are acquired in preparation of the test. Evaluation took place on an individual or institutional level. Further research is needed.

Counselling by primary care physicians may help patients with heartburn-predominant uninvestigated dyspepsia

Science.gov (United States)

Paré, Pierre; Math, Joanna Lee M; Hawes, Ian A

2010-01-01

OBJECTIVE: To determine whether strategies to counsel and empower patients with heartburn-predominant dyspepsia could improve health-related quality of life. METHODS: Using a cluster randomized, parallel group, multicentre design, nine centres were assigned to provide either basic or comprehensive counselling to patients (age range 18 to 50 years) presenting with heartburn-predominant upper gastrointestinal symptoms, who would be considered for drug therapy without further investigation. Patients were treated for four weeks with esomeprazole 40 mg once daily, followed by six months of treatment that was at the physician’s discretion. The primary end point was the baseline change in Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire score. RESULTS: A total of 135 patients from nine centres were included in the intention-to-treat analysis. There was a statistically significant baseline improvement in all domains of the QOLRAD questionnaire in both study arms at four and seven months (Pheartburn-predominant uninvestigated dyspepsia. Further investigation is needed to confirm the potential benefits of providing patients with comprehensive counselling regarding disease management. PMID:20352148

The first OSCE; does students' experience of performing in public affect their results?

Science.gov (United States)

Chan, Michael; Bax, Nigel; Woodley, Caroline; Jennings, Michael; Nicolson, Rod; Chan, Philip

2015-03-26

Personal qualities have been shown to affect students' exam results. We studied the effect of experience, and level, of public performance in music, drama, dance, sport, and debate at the time of admission to medical school as a predictor of student achievement in their first objective structured clinical examination (OSCE). A single medical school cohort (n = 265) sitting their first clinical exam in 2011 as third year students were studied. Pre-admission statements made at the time of application were coded for their stated achievements in the level of public performance; participation in each activity was scored 0-3, where 0 was no record, 1 = leisure time activity, 2 = activity at school or local level, 3 = activity at district, regional or national level. These scores were correlated to OSCE results by linear regression and t-test. Comparison was made between the highest scoring students in each area, and students scoring zero by t-test. There was a bell shaped distribution in public performance score in this cohort. There was no significant linear regression relationship between OSCE results and overall performance score, or between any subgroups. There was a significant difference between students with high scores in theatre, debate and vocal music areas, grouped together as verbal performance, and students scoring zero in these areas. (p < 0.05, t-test) with an effect size of 0.4. We found modest effects from pre-admission experience of verbal performance on students' scores in the OSCE examination. As these data are taken from students' admission statements, we call into question the received wisdom that such statements are unreliable.

Animal-Assisted Therapy and Counseling Support for Women With Breast Cancer: An Exploration of Patient's Perceptions.

Science.gov (United States)

White, Jennifer H; Quinn, Martina; Garland, Sheila; Dirkse, Dale; Wiebe, Patricia; Hermann, Madeline; Carlson, Linda E

2015-09-01

Animal-assisted therapy (AAT) interventions have been shown to assist in coping and improve patient responses to symptoms. Specifically, the presence of an animal has been found to lower anxiety and motivate participation in therapy. We aimed to explore the acceptability of and experience of AAT during individual breast cancer counseling sessions. Patients undertaking counseling with a therapy dog present were invited to participate in the study. Patients were individually interviewed and asked to reflect on their experiences of AAT. Data generation and analysis were concurrent. Transcripts were analyzed thematically using a process of constant comparison. Our sample included 8 female participants, 39 to 61 years old, at an average of 3 years post-breast cancer diagnosis. The majority of patients reported a positive experience with AAT. Themes that emerged around their counseling experience included benefits in the process of initiating counseling and benefits for greater engagement and personal disclosure. Incorporating AAT into the delivery of counseling for breast cancer patients appears to be feasible and acceptable at a patient level. From a clinical perspective, AAT promoted increased communication with health professionals. This is of clinical importance as a means to improve participation and engagement in therapy-important elements in therapeutic outcomes. However, further evaluation of the impact of AAT on specific patient outcomes and psychological morbidity is required. © The Author(s) 2015.

Pharmacy student self-perception of weight and relationship to counseling patients on lifestyle modification.

Science.gov (United States)

Antworth, Allen; Maffeo, Carrie

2014-03-12

To assess the accuracy of pharmacy students' self-assessment of body mass index (BMI) and determine the relationship of this to comfort level in counseling patients regarding lifestyle modification. A prospective, observational, cohort study was conducted that included first-, second-, and third-year pharmacy students who had previously undergone training in BMI self-assessment. Data on students' weight and height were collected and a survey that contained questions on self-perception of body weight and comfort with lifestyle counseling was conducted. Perceived BMI categories (underweight, normal, overweight, and obese) were then compared to actual calculated BMI to determine the accuracy of the student's self-perception. At baseline, participants' accuracy in self-assessment of BMI was 74%, 73.3%, and 75.6% respectively, for first-, second-, and third-year students (p=0.911). Students accuracy increased but not significantly as they progressed through the curriculum (7.2% and 13.3%, respectively; p=0.470 and p=0.209). Neither accuracy in self-assessment of BMI nor students' actual BMI significantly affected students' comfort level with lifestyle modification counseling within healthy weight, overweight, or obese patient categories. However, as the patients' BMI category increased, comfort level differences were observed among students of normal and overweight categories. Patients' BMI category may be a significant barrier to pharmacy students' comfort level in providing lifestyle modification counseling. This finding suggests the need to implement curriculum changes to better prepare students for lifestyle modification counseling.

'Hello, my name is Gabriel, I am the house officer, may I examine you?' or the Objective Santa Christmas Examination (OSCE).

Science.gov (United States)

Wood, D; Roberts, T; Bradley, P; Lloyd, D; O'Neill, P

1999-12-01

To design a clinical examination of high content validity suitable for use as a formative assessment tool with pre-registration house officers (PRHO'S) towards the end of their first house officer post. A multicentre collaboration between four UK medical schools who offer undergraduate curricula which are problem-based, systems-based, patient-orientated, student-centred, jargon-laden and utterly staff-bewildering. An objective structured clinical examination (OSCE) which is suitable for use with graduates of UK medical schools. It assesses the knowledge, skills and attitudes essential for future careers in a hierarchical system where protecting the senior staff from all forms of irritation is paramount. PRHO'S who excel in this examination get better references. The OSCE format can be used to provide 'real-life' scenarios appropriate to the season.

Generalized Optimal-State-Constraint Extended Kalman Filter (OSC-EKF)

Science.gov (United States)

2017-02-01

algorithms is demonstrated by achieving reasonable consistency and accuracy on a challenging micro aerial vehicle dataset. simultaneous localization...platforms exist,4 and many others have been constructed with low-cost components. Visual-inertial simultaneous localization and mapping (SLAM) and...epipolar constraints. The OSC-EKF used a window size of 10 frames. The SAM problem was constructed using an inverse -depth feature position param

Introduction of new guidelines for emergency patients: motivational counselling among smokers

DEFF Research Database (Denmark)

Backer, Vibeke; Nelbom, Bente Munkholm; Duus, Benn Rønnow

2007-01-01

Smoking is the most important risk factor for morbidity and mortality in hospital patients. Patient contact with the healthcare system should include smoking cessation counselling. Emergency admissions are seldom given this opportunity. Objective: The aim of the study was to illustrate the implem...

Discharge Medication Counseling and its Correlation with Reducing Readmissions for Patients with Chronic Obstructive Pulmonary Disease Exacerbations

Directory of Open Access Journals (Sweden)

Emily M. Laswell

2015-01-01

Full Text Available Objective: To determine the impact of pharmacist-provided discharge medication counseling on 30 and 90 day hospital readmissions and ED visits in patients admitted with COPD exacerbation. Methods: A hospital-wide improvement was initiated, where COPD patients received discharge medication counseling and follow up phone call by a pharmacist. A pilot study was implemented, and data on readmission rates at 30- and 90-days were collected and compared to a hand-matched, retrospective control group that had not received discharge counseling by a pharmacist. Differences in readmission rates were analyzed using Chi-squared tests. Results: A total of 28 patients received discharge counseling by the pharmacist and were compared to 28 retrospective patients. Differences in 30-day and 90-day readmission rates were not significant (p=1.000 and p=0.589, respectively. After thirty days, 7 (25% intervention and 7 (25% retrospective group patients had been readmitted. After ninety days, 11 (39.3% intervention and 13 (46.4% non-intervention patients had been readmitted. Since a small cohort of patients received discharge counseling, the study did not meet power. Conclusions: Although not statistically significant, patients who received discharge medication counseling provided by a pharmacist had lower 90-day readmission rates post discharge. As regulations are implemented that penalize hospitals for readmissions that occur within 30 days of discharge, it is imperative that health care systems develop new strategies aimed at reducing readmission rates. Further studies that are adequately powered are needed to assess the impact pharmacists can have on readmission rates.   Type: Original Research

Effect of Clinically Discriminating, Evidence-Based Checklist Items on the Reliability of Scores from an Internal Medicine Residency OSCE

Science.gov (United States)

Daniels, Vijay J.; Bordage, Georges; Gierl, Mark J.; Yudkowsky, Rachel

2014-01-01

Objective structured clinical examinations (OSCEs) are used worldwide for summative examinations but often lack acceptable reliability. Research has shown that reliability of scores increases if OSCE checklists for medical students include only clinically relevant items. Also, checklists are often missing evidence-based items that high-achieving…

Patient Activation through Counseling and Exercise – Acute Leukemia (PACE-AL) – a randomized controlled trial

DEFF Research Database (Denmark)

Jarden, Mary; Møller, Tom; Kjeldsen, Lars

2013-01-01

and treatment related symptoms and side effects. To date, there are no clinical practice exercise guidelines for patients with acute leukemia undergoing induction and consolidation chemotherapy. A randomized controlled trial is needed to determine if patients with acute leukemia can benefit by a structured...... and supervised counseling and exercise program.Methods/design: This paper presents the study protocol: Patient Activation through Counseling and Exercise -- Acute Leukemia (PACE-AL) trial, a two center, randomized controlled trial of 70 patients with acute leukemia (35 patients/study arm) following induction...... chemotherapy in the outpatient setting. Eligible patients will be randomized to usual care or to the 12 week exercise and counseling program. The intervention includes 3 hours + 30 minutes per week of supervised and structured aerobic training (moderate to high intensity 70 - 80%) on an ergometer cycle...

Long-term effectiveness of patient-centered training in cultural competence: what is retained? What is lost?

Science.gov (United States)

Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Hwang, Tzung-Jeng; Beach, Mary Catherine

2010-04-01

To determine whether the effects of a patient-centered cultural competence curriculum could be sustained for one year. In 2006, 57 fifth-year medical students at National Taiwan University were randomly assigned either to a group that received training in patient-centered cross-cultural communication skills or one that received no training. Students' scores on objective structured clinical exams (OSCEs) were compared in the realms of exploring (1) patient perspectives and (2) social factors related to illness, immediately after training (OSCE1) and one year after training (OSCE2). Regarding students' exploration of patient perspectives, the intervention group scored significantly higher than the control group at OSCE1, but there was a significant decrease from OSCE1 to OSCE2 in the intervention group and no significant difference between the intervention and control group at OSCE2. Regarding students' exploration of social factors related to illness, the intervention group scored significantly higher than the control group at OSCE1, with a nonsignificant decrease from OSCE1 to OSCE2 in the two groups, such that the intervention group again scored higher than the control group in OSCE2. The effect of a patient-centered cultural competence training curriculum on students' exploration of social factors related to illness was sustained to a significant degree after one year, whereas the effects on students' exploration of patient perspectives were not. Further research is needed to determine the extent to which additional training can prevent the loss of student skills.

Integrating Fieldwork into Employment Counseling for Methadone-Treatment Patients

Science.gov (United States)

Blankertz, Laura; Spinelli, Michael; Magura, Stephen; Bali, Priti; Madison, Elizabeth M.; Staines, Graham L.; Horowitz, Emily; Guarino, Honoria; Grandy, Audrey; Fong, Chunki; Gomez, Augustin; Dimun, Amy; Friedman, Ellen

2005-01-01

An innovative employment counseling model, Customized Employment Supports, was developed for methadone-treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, "vocational fieldwork," the delivery of services in the community rather than only within the clinic, was assessed through…

An innovative OSCE clinical log station: a quantitative study of its influence on Log use by medical students

Directory of Open Access Journals (Sweden)

Hudson Judith N

2012-11-01

Full Text Available Abstract Background A Clinical Log was introduced as part of a medical student learning portfolio, aiming to develop a habit of critical reflection while learning was taking place, and provide feedback to students and the institution on learning progress. It was designed as a longitudinal self-directed structured record of student learning events, with reflection on these for personal and professional development, and actions planned or taken for learning. As incentive was needed to encourage student engagement, an innovative Clinical Log station was introduced in the OSCE, an assessment format with established acceptance at the School. This study questions: How does an OSCE Clinical Log station influence Log use by students? Methods The Log station was introduced into the formative, and subsequent summative, OSCEs with careful attention to student and assessor training, marking rubrics and the standard setting procedure. The scoring process sought evidence of educational use of the log, and an ability to present and reflect on key learning issues in a concise and coherent manner. Results Analysis of the first cohort’s Log use over the four-year course (quantified as number of patient visits entered by all students revealed limited initial use. Usage was stimulated after introduction of the Log station early in third year, with some improvement during the subsequent year-long integrated community-based clerkship. Student reflection, quantified by the mean number of characters in the ‘reflection’ fields per entry, peaked just prior to the final OSCE (mid-Year 4. Following this, very few students continued to enter and reflect on clinical experience using the Log. Conclusion While the current study suggested that we can’t assume students will self-reflect unless such an activity is included in an assessment, ongoing work has focused on building learner and faculty confidence in the value of self-reflection as part of being a competent

Modifying the organic/electrode interface in Organic Solar Cells (OSCs) and improving the efficiency of solution-processed phosphorescent Organic Light-Emitting Diodes (OLEDs)

Energy Technology Data Exchange (ETDEWEB)

Xiao, Teng [Iowa State Univ., Ames, IA (United States)

2012-01-01

Organic semiconductors devices, such as, organic solar cells (OSCs), organic light-emitting diodes (OLEDs) and organic field-effect transistors (OFETs) have drawn increasing interest in recent decades. As organic materials are flexible, light weight, and potentially low-cost, organic semiconductor devices are considered to be an alternative to their inorganic counterparts. This dissertation will focus mainly on OSCs and OLEDs. As a clean and renewable energy source, the development of OSCs is very promising. Cells with 9.2% power conversion efficiency (PCE) were reported this year, compared to < 8% two years ago. OSCs belong to the so-called third generation solar cells and are still under development. While OLEDs are a more mature and better studied field, with commercial products already launched in the market, there are still several key issues: (1) the cost of OSCs/OLEDs is still high, largely due to the costly manufacturing processes; (2) the efficiency of OSCs/OLEDs needs to be improved; (3) the lifetime of OSCs/OLEDs is not sufficient compared to their inorganic counterparts; (4) the physics models of the behavior of the devices are not satisfactory. All these limitations invoke the demand for new organic materials, improved device architectures, low-cost fabrication methods, and better understanding of device physics. For OSCs, we attempted to improve the PCE by modifying the interlayer between active layer/metal. We found that ethylene glycol (EG) treated poly(3,4-ethylenedioxythiophene): polystyrenesulfonate (PEDOT: PSS) improves hole collection at the metal/polymer interface, furthermore it also affects the growth of the poly(3- hexylthiophene) (P3HT):phenyl-C61-butyric acid methyl ester (PCBM) blends, making the phase segregation more favorable for charge collection. We then studied organic/inorganic tandem cells. We also investigated the effect of a thin LiF layer on the hole-collection of copper phthalocyanine (CuPc)/C70-based small molecular OSCs. A

Barriers to counselling support for HIV/AIDS patients in south-western Cameroon.

Science.gov (United States)

Fonchingong, Charles C; Mbuagbo, Timothy O; Abong, Jennifer T

2004-11-01

The potential synergy between counselling and HIV/AIDS prevention is gaining recognition in Cameroon as counselling sessions are more often organised at health centres. In order to evaluate the actual achievements of these efforts, a qualitative ethnographic survey (based on interviews and focus group discussions) was conducted in two public and two private hospitals in the South-West Province. Churches and public health officials in Cameroon are struggling with the psycho-social, philosophical, psychological, theological, social, moral, ethical and cultural dimensions of HIV/AIDS, as they seek out viable prevention strategies. Health centres are also struggling to embrace the full meaning of counselling and to make psychological and spiritual support to AIDS patients available through the centres. Patients using these health centres may receive HIV testing against a backdrop of cultural standards that allow unsafe sex and bar open discussion on sex and sexuality. We propose that reversing the trend of the epidemic requires the intervention of the State, organisations in civil society and the family. Equally crucial is the role played by the churches - especially in confronting issues of stigmatisation and abandonment that often accompany patient disclosure, and in providing spiritual, emotional and psychological support to patients undergoing treatment.

Reacting to Conflict: Civilian Capabilities in the EU, UN and OSCE

NARCIS (Netherlands)

Dijkstra, Hylke; Petrov, Petar; Mahr, Ewa

2016-01-01

This report analyses how the EU, UN and OSCE make resources available for civilian missions. It starts with an overview of civilian missions around the world before comparing civilian planning and conduct procedures in these international organisations. The report zooms in on EU civilian

Patients' need for more counseling on diet, exercise, and smoking cessation: results from the National Ambulatory Medical Care Survey.

Science.gov (United States)

Heaton, Pamela C; Frede, Stacey M

2006-01-01

To determine the percentage of physicians who reported counseling patients on diet/nutrition, exercise, weight reduction, or smoking cessation during their office visits when responding to the 2002 National Ambulatory Medical Care Survey (NAMCS). We sought to establish whether patients are receiving adequate counseling from physicians on the basis of this nationwide survey. Retrospective database analysis. United States. Data included 184,668,007 physician visits for patients diagnosed with type 2 diabetes, hyperlipidemia, hypertension, or obesity; 140,362,102 physician visits for patients in which insulin/oral antidiabetics, antihyperlipidemia drugs, angiotensin-converting enzyme inhibitors, thiazide diuretics, or weight loss drugs were prescribed; and 82,317,640 physician visits for patients who smoked or used tobacco. Not applicable. Frequency of responses for counseling/education/therapy about diet/nutrition, exercise, weight reduction, and tobacco use/exposure. For patients with type 2 diabetes, hyperlipidemia, or hypertension, or patients receiving a drug in one of the drug classes that may indicate the presence of these diseases, patients did not receive any type of diet or exercise counseling during more than one half of all visits. Visits by patients who were diagnosed as obese were most likely to receive any type of counseling (80.2%). Of visits for patients who used tobacco, 78.6% did not include any counseling about smoking cessation. Patients are insufficiently counseled and educated about the need for lifestyle changes that can affect their risks for common chronic diseases. As accessible and ideally positioned health care providers, pharmacists could potentially affect the rising epidemic of obesity and other lifestyle-related diseases by filling this void.

Impact of Physician Training on Diagnosis and Counseling of Overweight and Obese Asian Patients.

Science.gov (United States)

Vasudevan, Deepa A; Northrup, Thomas F; Mandayam, Sreedhar; Bamidele, Oluwatosin O; Stotts, Angela L

2017-06-01

Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients. Physicians (N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training (n = 198) and 3 months following the training (n = 163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators. Patients were predominantly male (63.1 %), with a mean age of 46.0 years (SD = 14.9) and an average BMI of 28.2 (SD = 3.8). Across all physicians, 26.8 and 45.1 % of patients were accurately diagnosed as overweight or obese before and after the training, respectively (p Asian patients as overweight or obese were 102 % higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0 %) following training compared to pre-training levels (43.9 %) but failed to reach significance (p = 0.06). Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.

Preliminary program evaluation of emergency department HIV prevention counseling.

Science.gov (United States)

Sitlinger, Andrea P; Lindsell, Christopher J; Ruffner, Andrew H; Wayne, D Beth; Hart, Kimberly W; Trott, Alexander T; Fichtenbaum, Carl J; Lyons, Michael S

2011-07-01

Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit

eLearning to enhance physician patient communication: a pilot test of "doc.com" and "WebEncounter" in teaching bad news delivery.

Science.gov (United States)

Daetwyler, Christof J; Cohen, Diane G; Gracely, Edward; Novack, Dennis H

2010-01-01

Physician-patient communication skills help determine the nature and quality of diagnostic information elicited from patients, the quality of the physician's counseling, and the patient's adherence to treatment. In spite of their importance, surveys have demonstrated a wide variability and deficiencies in the teaching of these skills. Describe two specific methodologies for teaching physician-patient communication skills developed at our institution and pilot test them for effectiveness. Between 2004 and 2009 we developed "doc.com," a series of 41 media-rich online modules on all aspects of healthcare communication jointly with the American Academy on Communication in Healthcare. Starting in 2006, we expanded our pre-existing experience with the videoconferencing system "WebOSCE" into the online application "WebEncounter." This new methodology combines practice of communication skills on standardized patients with structured assessment and constructive feedback. We had three randomized groups: controls who did only the assessment parts of a WebOSCE on two occasions, a doc.com group who had doc.com in between the assessment occasions, and a combined group that had both doc.com and a WebEncounter between assessments. We found significant improvement in skills as components were added, and the training program was well received.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

Science.gov (United States)

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Belarus and Russia in OSCE Ministerial Council focus / Rokas M. Tracevskis

Index Scriptorium Estoniae

Tracevskis, Rokas M.

2011-01-01

6.-7. detsembril Vilniuses toimunud OSCE Ministrite Nõukogu kohtumisel räägiti inimõiguste probleemidest, meediavabadusest, Afganistanist, Araabia kevadest, Valgevenes toimuvast ja Venemaal toimunud parlamendivalimistest. Kohtumise avas Leedu president Dalia Grybauskaite. 6. detsembril kohtus USA riigisekretär Hillary Clinton president Dalia Grybauskaite ja välisminister Audronius Azubalisega

Breast cancer genetic counseling among Dutch patients from Turkish and Moroccan descent: participation determinants, and perspectives of patients and healthcare professionals.

OpenAIRE

Baars, J.E.; Dulmen, S. van; Veldhuizen, M.E. van; Riel, E. van; Ausems, M.G.E.M.

2017-01-01

Abstract Lower participation rates in cancer genetic counseling are observed among different ethnic minorities. The goal of our study is to gain insight into determinants of Turkish and Moroccan patients’ participation in breast cancer genetic counseling and DNA testing, from the point of view of healthcare professionals and patients. Questionnaire-based telephone interviews about awareness, perceptions, and reasons for (non-) participation in cancer genetic counseling were conducted with 78 ...

Female veterans' preferences for counseling related to intimate partner violence: Informing patient-centered interventions.

Science.gov (United States)

Iverson, Katherine M; Stirman, Shannon Wiltsey; Street, Amy E; Gerber, Megan R; Carpenter, S Louisa; Dichter, Melissa E; Bair-Merritt, Megan; Vogt, Dawne

2016-01-01

Female veterans are at high risk for intimate partner violence (IPV). A critical issue in the provision of health care to women who experience IPV is the delivery of effective brief counseling interventions that address women's unique needs. We aimed to identify female veterans' priorities and preferences for healthcare-based IPV counseling. A 2014 Web-based survey was administered to a national sample of US female veterans. Among 411 respondents (75% participation rate), 55% (n=226) reported IPV during their lifetime. These women identified priorities for the content focus of IPV-related counseling and preferences for the delivery of these services. Women prioritized counseling that focuses on physical safety and emotional health, with learning about community resources being a relatively lower priority. Participants preferred counseling to focus specifically on enhancing coping skills and managing mental health symptoms. In addition, women want counseling to be individualized and preferred the option to meet with a counselor immediately following disclosure. Affordable services and attention to privacy concerns were of paramount importance in the context of IPV-related counseling. These findings can inform patient-centered brief counseling interventions for women who experience IPV, which may ultimately reduce health disparities and violence among this population. Published by Elsevier Inc.

The Objective Structured Clinical Examination (OSCE) as a strategy for assessing clinical competence in midwifery education in Ireland: a critical review.

Science.gov (United States)

Smith, Valerie; Muldoon, Kathryn; Biesty, Linda

2012-09-01

In Ireland, to register as a midwife, all student midwives must be deemed competent to practice with the assessment of competence an essential component of midwifery education. A variety of assessment strategies, including observed practice, clinical interviews, portfolios of reflection, the Objective Structured Clinical Examination (OSCE) and written examination papers, are utilised to assess midwifery students' clinical competence. In this paper, a critical review of the OSCE as a strategy for assessing clinical competence in one third level institution in Ireland is offered. Although utilised for assessing competence across a range of areas (e.g. obstetric emergencies and pharmacology/drug administration), the use of the OSCE for assessing midwifery students' competence in lactation and infant feeding practices, as an example for this paper, is described. The advantages, disadvantages, validity and reliability of the OSCE, as an assessment strategy, are critically explored. Recognising that no single assessment strategy can provide all the information required to assess something as complex as clinical performance, the OSCE, when viewed alongside other forms of assessment, and with relevance to the topic under examination, may be considered a valuable strategy for enhancing the assessment of students' clinical competence, and for embracing diversity within midwifery education and training. Copyright © 2012 Elsevier Ltd. All rights reserved.

Training chiropractic students in weight management counseling using standardized patients.

Science.gov (United States)

Hawk, Cheryl; Ramcharan, Michael; Kruger, Carla LeRiche

2017-03-01

The aim of this study was to describe and assess an activity that trained chiropractic students to counsel patients on weight management through the use of standardized patients. This was a descriptive study using mixed methods. Students were trained to apply health behavior theory and the transtheoretical model. Standardized patients were given a case to portray with the students. Students had 15 minutes for the encounter. The encounters were assessed in 2 ways: (1) standardized patients answered a brief questionnaire about the students' performance, and (2) students answered a questionnaire about the utility of the intervention. Numerical data were extracted from the audiovisual management platform, and statistics were computed for each question. Comments made by students and patients were transferred verbatim for content analysis. A total of 102 students took part in the activity. Students' performance in the encounter was uniformly high, with over 90% "yes" responses to all questions except "gave me printed information material" and "discussed the printed material with me." The key issue identified in the comments by standardized patients was that students tended not to connect weight management with their chief complaint (low back pain). Nearly all students (97%) thought the activity would be useful to their future practice, and 97% felt it had increased their confidence in providing weight management counseling. This experiential activity was assessed to be useful to students' future practice and appeared to provide them with skills to successfully communicate with patients on weight management.

Breast cancer genetic counseling among Dutch patients from Turkish and Moroccan descent : participation determinants and perspectives of patients and healthcare professionals

NARCIS (Netherlands)

Baars, J E; van Dulmen, A M; Velthuizen, M E; van Riel, E; Ausems, M G E M

2017-01-01

Lower participation rates in cancer genetic counseling are observed among different ethnic minorities. The goal of our study is to gain insight into determinants of Turkish and Moroccan patients' participation in breast cancer genetic counseling and DNA testing, from the point of view of healthcare

Patient counseling materials: The effect of patient health literacy on the comprehension of printed prescription drug information.

Science.gov (United States)

Patel, Amit; Bakina, Daria; Kirk, Jim; von Lutcken, Scott; Donnelly, Tom; Stone, William; Ashley-Collins, Heather; Tibbals, Karen; Ricker, Lynn; Adler, Jeffrey; Ewing, John; Blechman, Michelle; Fox, Sherry; Leopold, Will; Ryan, Daniel; Wray, Donna; Turkoz, Heather

2018-05-16

Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. To explore the impact of reducing the health literacy demands of written patient health information. 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Diet Quality of Chronic Kidney Disease Patients and the Impact of Nutritional Counseling.

Science.gov (United States)

Fernandes, Andréia Silva; Ramos, Christiane Ishikawa; Nerbass, Fabiana Baggio; Cuppari, Lilian

2017-12-06

The aims of the study were to evaluate the quality of the diet of nondialysis-dependent patients with chronic kidney disease and to investigate the impact of dietary counseling in the quality of the diet of these patients. In the cross-sectional analysis, 3-day food records of 100 nondialysis-dependent patients with chronic kidney disease patients, in the first visit to the renal dietitians, were evaluated using the Diet Quality Index (DQI). Under-reporters were excluded. DQI is comprised by 10 components: 6 are food groups (fruits, vegetables, cereals, milk and dairy, meats and eggs, and legumes); 3 are nutrients (total fat, sodium, and cholesterol), and the last one is the diet variety. Each component is scored from 0 to 10, according to the adequacy of the Brazilian dietary guideline, and an overall score ranging from 0 (poor) to 100 (good) is obtained. In a subsample of 44 patients, a prospective analysis was performed to compare the DQI and its components before and after dietary counseling. The median DQI score was 68.6 (62.3-75.6; interquartile range), which means that most of the patients (92%) had a diet that "needs improvement" (DQI between 50 and 80 points). The DQI components with the lowest scores (lower adequacy) were sodium (0.0 [0.0-0.9]), dairy (3.9 [2.1-6.0]), and vegetables (6.0 [2.8-9.5]), whereas meat/egg, legumes, and cholesterol had the highest scores. Vegetables, legumes, and diet variety components were significantly lower in the lower tertiles of DQI. After a median follow-up of 25.0 (17.0-35.8) months comprising 6 (5-10) visits to the dietitian, energy, protein, and micronutrients intake were significantly reduced. The dietary counseling did not improve the overall DQI (after: 69.0 [69.0-74.8]; P = .95) and, a significant reduction in the score of legumes (from 10.0 [2.7-10.0] to 7.8 [4.7-10.0], P = .00) and diet variety (from 7.0 [5.3-10.0] to 6.0 [4.0-9.0], P = .02) components were observed. The diet of this cohort of patients

Cost-effectiveness of Nutritional Counseling for Obese Patients and Patients at Risk of Ischemic Heart Disease

DEFF Research Database (Denmark)

Olsen, Jens; Willain, I.; Ladelund, S.

2005-01-01

OBJECTIVES: Obesity and dyslipidemia are risk factors for ischemic heart disease, and prevention and treatment in primary care can reduce these risks. The objective of this cost-effectiveness analysis was to compare the costs and effects (in terms of life years gained) of providing nutritional...... counseling by a general practitioner (GP) or a dietician. METHODS: A total of 60 GPs, who accepted to participate, were randomized either to give nutritional counseling or to refer patients to a dietician for counseling. The life years gained was estimated using a Cox regression model. Costs were estimated...... proven that the GP group was the most cost-effective-the cost of gaining 1 extra life year was estimated to be 8213 DKK compared with the dietician group, for which the incremental cost-effectiveness ratio was estimated to be 59,987 DKK. CONCLUSIONS: The effects were moderate, but other studies of other...

Patients' general satisfaction with telephone counseling by pharmacists and effects on satisfaction with information and beliefs about medicines: Results from a cluster randomized trial.

Science.gov (United States)

Kooy, Marcel Jan; Van Geffen, Erica C G; Heerdink, Eibert R; Van Dijk, Liset; Bouvy, Marcel L

2015-06-01

Assess effects of pharmacists' counseling by telephone on patients' satisfaction with counseling, satisfaction with information and beliefs about medicines for newly prescribed medicines. A cluster randomized trial in Dutch community pharmacies. Patients ≥18 years were included when starting with antidepressants, bisphosphonates, RAS-inhibitors or statins. The intervention comprised counseling by telephone to address barriers to adherent behavior. It was supported by an interview protocol. Controls received usual care. Outcomes were effects on beliefs about medication, satisfaction with information and counseling. Data was collected with a questionnaire. Responses of 211 patients in nine pharmacies were analyzed. More intervention arm patients were satisfied with counseling (adj. OR 2.2 (95% CI 1.3, 3.6)). Patients with counseling were significantly more satisfied with information on 4 items, had less concerns and less frequently had a 'skeptical' attitude towards medication (adj. OR 0.5 (0.3-0.9)). Effects on most outcomes were more pronounced in men than in women. Telephone counseling by pharmacists improved satisfaction with counseling and satisfaction with information on some items. It had a small effect on beliefs about medicines. Pharmacists can use counseling by telephone, but more research is needed to find out which patients benefit most. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Have You Ever Googled a Patient or Been Friended by a Patient? Social Media Intersects the Practice of Genetic Counseling.

Science.gov (United States)

Omaggio, NinaMarie F; Baker, Maria J; Conway, Laura J

2018-04-01

Patients and healthcare providers are becoming increasingly connected via social media, bringing new opportunities and challenges. Direct connection can occur between patients and providers using online tools such as Facebook and LinkedIn. In addition, providers can gather information about patients using a search engine such as Google, referred to as patient-targeted Googling (PTG). An online 54-item survey was used to gain information on (1) how and to what extent genetic counseling students and genetic counselors connect directly with patients via social media sites, and (2) gather information on providers using PTG. Four hundred genetic counseling students and genetic counselors participated in the survey. The majority of respondents (88.9%; n = 344/387) find it is never or rarely acceptable to interact with current patients via social media sites; however, 27.7% (n = 110/397) have visited a patient's social media site. Gathering information for patient care was the most commonly reported reason (76.8%; n = 43/56). Thirty-three percent (n = 130/394) have considered searching online or actually searched online for information about a patient. Curiosity was the most common reason (92.7%; n = 114/123); although, respondents also used PTG to obtain contact information and to prepare for patient sessions. Our study supports the need for development and dissemination of professional guidelines to serve as a valuable resource for practicing genetic counselors and genetic counseling training programs.

Migrant breast cancer patients and their participation in genetic counseling : results from a registry-based study

NARCIS (Netherlands)

Baars, J E; van Dulmen, A M; Velthuizen, M E; Theunissen, E B M; Vrouenraets, B C; Kimmings, A N; van Dalen, T; van Ooijen, B; Witkamp, A J; van der Aa, M A; Ausems, M G E M

Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study.

NARCIS (Netherlands)

Baars, J.E.; Dulmen, A.M. van; Velthuizen, M.E.; Theunissen, E.B.M.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; Ooijen, B. van; Witkamp, A.J.; Aa, M.A. van der; Ausems, M.G.E.M.

2016-01-01

Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study

NARCIS (Netherlands)

Baars, J.E.; Dulmen, A.M. van; Velthuizen, M.E.; Theunissen, E.B.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; Ooijen, B. van; Witkamp, A.J.; Aa, M.A. van der; Ausems, M.G.

2016-01-01

Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of

Efficacy of physical activity counseling plus sleep restriction therapy on the patients with chronic insomnia

Directory of Open Access Journals (Sweden)

Wang J

2015-10-01

Full Text Available Jihui Wang, Guangxia Yin, Guanying Li, Wenjing Liang, Qinling Wei Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China Objective: Lack of physical activity (PA is common in patients with chronic insomnia. Studies to increase PA and decrease sedentary behavior in those patients are limited. Therefore, we investigated the efficacy of “PA counseling combined with sleep restriction (SR therapy (PASR” vs only SR in the patients with chronic insomnia. Methods: Seventy-one outpatients were assigned to either PASR (n=35, consisting of four weekly PA counseling sessions based on 5A model (assess, advise, agree, assist, and arrange + SR, or SR (n=36, consisting of four weekly SR. International Physical Activity Questionnaire (Chinese version and pedometer-based daily steps were evaluated as the primary endpoints. Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Scale-14, and Sleep Diary were evaluated as the secondary endpoints. Results: The results showed that the patients in the PASR group gained more benefits than the SR group in terms of PA level and pedometer-based daily steps (all P<0.05. Better improvements of the study group were also shown in Epworth Sleepiness Scale, Fatigue Scale-14, and Sleep efficiency (all P<0.05. Conclusion: We conclude that PA counseling based on 5A model combined with SR cannot only effectively increase the PA levels but also improve the sleep quality for patients with chronic insomnia. Keywords: behavioral therapy, physical activity, sleep disorders, sleep restriction, counseling

Nondirective counseling interventions with schizophrenics.

Science.gov (United States)

Gerwood, J B

1993-12-01

Counseling interventions with paranoid schizophrenics can be daunting. While chemical, directive, and behavioral controls often are considered important, nondirective counseling techniques used by the therapeutic staff may help schizophrenic patients explore their thoughts and feelings. Several nondirective concepts pioneered by Carl Rogers are examined. These methods, which represent basic concepts of the person-centered approach, are empathy, unconditional positive regard, and congruence. A brief illustration of an interaction with a patient diagnosed as paranoid schizophrenic is presented to suggest the effectiveness of Rogerian counseling.

Individualised motivational counselling to enhance adherence to antiretroviral therapy is not superior to didactic counselling in South African patients: findings of the CAPRISA 058 randomised controlled trial.

Science.gov (United States)

van Loggerenberg, Francois; Grant, Alison D; Naidoo, Kogieleum; Murrman, Marita; Gengiah, Santhanalakshmi; Gengiah, Tanuja N; Fielding, Katherine; Abdool Karim, Salim S

2015-01-01

Concerns that standard didactic adherence counselling may be inadequate to maximise antiretroviral therapy (ART) adherence led us to evaluate more intensive individualised motivational adherence counselling. We randomised 297 HIV-positive ART-naïve patients in Durban, South Africa, to receive either didactic counselling, prior to ART initiation (n = 150), or an intensive motivational adherence intervention after initiating ART (n = 147). Study arms were similar for age (mean 35.8 years), sex (43.1 % male), CD4+ cell count (median 121.5 cells/μl) and viral load (median 119,000 copies/ml). Virologic suppression at 9 months was achieved in 89.8 % of didactic and 87.9 % of motivational counselling participants (risk ratio [RR] 0.98, 95 % confidence interval [CI] 0.90-1.07, p = 0.62). 82.9 % of didactic and 79.5 % of motivational counselling participants achieved >95 % adherence by pill count at 6 months (RR 0.96, 95 % CI 0.85-1.09, p = 0.51). Participants receiving intensive motivational counselling did not achieve higher treatment adherence or virological suppression than those receiving routinely provided didactic adherence counselling. These data are reassuring that less resource intensive didactic counselling was adequate for excellent treatment outcomes in this setting.

Effectiveness of chemotherapy counselling on self-esteem and psychological affects among cancer patients in Malaysia: Randomized controlled trial.

Science.gov (United States)

Mohd-Sidik, Sherina; Akhtari-Zavare, Mehrnoosh; Periasamy, Ummavathy; Rampal, Lekhraj; Fadhilah, Siti Irma; Mahmud, Rozi

2018-05-01

The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia. A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted. Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia. This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Counseling on Sun Protection and Indoor Tanning.

Science.gov (United States)

Balk, Sophie J; Gottschlich, Elizabeth A; Holman, Dawn M; Watson, Meg

2017-12-01

The US Preventive Services Task Force recommends clinical counseling for individuals ages 10 to 24 years to decrease skin cancer risk. A national, random sample of US American Academy of Pediatrics members practicing primary care in 2002 (response rate 55%) and 2015 (response rate 43%). Surveys explored attitudes and experiences regarding sun protection counseling; indoor tanning questions were added in 2015. χ 2 tests compared demographics and counseling responses across years, and multivariable logistic regression models examined counseling predictors. More pediatricians in 2015 (34%) than in 2002 (23%) reported discussing sun protection during recent summer months with ≥75% of patients. This pattern held across all patient age groups (each P tanning at least once with 10 to 13 year-old patients; approximately half discussed this with older adolescents. Most (70%) did not know if their states had laws on minors' indoor tanning access; those stating they knew whether a law existed counseled more. Although improved, sun protection counseling rates remain low. Indoor tanning counseling can be improved. Because early-life exposure to UV radiation increases risk and clinician counseling can positively impact prevention behaviors, pediatricians have an important role in skin cancer prevention; counseling may save lives. Time constraints remain a barrier. Copyright © 2017 by the American Academy of Pediatrics.

INTRODUCING OVER THE COUNTER COUNSELING

Directory of Open Access Journals (Sweden)

Nataša Bakić-Mirić

2009-01-01

Full Text Available A pharmacist in today’s world has a great responsibility – to help and educate patients about diverse ways for effective self-treatment. Whereas self-care is becoming increasingly popular among patients today the availability of over-the-counter medications makes it possible for patients to treat numerous conditions on their own but still under the supervision of a healthcare provider. During the pharmacist-patient encounter, the pharmacist’s obligation is to evaluate the patient’s medical condition, provide proper advice and counsel the patient on the proper course of treatment to be taken. Also by employing effective over the counter (OTC counseling as the most proper means in a pharmacist/patient communication process and, accordingly, rapport building in the OTC area, the pharmacist needs to demonstrate high energy, enthusiasm, respect, empathy, know-how of sensitive intercultural issues alongside personal appearance, body language, eye contact that all together make his/her personal “signature”. Accordingly, apart from patient education, the primary objective of OTC counseling becomes to educate pharmacists on basic principles used in assisting patients in the selection of over-the-counter (OTC products, provide examples of proper communication techniques for effective patient counseling concerning the OTC products (i.e. dosage, administration technique, storage, food and beverage interaction, monitoring etc where the pharmacist plays the key role in helping patients maximize their pharmaceutical care.

User evaluation of patient counselling, combining nurse consultation and eHealth in hand eczema

DEFF Research Database (Denmark)

Mollerup, Annette; Harboe, Gitte; Johansen, Jeanne D

2016-01-01

BACKGROUND AND OBJECTIVE: This study reports the findings from a user evaluation of a counselling programme for hand eczema patients in which face-to-face encounters were supplemented with user access to a new website. PATIENTS AND METHODS: Patients treated for hand eczema in two different settin...

Sexual counseling and cardiovascular disease: practical approaches

Directory of Open Access Journals (Sweden)

Elaine E Steinke

2015-02-01

Full Text Available Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.

Counseling by epileptologists affects contraceptive choices of women with epilepsy.

Science.gov (United States)

Espinera, Alyssa R; Gavvala, Jay; Bellinski, Irena; Kennedy, Jeffrey; Macken, Micheal P; Narechania, Aditi; Templer, Jessica; VanHaerents, Stephen; Schuele, Stephan U; Gerard, Elizabeth E

2016-12-01

There are several important interactions between antiepileptic drugs (AEDs) and hormonal contraception that need to be carefully considered by women with epilepsy (WWE) and their practitioners. Many AEDs induce hepatic enzymes and decrease the efficacy of hormonal contraception. In addition, estrogen-containing hormonal contraception can increase the metabolism of lamotrigine, the most commonly prescribed AED in women of childbearing age. The intrauterine device (IUD) is a highly effective form of reversible contraception without AED drug interactions that is considered by many to be the contraceptive of choice for WWE. Women with epilepsy not planning pregnancy require effective contraceptive counseling that should include discussion of an IUD. There are no guidelines, however, on who should deliver these recommendations. The objective of this study was to explore the hypothesis that contraceptive counseling by a neurologist can influence the contraceptive choices of WWE. In particular, we explored the relationship between contraceptive counseling in the epilepsy clinic and the likelihood that patients would obtain an IUD. We conducted a retrospective chart review of female patients age 18-45 seen at our institution for an initial visit between 2010 and 2014 to ascertain the type of contraceptive counseling each patient received as well as AED use and contraceptive methods. Patients who were pregnant or planning pregnancy at the first visit were excluded from further analyses as were patients with surgical sterilization. We also examined a subgroup of 95 patients with at least 4 follow-up visits to evaluate the efficacy of epileptologists' counseling. Specifically, we looked at the likelihood a patient obtained an IUD based on the type of counseling she had received. Fisher exact tests assessed associations between counseling type and whether patients had obtained an IUD. Three hundred and ninety-seven women met criteria for inclusion. Only 35% of female patients

Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

Science.gov (United States)

Oranye, Nelson Ositadimma; Ahmad, Che'an; Ahmad, Nora; Bakar, Rosnida Abu

2012-06-01

The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

OSCE para Competências de Comunicação Clínica e Profissionalismo: Relato de Experiência e Meta-Avaliação

Directory of Open Access Journals (Sweden)

Camila Ament Giuliani dos Santos Franco

Full Text Available RESUMO A comunicação clínica e o profissionalismo estão entre as principais competências médicas e, portanto, devem ter sua avaliação garantida. Nesse contexto, o exame clínico objetivo estruturado (OSCE tem papel fundamental. Objetivos Descrever as etapas de elaboração de um OSCE, bem como a avaliação da qualidade das estações e a percepção do estudante de Medicina sobre a sua realização. Método O estudo é composto pela realização de um OSCE com quatro estações por 16 estudantes de Medicina e pela análise da qualidade psicométrica e aplicação de um questionário de satisfação. Resultados Para os estudantes, o OSCE é o método que melhor avalia e ensina essas competências, ao passo que os testes de múltipla escolha estão no polo oposto quanto à avaliação. Em relação à qualidade múltipla das estações: duas se apresentaram com boa confiabilidade, uma se tornou satisfatória após adequação e uma se revelou inconsistente. Conclusão Mesmo bem avaliadas pelos estudantes, algumas estações apresentaram falhas. A análise do OSCE é fundamental para sua validade e mensurabilidade, em especial para o OSCE de alta aposta.

A Comparison of Standard-Setting Procedures for an OSCE in Undergraduate Medical Education.

Science.gov (United States)

Kaufman, David M.; Mann, Karen V.; Muijtjens, Arno M. M.; van der Vleuten, Cees P. M.

2000-01-01

Compared four standard-setting procedures for an objective structure clinical examination (OSCE) in medical education. Applied Angoff, borderline, relative, and holistic procedures to the data used to establish a cutoff score for a pass/fail decision. The Angoff and borderline procedures gave similar results; however, the relative and holistic…

Counseling Patients with Senile Dementia of the Alzheimer Type and Their Families.

Science.gov (United States)

LaBarge, Emily

1981-01-01

Discusses symptoms of Alzheimer Disease and suggests client-centered counseling techniques to use with patients and family. Considers the disease's effect on family relationships relative to stage of family development. Examines the adjustment of the caregiving spouse. Offers practical suggestions for coping. (RC)

Operationalizing the Reciprocal Engagement Model of Genetic Counseling Practice: a Framework for the Scalable Delivery of Genomic Counseling and Testing.

Science.gov (United States)

Schmidlen, Tara; Sturm, Amy C; Hovick, Shelly; Scheinfeldt, Laura; Scott Roberts, J; Morr, Lindsey; McElroy, Joseph; Toland, Amanda E; Christman, Michael; O'Daniel, Julianne M; Gordon, Erynn S; Bernhardt, Barbara A; Ormond, Kelly E; Sweet, Kevin

2018-02-19

With the advent of widespread genomic testing for diagnostic indications and disease risk assessment, there is increased need to optimize genetic counseling services to support the scalable delivery of precision medicine. Here, we describe how we operationalized the reciprocal engagement model of genetic counseling practice to develop a framework of counseling components and strategies for the delivery of genomic results. This framework was constructed based upon qualitative research with patients receiving genomic counseling following online receipt of potentially actionable complex disease and pharmacogenomics reports. Consultation with a transdisciplinary group of investigators, including practicing genetic counselors, was sought to ensure broad scope and applicability of these strategies for use with any large-scale genomic testing effort. We preserve the provision of pre-test education and informed consent as established in Mendelian/single-gene disease genetic counseling practice. Following receipt of genomic results, patients are afforded the opportunity to tailor the counseling agenda by selecting the specific test results they wish to discuss, specifying questions for discussion, and indicating their preference for counseling modality. The genetic counselor uses these patient preferences to set the genomic counseling session and to personalize result communication and risk reduction recommendations. Tailored visual aids and result summary reports divide areas of risk (genetic variant, family history, lifestyle) for each disease to facilitate discussion of multiple disease risks. Post-counseling, session summary reports are actively routed to both the patient and their physician team to encourage review and follow-up. Given the breadth of genomic information potentially resulting from genomic testing, this framework is put forth as a starting point to meet the need for scalable genetic counseling services in the delivery of precision medicine.

Production of nuclear ceramic fuel for nuclear power plants at 'Ulba metallurgical plant' OSC

International Nuclear Information System (INIS)

Khadeev, V.G.

2000-01-01

The paper describes the flow-sheet of production of uranium dioxide powders and nuclear ceramic fuel pellets of them existing at the facility. 'UMP' OSC applies ADU extraction process of UO2 powders production. An indisputable success of the process is the possibility of use of the wide range of raw materials. Uranium hexafluoride, uranium oxides, uranium metal, uranium tetrafluoride, uranyl salts, uranium ore concentrates, all possible types of uranium-containing materials the processing of which by routine methods is difficult (ashes, scraps, etc.) are used as the raw materials. In addition, a reprocessed nuclear fuel can be used for fuel production. The quality of uranium dioxide powder produced does not depend on the type of uranium raw material used. High selectivity of extraction refining makes possible to obtain material with rather low impurities content that meets practically all specifications for uranium dioxide known to us. Ceramic and process features of uranium dioxide powders, namely, specific surface, bulk density, grain size and sinterability make possible to produce nuclear ceramic fuel with specified features. Quality of uranium dioxide powders produced by 'UMP' OSC was highly rated by General Electric company that is one of the leading companies from fuel manufactures in the USA market . It has certified 'UMP' OSC as its supplier. Currently, our company makes great efforts on establishing production of uranium dioxide powders with natural isotopes content for production of fuel for CANDU reactors. Trial lots of such powders are under tests at some companies manufacturing fuel for this type reactors in Canada, USA and Corea

[Malnutrition and weight loss - nurse assessment of nutritional status and counselling: experiences of patients with newly diagnosed or relapsed cancer].

Science.gov (United States)

Kröner, A; Stoll, H; Spichiger, E

2012-04-01

Due to the anorexia-cachexia syndrome, cancer patients are already suffering from nutritional problems and weight loss by the time they receive their diagnosis and start chemotherapy. In the oncology outpatient clinic of a Swiss university hospital, patients currently undergo a nutritional assessment and receive individual counselling at the beginning of cancer treatment. This qualitative study explored cancer patients' experiences with weight loss and nutritional problems as well as how they experienced the assessment and the consecutive counselling by nurses. Interviews were conducted with 12 patients and qualitative content analysis was used for data analysis. Results showed that patients barely registered the weight loss and did not interpret it as an early warning signal. Nevertheless, they attempted to improve their nutritional habits soon after diagnosis, prior to receiving any counselling. The patients did not experience the assessment as troublesome. They appreciated the nurses' advice and implemented the suggestions they found appropriate. This study highlights the importance of patient education regarding weight loss and nutritional problems early in the course of an illness. Patients may not be aware of nutritional problems at this early stage and may lack the necessary specialised knowledge. Assessment and counselling provided by nurses offer targeted measures for prevention of malnutrition and weight loss.

Sending family history questionnaires to patients before a colonoscopy improves genetic counseling for hereditary colorectal cancer.

Science.gov (United States)

Kessels, Koen; Eisinger, Joey D; Letteboer, Tom G; Offerhaus, G Johan A; Siersema, Peter D; Moons, Leon M G

2017-06-01

To investigate whether sending a family history questionnaire to patients prior to undergoing colonoscopy results in an increased availability of family history and better genetic counseling. A questionnaire was mailed to patients before they underwent outpatient colonoscopy at a university hospital in 2013. These patients' additional characteristics and referral for genetic evaluation were retrieved from the electronic medical records. Patients undergoing inpatient coloboscopy, with confirmed hereditary colorectal cancer (CRC) or inflammatory bowel disease were excluded. All study patients from 2010 to 2013 were matched with the database of the genetics department to determine who consulted a geneticist. A total of 6163 patients underwent colonoscopy from 2010 to 2013. Of 1421 who underwent colonoscopy in 2013, 53 (3.7%) consulted a geneticist, while 75 (1.6%) of 4742 patients undergoing colonoscopy between 2010 and 2012 did so (P history was not recorded in the electronic medical records of 393 (40.3%). In 129 (32.8%), family history was obtained from the completed questionnaire. In 2013, 49 (60.5%) out of 81 patients referred for genetic counseling were referred based on their family history. Eight (9.9%) patients were referred based on the completed questionnaire. Screening for hereditary CRC in a population undergoing outpatient colonoscopy with a questionnaire sent by mail resulted in an increased availability of family histories and genetic counseling. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

[The influence of counseling for patients with cancer on their discharge from the palliative care support department of the community health care service of Minoh City Hospital].

Science.gov (United States)

Suita, Tomoko; Kato, Rika; Fujita, Misao; Hidaka, Kumi; Iijima, Shohei

2014-12-01

Counseling for patients with cancer by a certified nurse in palliative care began in April 2011 in Minoh City Hospital. Counseling was provided immediately after a patient was informed by the treating physician of a primary diagnosis of cancer, a metastatic recurrence, or a decision to terminate cancer therapy. We examined the patient's support system after the counseling ended. The number of patients receiving end-of-life support with home or hospital care rapidly increased from 118 prior to the program's beginning to 186. The number of patients counseled was comparable to the rapid increase in their number(n=68). New cases in the outpatient department comprised 59% of all patients, of which, 45% began supportive counseling, with 43%of them ultimately returning home. Of the new cases receiving counseling in the hospital, 34%eventually returned home after discharge, and the highest percentage of discharges were to a palliative care unit or hospice program (48%). The initiation of counseling in the outpatient department allowed us to provide sufficient time to make decisions about appropriate places for end-of-life care. Cooperation with the patients' physicians was necessary to provide counseling from the outpatient department. Our findings suggest the importance of sharing the patients' medical and social information among the staff when necessary.

Sexual concerns and sexual counseling in heart failure.

NARCIS (Netherlands)

Medina, M.; Walker, C.; Steinke, E.E.; Wright, D.W.; Mosack, V.; Farhoud, M.H.

2009-01-01

Patients with heart failure (HF) face significant challenges in maintaining quality of life (QOL), particularly for sexual intimacy. Although recommended for all cardiac patients, it has been suggested that few HF patients receive sexual counseling. This study explored sexual counseling needs,

Randomized trial of the effects of individual nutritional counseling in cancer patients

DEFF Research Database (Denmark)

Møller, Grith; Pedersen, Louise Lindkvist; Østerlind, Kell

2014-01-01

Cancer-related malnutrition is multifactorial and related to a bad prognosis. The aim of this study was to investigate the effect of intensive, individual dietary counseling of patients in radiotherapy and/or chemotherapy for gynecologic-, gastric-, or esophageal cancer....

Outcome of chemotherapy counseling by pharmacists on psychological effects and self esteem among oncology patients in a Government Hospital in Malaysia.

Science.gov (United States)

Ummavathy, P; Sherina, M S; Rampal, L; Siti Irma Fadhilah, I

2015-06-01

Chemotherapy is the most common form of treatment among cancer patients. It is also known to cause many physical and psychological side-effects. This study developed, implemented and evaluated the outcome of a chemotherapy counseling module among oncology patients by pharmacists based on their psychological effects (depression, anxiety) and selfesteem. A randomized, single blind, placebo controlled study was conducted among 162 patients undergoing chemotherapy in a government hospital in Malaysia. Counseling sessions were conducted using the 'Managing Patients on Chemotherapy' module for oncology patients undergoing chemotherapy at each treatment cycle. The outcome of repetitive chemotherapy counseling using the module was determined at baseline, first follow-up, second follow-up and third follow-up. The findings revealed that there was significant improvement in the intervention group as compared to the control group with large effect size on depression (p = 0.001, partial η(2) = 0.394), anxiety (p = 0.001, partial η(2) = 0.232) and self-esteem (p = 0.001, partial η(2) = 0.541). Repetitive counseling using the 'Managing Patients on Chemotherapy' module was found to be effective in improving psychological effects and self-esteem among patients undergoing chemotherapy.

Active-learning instruction on emergency contraception counseling.

Science.gov (United States)

Young, Shardae; Griffin, Brooke; Vest, Kathleen

2013-06-12

To increase pharmacy students' knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Approximately 200 third-year pharmacy students participated in the Women's Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students' knowledge scores increased from 86% to 93% (pemergency contraception before completing the active-learning exercise compared to 58.5% after (pemergency contraception and significantly reduced several barriers to counseling identified prior to participation.

Effectiveness of the Healthy Skin Clinic – a randomized clinical trial of nurse-led patient counselling in hand eczema

DEFF Research Database (Denmark)

Mollerup, Annette; Veien, Niels K; Johansen, Jeanne D

2014-01-01

BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse-led...... or burden of disease were found between the two groups. CONCLUSION: A tailored nurse-led programme of skin protection counselling may be recommended as an essential part of hand eczema treatment.......BACKGROUND: Hand eczema is a common disease, and continuous preventive skin protection and skin care must be adopted to prevent a chronic course. Hand eczema is not a uniform disease, and counselling must therefore be individually tailored. OBJECTIVES: To evaluate the effectiveness of a nurse......-led counselling programme, the Healthy Skin Clinic, emphasizing the patient's self-management, resources, and risks. PATIENTS AND METHODS: Patients (n = 306) referred for diagnostic work-up and treatment of hand eczema were randomized and allocated either to the programme or to usual care. The primary outcome...

Design and Implementation of a Randomized Controlled Trial of Genomic Counseling for Patients with Chronic Disease

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Kevin Sweet

2014-01-01

Full Text Available We describe the development and implementation of a randomized controlled trial to investigate the impact of genomic counseling on a cohort of patients with heart failure (HF or hypertension (HTN, managed at a large academic medical center, the Ohio State University Wexner Medical Center (OSUWMC. Our study is built upon the existing Coriell Personalized Medicine Collaborative (CPMC®. OSUWMC patient participants with chronic disease (CD receive eight actionable complex disease and one pharmacogenomic test report through the CPMC® web portal. Participants are randomized to either the in-person post-test genomic counseling—active arm, versus web-based only return of results—control arm. Study-specific surveys measure: (1 change in risk perception; (2 knowledge retention; (3 perceived personal control; (4 health behavior change; and, for the active arm (5, overall satisfaction with genomic counseling. This ongoing partnership has spurred creation of both infrastructure and procedures necessary for the implementation of genomics and genomic counseling in clinical care and clinical research. This included creation of a comprehensive informed consent document and processes for prospective return of actionable results for multiple complex diseases and pharmacogenomics (PGx through a web portal, and integration of genomic data files and clinical decision support into an EPIC-based electronic medical record. We present this partnership, the infrastructure, genomic counseling approach, and the challenges that arose in the design and conduct of this ongoing trial to inform subsequent collaborative efforts and best genomic counseling practices.

Effect of intensive nutritional counseling and support on clinical outcomes of hemodialysis patients.

Science.gov (United States)

Molfino, Alessio; Chiappini, Maria Grazia; Laviano, Alessandro; Ammann, Thomas; Bollea, Maria Rosa; Alegiani, Filippo; Rossi Fanelli, Filippo; Muscaritoli, Maurizio

2012-10-01

Protein-energy wasting is frequently found in patients on hemodialysis (HD). Anorexia and hypophagia contribute to malnutrition and increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether the correction of hypophagia influences morbidity and mortality in anorexic patients on HD. Thirty-four patients on HD were enrolled in a 2-y follow-up program including regular nutritional assessments. Patients not meeting the nutritional requirements during the follow-up received nutritional counseling, consisting of advice, individually tailored diets, and, for a failed dietary intervention, artificial nutrition. Biochemical, anthropometric, and body composition parameters, morbidity, and mortality were recorded in all patients at 12 and 24 mo. At baseline, 14 patients (41%) were anorexic, and 20 patients (59%) were non-anorexic. Anorexic patients were hypophagic and presented with a decreased fat-free mass. After 12 and 24 mo, cholesterol, albumin, lymphocyte count, and body mass index did not differ between the groups, whereas fat-free mass (percentage) in supplemented anorexic patients significantly improved in no longer differing from non-anorexic patients (65.8 ± 4.4 versus 65.4 ± 8.9, respectively, P = NS; 65.8 ± 4.4 versus 66.7 ± 10.78, respectively, P = NS). Morbidity and mortality were not different between the two groups. In patients on HD, nutritional counseling and nutritional support positively affect the nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to those of non-anorexic patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Motivational counselling and SMS-reminders for reduction of daily sitting time in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Thomsen, T; Aadahl, Mette; Beyer, Nina Ann-Marie

2016-01-01

for daily leisure time sitting > 4 h. The 16-week intervention included 1) three individual motivational counselling sessions and 2) individual text message reminders aimed at reducing daily sitting time. The control group was encouraged to maintain their usual lifestyles. Outcomes were assessed at baseline...... and screened before 20 met eligibility criteria and consented; reasons for declining study participation were mostly flares, lack of time and co-morbidities. One patient from the control group dropped out before end of intervention (due to a RA flare). Intervention participants completed all counselling...... tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA. METHODS: A randomised, controlled trial with two parallel groups. RA patients >18 years of age and Health Assessment Questionnaire (HAQ) score 

The influence of cancer-related distress and sense of coherence on anxiety and depression in patients with hereditary cancer: a study of patients' sense of coherence 6 months after genetic counseling.

Science.gov (United States)

Siglen, Elen; Bjorvatn, Cathrine; Engebretsen, Lars Fredrik; Berglund, Gunilla; Natvig, Gerd Karin

2007-10-01

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.

The use of narrative hermeneutical approach in the counselling of abortion patients within an African context

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Elijah M. Baloyi

2012-08-01

Full Text Available Our country has celebrated democracy for more than a decade now, the democracy in which everyone enjoys all the basic human rights, including the right to an abortion. Public and private hospitals and some traditional healers are engaged in this act where some give pre-abortion and post-abortion counselling to their patients whilst others do not. It becomes a serious question of course to ask whether those patients who did not receive counselling, cope with life after the experienced trauma. By the looks of things it seems very clear that the people who commit abortion have a special need for help in order to cope with life thereafter. Another question now is whether the little counselling that they receive in the hospital before and after an abortion is satisfactory to their individual needs. That is why the author’s focus is on the method or approach which the author thinks will better help the patients who find themselves in such a traumatic situation. The concentration is on the narrative-hermeneutical approach as one of the applicable approaches from the author’s point of view.

A Procedural Skills OSCE: Assessing Technical and Non-Technical Skills of Internal Medicine Residents

Science.gov (United States)

Pugh, Debra; Hamstra, Stanley J.; Wood, Timothy J.; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

2015-01-01

Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal…

Exercise on prescription: a randomized study on the effect of counseling vs counseling and supervised exercise

DEFF Research Database (Denmark)

Kragstrup, J.; Skovgaard, T.; Puggaard, L.

2008-01-01

(counseling) using maximal oxygen uptake (VO(2max)) as the primary outcome. The study was conducted as a randomized trial in 2005-2006 with a high and a low-intensive group. All the patients referred to the EoP scheme by their GP in the counties of Vejle and Ribe, Denmark, were eligible for the trial....... The high-intensive EoP group received 4 months of group-based supervised training and attended five motivational counseling sessions. The low-intensive group only attended four motivational counseling sessions. Three hundred and twenty-seven patients entered the EoP scheme, and 52 (16%) volunteered......The aim of this study was to compare short- (0-4 months) and long-term (0-10 months) effects of high-intensive Exercise on Prescription (EoP) intervention (counseling and supervised exercise) implemented in primary healthcare in a number of Danish counties with a low-intensive intervention...

Brief Training of HIV Medical Providers Increases Their Frequency of Delivering Prevention Counselling to Patients at Risk of Transmitting HIV to Others

Science.gov (United States)

Patel, Shilpa N.; Marks, Gary; Gardner, Lytt; Golin, Carol E.; Shinde, Sanjyot; O'Daniels, Christine; Wilson, Tracey E.; Quinlivan, E. Byrd; Banderas, Julie W.

2013-01-01

Objective: The aim of this study was to examine whether brief training of human immunodeficiency virus (HIV) medical providers increased the frequency with which they routinely delivered prevention counselling to patients, and whether patient characteristics were associated with receipt of that counselling. Design: Longitudinal. Setting: Seven HIV…

The effectiveness of group dietary counselling among non insulin dependent diabetes mellitus (NIDDM) patients in resettlement scheme areas in Malaysia.

Science.gov (United States)

Talib, R; Ali, O; Arshad, F; Kadir, K A

1997-06-01

A study was undertaken in FELDA (Federal Land Development Authority) resettlement scheme areas in Pahang, Malaysia, to determine the effectiveness of group dietary counselling in motivating diabetic patients to achieve good dietary habits, and weight and diabetes control. Sixty-one non-insulin dependent diabetes mellitus (NIDDM) patients were randomly assigned to either the experimental or control group. The experimental group received six sessions of group dietary counselling over 5 months and the control group received mass media diabetes-educational program during the same period. The one hour group dietary counselling sessions discussed general knowledge of diabetes, food groups for meal planning, the importance of dietary fibre-rich foods, types of fat in food, exercise and weight control. The experimental group met monthly with a dietitian as a counsellor. Effectiveness was assessed by improvement in food choice, and decline in percentage glycated haemoglobin (total HbA1) or body mass index (BMI). Measurements were made at a baseline visit, every two months during the six month program, and six months afterwards. Patients in the experimental group improved their food choices, resulting in a healthier diet high in unrefined carbohydrates and dietary fibre rich foods, and low in fat. There were significant reductions of their percentage total HbA1 levels and BMI following the counselling sessions, which decreased further six months after the program compared with patients in the control group. Thus group dietary counselling is effective in motivating NIDDM patients to achieve better food choice, and related weight and glycaemic control in a Malaysian setting.

Counselling users of hearing technology: a comprehensive literature review.

Science.gov (United States)

Meibos, Alex; Muñoz, Karen; Schultz, Jared; Price, Tanner; Whicker, John J; Caballero, Ana; Graham, Laurel

2017-12-01

The purpose of this review is to determine the scope of peer-reviewed empirical research related to counselling in audiology with patients using hearing technology and to identify limitations and gaps to guide recommendations for future research. A rapid evidence assessment was used to identify relevant articles for the review. Eighteen articles met the inclusion criteria. Three themes were identified: (1) audiologist counselling perspectives, (2) counselling communication trends in practice and (3) audiologist experiences with professional training and reported patient outcomes. Findings revealed audiologists are more confident providing information than counselling that addresses adjustment aspects, and other communication gaps have been observed. There is limited research related to counselling in audiology. Audiologists continue to report a need for more training in counselling in their graduate programmes. Additional research is needed to determine effective ways to implement counselling in practice and to improve graduate student supervision for the development of counselling competencies and confidence in using skills in practice.

Which female cancer patients fail to receive fertility counseling before treatment in the state of Georgia?

Science.gov (United States)

Chin, Helen B; Howards, Penelope P; Kramer, Michael R; Mertens, Ann C; Spencer, Jessica B

2016-12-01

To assess which characteristics are associated with failure to receive fertility counseling among a cohort of young women diagnosed with cancer. Population-based cohort study. Not applicable. A total of 1,282 cancer survivors, of whom 1,116 met the inclusion criteria for the analysis. None. The main outcome in this study was whether or not women reported receiving any information at the time of their cancer diagnosis on how cancer treatment might affect their ability to become pregnant. Forty percent of cancer survivors reported that they did not receive fertility counseling at the time of cancer diagnosis. Women were more likely to fail to receive counseling if they had only a high school education or less or if they had given birth. Cancer-related variables that were associated with a lack of counseling included not receiving chemotherapy as part of treatment and diagnosis with certain cancer types. Counseling about the risk of infertility and available fertility preservation options is important to cancer patients. Additionally, counseling can make women aware of other adverse reproductive outcomes, such as early menopause and its associated symptoms. Less-educated women and parous women are at particular risk of not getting fertility-related information. Programs that focus on training not just the oncologist, but also other health care providers involved with cancer care, to provide fertility counseling may help to expand access. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.

NARCIS (Netherlands)

Verheijden, M.E.; Bakx, J.C.; Akkermans, R.P.; Hoogen, H.J.M. van den; Godwin, N.M.; Rosser, W.W.; Staveren, W.A. van; Weel, C. van

2004-01-01

BACKGROUND: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. OBJECTIVE: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: Randomized controlled trial

NARCIS (Netherlands)

Verheijden, M.; Bakx, J.C.; Akkermans, R.; Hoogen, H. van den; Godwin, N.M.; Rosser, W.; Staveren, W. van; Weel, C. van

2004-01-01

Background: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. Objective: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.

NARCIS (Netherlands)

Verheijden, M.W.; Bakx, J.C.; Akkermans, R.; Hoogen, van den H.; Godwin, M.; Rosser, W.; Staveren, van W.A.; Weel, van C.

2004-01-01

Background: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. Objective: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

Impact of Pharmacist Counselling on Clozapine Knowledge

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Ciara Ní Dhubhlaing

2017-01-01

Full Text Available Clozapine is the only antipsychotic with evidence for efficacy in treatment of resistant schizophrenia but it carries a high side effect burden. Patient information is provided but may be poorly retained. This study aims to examine the impact of pharmacist counselling upon patient knowledge of clozapine. Outpatients, aged 18 years and over, attending St. Patrick’s University Hospital, Dublin, participated in this study between June and August 2015. The intervention consisted of pharmacist counselling on two occasions one month apart. Knowledge was assessed using a 28-point checklist devised from the currently available clozapine patient information sources, at baseline and after each counselling session. Ethics approval was obtained. Twenty-five participants (40% female; mean age 45.1 years, SD 9.82; 64% unemployed, 28% smokers showed an improvement in knowledge scores of clozapine from baseline to postcounselling on each occasion with an overall improvement in knowledge score, from baseline to postcounselling at one month, of 39.43%; p<0.001. This study adds to the evidence that interventions involving pharmacist counselling can improve patient knowledge, whilst the specific knowledge gained relating to recognition of side effects may help patients towards more empowerment regarding their treatment.

Medical paraclinical standards, political economy of clinic, and patients' clinical dependency; a critical conversation analysis of clinical counseling in South of iran.

Science.gov (United States)

Kalateh Sadati, Ahmad; Iman, Mohammad Taghi; Bagheri Lankarani, Kamran

2014-07-01

Despite its benefits and importance, clinical counseling affects the patient both psychosocially and socially. Illness labeling not only leads to many problems for patient and his/her family but also it imposes high costs to health care system. Among various factors, doctor-patient relationship has an important role in the clinical counseling and its medical approach. The goal of this study is to evaluate the nature of clinical counseling based on critical approach. The context of research is the second major medical training center in Shiraz, Iran. In this study, Critical Conversation Analysis was used based on the methodologies of critical theories. Among about 50 consultation meetings digitally recorded, 33 were selected for this study. RESULTS show that the nature of doctor-patient relationship in these cases is based on paternalistic model. On the other hand, in all consultations, the important values that were legitimated with physicians were medical paraclinical standards. Paternalism in one hand and standardization on the other leads to dependency of patients to the clinic. Although we can't condone the paraclinical standards, clinical counseling and doctor-patient relationship need to reduce its dominance over counseling based on interpretation of human relations, paying attention to social and economical differences of peoples and biosocial and biocultural differences, and focusing on clinical examinations. Also, we need to accept that medicine is an art of interaction that can't reduce it to instrumental and linear methods of body treatment.

Bringing patients' social context into the examination room: an investigation of the discussion of social influence during contraceptive counseling.

Science.gov (United States)

Levy, Kira; Minnis, Alexandra M; Lahiff, Maureen; Schmittdiel, Julie; Dehlendorf, Christine

2015-01-01

Although social networks are an increasingly recognized influence on contraceptive use, little is known about if and how social influences are discussed during women's contraceptive counseling visits. We performed a mixed-methods analysis of audio recordings of contraceptive counseling visits. We examined predictors of discussion of social influence arising in a contraceptive counseling visit and analyzed the content and process of social influence discussions. Social influences were mentioned in 42% of the 342 visits included in the sample, with these discussions most commonly initiated by patients. Younger patients were more likely to have social influence mentioned than older patients. The content of social influence focused on side effects and adverse events, with the sources of influence being predominantly patients' friends and the media, with little input from partners. Providers were more likely to engage around the content of the social influence than the social influence itself. The frequency with which social influence was mentioned in these visits supports the importance of women's social context on their contraceptive decision making. However, the fact that patients initiated the discussion in the majority of cases suggests that providers may not recognize the relevance of these influences or may not be comfortable engaging with them. Increasing providers' ability to elicit and engage patients about their social context with regard to contraception could enhance providers' ability to understand women's contraceptive preferences and provide appropriate counseling to address their specific concerns or questions. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Young female cancer patients' experiences with fertility counselling and fertility preservation

DEFF Research Database (Denmark)

Hoeg, Didde; Schmidt, Lone; Tryde Macklon, Kirsten

2016-01-01

were aware that chemotherapy could destroy their eggs. The participants described how specialized fertility counselling and fertility preservation contributed to a belief in life after cancer, which gave them hope that they would survive their cancer disease. Further, the women described how......Introduction: Fertility counselling for young women newly diagnosed with cancer is an important field of preconceptional counselling. This qualitative, small-scale study explored how young women newly diagnosed with cancer experienced specialized fertility preservation counselling and treatment...... in the public Danish health care system. Methods: Semi-structured, in-depth interviews were conducted with five women below 40 years recently diagnosed with cancer. All women received fertility counselling by a fertility specialist at the Fertility Clinic, University Hospital of Copenhagen, Denmark before...

Patients' general satisfaction with telephone counseling by pharmacists and effects on satisfaction with information and beliefs about medicines : Results from a cluster randomized trial

NARCIS (Netherlands)

Kooy, Marcel Jan; Van Geffen, Erica C G; Heerdink, Eibert R.; Van Dijk, Liset; Bouvy, Marcel L.

2015-01-01

Assess effects of pharmacists' counseling by telephone on patients' satisfaction with counseling, satisfaction with information and beliefs about medicines for newly prescribed medicines. Methods: A cluster randomized trial in Dutch community pharmacies. Patients ≥18 years were included when

Determination of Trace Amounts of Gold in Environmental Samples by Adsorptive Stripping Voltammetry of Its Complex with Rhodamine Using Osc-Pls

Directory of Open Access Journals (Sweden)

A. Akrami

2012-11-01

Full Text Available The multivariate calibration method was applied for the determination of trace amounts of gold based on a hanging mercury drop electrode (HMDE in the presence of rhodanine, followed by reduction of adsorbed gold by voltammetric scan using differential pulse modulation The optimum experimental conditions are: rhodanine concentration of 0.20 mg mL-1, pH 5.0, accumulation potential of -600 mV versus Ag/AgCl, accumulation time of 100 sec, scan rate of 30 mV s-1 and pulse height of 100 mV. The calibration matrix for partial least squares (PLS regression was designed with 9 samples. Orthogonal signal correction (OSC is a preprocessing technique used for removing the information unrelated to the target variables based on constrained principal component analysis. OSC is a suitable preprocessing method for PLS calibration without loss of prediction capacity using electrochemical method. The RMSEP for gold determination with PLS and OSC-PLS were 8.51 and 1.94, respectively. This procedure allows the determination of gold in synthetic and real samples with good reliability of the determination. 

Young Men With Cancer Experience Low Referral Rates for Fertility Counseling and Sperm Banking.

Science.gov (United States)

Grover, Natalie S; Deal, Allison M; Wood, William A; Mersereau, Jennifer E

2016-05-01

With improved cancer survival rates and the current trend of delaying parenthood, fertility is a growing issue among cancer patients. The purpose of this study was to evaluate the incidence of fertility counseling and sperm banking in reproductive-age male cancer patients and to assess factors that influence counseling and banking. Male patients ages 13 to 50 years who received a new cancer diagnosis from January 1, 2013, to May 1, 2015, and planned to initiate curative chemotherapy at our center were identified. Documentation of fertility counseling and sperm cryopreservation was abstracted from the medical record. Univariable and multivariable logistic regression modeling was used to examine variables associated with fertility counseling and sperm banking. Of 201 patients who fit the study criteria, 59 (29%) received fertility counseling and 23 (11%) attempted sperm banking. All patients who banked sperm had documentation of fertility counseling. Younger patients were significantly more likely to be counseled, with mean ages of 27.4 and 40.4 years for counseled and noncounseled patients, respectively (P year odds ratio, 0.61; P fertility counseling and referral for sperm banking in young men with cancer receiving chemotherapy. Further work is needed to develop interventions to improve fertility counseling rates and opportunities for sperm banking. Copyright © 2016 by American Society of Clinical Oncology.

The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy

Directory of Open Access Journals (Sweden)

Duncan I

2012-04-01

Full Text Available Michael Taitel1, Jenny Jiang1, Kristi Rudkin2, Susan Ewing2, Ian Duncan 1Clinical Outcomes and Analytics, Walgreens, 2Corporate Innovation Team, Walgreens, Deerfield, Illinois, USAPurpose: To evaluate the impact of a community-based pharmacist-led face-to-face counseling program on medication adherence for patients who were new to therapy (NTT for statin medications.Patients and methods: This retrospective cohort study evaluated a program that was implemented in 76 national community pharmacies located in the midwest USA. It consisted of two face-to-face patient counseling sessions with a pharmacist that addressed patient barriers to adherence. A group of 2056 NTT statin patients was identified between September 1, 2010 and October 31, 2010, and was followed for 12 months. The intervention group consisted of 586 patients, and the comparison group comprised 516 patients. Outcomes were measured using the continuous medication possession ratio (MPR, categorical MPR, and medication persistency.Results: After adjusting for covariates, the intervention group had statistically greater MPR than the comparison group at every month measured. For example, at 12 months the intervention group had a MPR of 61.8% (CI, 54.5%–69.2% and the comparison group had a MPR of 56.9% (CI, 49.5%–64.3%; this 4.9% difference is significant (P < 0.01. The 12 month categorical MPR also showed significant differences between groups (χ2 = 6.12, P < 0.05; 40.9% of the intervention group and 33.7% of comparison group had a MPR greater than or equal to 80%. Finally, the intervention group had significantly greater persistency with their medication therapy than the comparison group at 60, 90, 120, and 365 days.Conclusion: Patients who participated in brief face-to-face counseling sessions with a community pharmacist at the beginning of statin therapy demonstrated greater medication adherence and persistency than a comparison group. This brief targeted intervention at the

ROLE OF COUNSELING ON MEDICAL ADHERENCE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

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Anoop Kumar

2015-11-01

Full Text Available BACKGROUND: Diabetes Mellitus (DM refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. It is the leading cause of of end stage renal disease, non-traumatic limb amputation and adult blindness. The studies have shown that complications of DM can be prevented by the proper control of blood glucose, which is dependent on the patient’s adherence to medication, life style modification, frequent monitoring of blood glucose etc. and can be influenced by proper education and counseling of the patient. The patients with DM should receive education about exercise, care of DM during illness and medications to lower plasma glucose1 . This study aims to assess the impact of patients counseling on the medication adherence in type 2DM. METHOD: This is a prospective randomized study that includes 100 patients with type 2 DM in the out-patient department of internal medicine in a tertiary care teaching hospital, north Kerala. After getting informed consent, they were kept in two groups by simple randomization technique and were assessed and followed at 4 weeks interval. Data related to the medication adherence was collected using Morisky Medication Adherence Scale questionnaire (MMAS-8. RESULTS: Out of 100 patients 33% were male and 67% female. Both baseline and 1st follow up showed a low adherence value (<6 both in control and intervention group. In the second follow up most of the patients in intervention group showed a moderate adherence (6-8, whereas control group did not show any improvement. CONCLUSION: It can be concluded that there is a stastically significant improvement in the adherence level after patient counseling and education. Knowledge about the disease and treatment has improved the patient’s adherence to medication.

Impact of one-dose package dispensing with patient counseling on medication adherence in geriatrics suffering from chronic disorders

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Narayana Goruntla

2018-01-01

Full Text Available Introduction: Medication nonadherence in elderly patients could result in a waste of medical expenses in a long-time span as well as deterioration of the patient's medical condition. Aim: The aim of this study is to evaluate the impact of one-dose package dispensing with patient counseling on medication adherence among elderly patients suffering from chronic disorders. Settings and Design: This is prospective, open-labeled, randomized trial carried out at dispensing pharmacy of the secondary care referral hospital, located in resource-limited settings of Anantapur District, Andhra Pradesh, India. Subjects and Methods: A total of 330 (aged ≥60 years patients were randomly assigned to one of three study groups: Group A (n = 110, no change in dosing and packing; Group B (n = 110, one-dose package dispensing; Group C (n = 110, One-dose package dispensing with patient counseling. Medication adherence levels were measured using a pill count and visual analog scale (VAS method at baseline and follow-up (after 1 month. Statistical Analysis: Descriptive statistics were used to represent the sociodemographic, clinical, and medication adherence profile of study participants. One-way ANOVA test is used to assess significant differences between three groups with a P 60 years who are on multiple medications can benefit from one-dose package dispensing and appropriate counseling. This will improve medication adherence hence better outcomes.

Moderating Nutritious Habits in Psychiatric Patients Using Transtheoretical Model of Change and Counseling.

Science.gov (United States)

Anastopoulou, Konstantina; Fradelos, Evangelos C; Misouridou, Evdokia; Kourakos, Michael; Berk, Aristea; Papathanasiou, Ioanna V; Kleisiaris, Christos; Zyga, Sofia

2017-01-01

Motivational Interviewing provides the opportunity to health professionals to have an effective strategy to increase the level of readiness to change health behaviors. Along with the Transtheoretical Model (Stages of Change Model) compose the theoretical base of intervention in psychiatry settings. This study was aimed to change nutritious behavior of psychiatric patients using a specific Model of Change and Counseling implementing a health education program. A quasi-experimental design was adopted on a random sample of 60 psychiatric patients at Military Hospital of Athens. Patients were divided into two groups as follows; (a) Intervention Group (four sessions of counseling and encouraging motivation for modification of their nutritious habits), and (b) Control Group (simple information sessions about the principles of healthy alimentation). The mean age of Intervention Group (IG) was 43.9 ± 9.5 and Control Group (CG) 46.1 ± 9.1, ranging from 40 to 55 years old. Also, 26.7% of the participants were female, 23.3% were married and, 10% divorced. Our analyses showed that IG patients were significantly loss weight post-intervention compared to CG patients. Specifically, IG patients were significantly moderated the intake of starchy foods in every meal (p moderated the intake of low fat dairy foods while they changed the full fat dairy foods with low fat (p moderating unhealthy nutritious behaviors (p = 0.032). Our results confirms that health educational and promotional Interventions may change behavior of psychiatric patients and thus may positively influence their nutritious habits.

[Nutrition counseling in tumor cachexia so patients will eat better].

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Krumwiede, K H

2003-03-13

With the aim of preventing, or at least limiting, malnutrition in patients suffering from cancer, they should receive appropriate nutritional advice before, during and after treatment. Such problems as loss of appetite, nausea, gustatory disturbances, dry mouth, etc., may be ameliorated by specific counseling. Enteral liquid diets and commercially available baby food products offer a good alternative to normal diet, or may be used to supplement it. Such supplements as vitamin and/or mineral tablets, and vegetable and fruit concentrates should only be used selectively and for well-founded indications. The metabolic situation in cachectic patients is not particularly amenable to oral nutritional measures. A fat-rich diet is recommended. The administration of pharmacological doses of omega-3 fatty acids may offer some benefit.

The emerging role of exercise and health counseling in patients with acute leukemia undergoing chemotherapy during outpatient management

DEFF Research Database (Denmark)

Jarden, Mary; Adamsen, Lis; Kjeldsen, Lars

2013-01-01

This study investigates the feasibility, safety and benefits of a 6-week exercise and health counseling intervention in patients with acute leukemia undergoing consolidation chemotherapy during outpatient management. Seventeen of twenty patients completed study requirements (85%), adherence...... to exercise was 73% and for health counseling 92%. There were improvements in the 6-min-walk-distance (p=0.0013), sit-to-stand test (p=0.0062), the right and left biceps arm-curl tests p=0.0002 and p=0.0002, respectively; health-related quality of life (p=0.0209) (FACT-An), vitality (p=0.0015), mental health...

A Pragmatic Evaluation of the National Cancer Institute Physician Data Query (PDQ)®-Based Brief Counseling on Cancer-Related Fatigue among Patients Undergoing Radiation Therapy

Science.gov (United States)

Bauml, Joshua; Xie, Sharon X; Penn, Courtney; Desai, Krupali; Dong, Kimberly W; Bruner, Deborah Watkins; Vapiwala, Neha; Mao, Jun James

2018-01-01

Purpose Cancer-Related Fatigue (CRF) negatively affects quality of life among cancer patients. This study seeks to evaluate the outcome and patient receptiveness of a brief counseling program based on National Cancer Institute (NCI) PDQ® information to manage CRF when integrated into Radiation Therapy (RT). Methods We conducted a prospective cohort study among patients undergoing non-palliative RT. Patients with stage I–III tumors and with Karnofsky score 60 or better were given a ten-minute behavioral counseling session during the first two weeks of RT. The Brief Fatigue Inventory (BFI) was administered at baseline/end of RT. Results Of 93 patients enrolled, 89% found the counseling useful and practical. By the end of RT, 59% reported increased exercise, 41.6% sought nutrition counseling, 72.7% prioritized daily activities, 74.4% took daytime naps, and 70.5% talked with other cancer patients. Regarding counseling, patients who had received chemotherapy prior to RT had no change in fatigue (−0.2), those who received RT alone had mild increase in fatigue (0.7, p=0.02), and those who received concurrent chemotherapy experienced a substantial increase in fatigue (3.0 to 5.2, p=0.05). Higher baseline fatigue and receipt of chemotherapy were predictive of worsened fatigue in a multivariate model (both p<0.01). Conclusion Our data suggests that brief behavioral counseling based on NCI guidelines is well accepted by patients showing an uptake in many activities to cope with CRF. Those who receive concurrent chemotherapy and with higher baseline fatigue are at risk for worsening fatigue despite of guideline-based therapy. PMID:29479490

Is the OSCE more stressful? Examination anxiety and its consequences in different assessment methods in dental education

NARCIS (Netherlands)

Brand, H.S.; Schoonheim-Klein, M.

2009-01-01

Objective: To measure the levels of anxiety, self-perception of preparation and expectation for success induced by an objective structured clinical examination (OSCE), a written examination and a preclinical preparation test, and to examine the effects of the three predictive variables on the

Evaluation of the FOCUS (Feedback on Counseling Using Simulation) Instrument for Assessment of Client-Centered Nutrition Counseling Behaviors

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Henry, Beverly W.; Smith, Thomas J.

2010-01-01

Objective: To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise. Methods: Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern…

Sex and Race/Ethnicity Differences in Implantable Cardioverter-Defibrillator Counseling and Use Among Patients Hospitalized With Heart Failure: Findings from the Get With The Guidelines-Heart Failure Program.

Science.gov (United States)

Hess, Paul L; Hernandez, Adrian F; Bhatt, Deepak L; Hellkamp, Anne S; Yancy, Clyde W; Schwamm, Lee H; Peterson, Eric D; Schulte, Phillip J; Fonarow, Gregg C; Al-Khatib, Sana M

2016-08-16

Previous studies have found that women and black patients eligible for a primary prevention implantable cardioverter-defibrillator (ICD) are less likely than men or white patients to receive one. We performed an observational analysis of the Get With The Guidelines-Heart Failure Program from January 1, 2011, to March 21, 2014. Patients admitted with heart failure and an ejection fraction ≤35% without an ICD were included. Rates of ICD counseling among eligible patients and ICD receipt among counseled patients were examined by sex and race/ethnicity. Among 21 059 patients from 236 sites, 4755 (22.6%) received predischarge ICD counseling. Women were counseled less frequently than men (19.3% versus 24.6%, Prace/ethnic group 14.4% versus white 24.3%, Pdifferences by race and ethnicity persisted. © 2016 American Heart Association, Inc.

Counselling adults who experience a first seizure.

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Legg, Karen T; Newton, Mark

2017-07-01

A first seizure can result in significant uncertainty, fear and apprehension. One of the key roles of the clinician in the setting of first seizure is to provide accurate, timely information and counselling. We review the numerous components to be considered when counselling an adult patient after a first seizure. We provide a framework and manner to provide that counselling. We focus on an individualized approach and provide recommendations and information on issues of diagnosis, etiology, prognosis, the role and importance of medical testing, lifestyle considerations, driving, medication and other key counselling considerations. Accurate, timely counselling can allay fears and anxieties, remove misconceptions and reduce the risk for injury in seizure recurrence. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Training Pediatric Residents to Provide Smoking Cessation Counseling to Parents

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Rebecca L. Collins

2005-01-01

Full Text Available The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.

Feedback promotes learning success! Which kind of feedback for the faculty is given by an interdisciplinary OSCE with focus on decision-making?

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Stibane, Tina

2016-08-01

Full Text Available Clinical skills such as history taking, diagnostic reasoning, therapy planning, and giving advice are even more complex than practical skills like lung auscultation and have to be applied in complex clinical situations. We judged this competence in an interdisciplinary formative OSCE conducted with students of Marburg University. Results of 218 students passing 643 OSCE stations composed of 37 different scenarios were analyzed. As a competence based examination that reflects the practical skills gained during clinical training, the here presented analysis serves also as a feedback instrument for clinical teachers, their respective disciplines and the medical faculty as a whole.

Experiences of patients with multiple sclerosis from group counseling.

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Mazaheri, Mina; Fanian, Nasrin; Zargham-Boroujeni, Ali

2011-01-01

Group counseling is one of the most important methods in somatic and psychological rehabilitation of the multiple sclerosis (M.S.) patients. Knowing these patients' experiences, feelings, believes and emotion based on learning in group is necessary to indicate the importance of group discussion on quality of life of the patients. This study was done to achieve experiences of M.S. patients from group training. This was a qualitative study using phenomenological method. The samples were selected using purposeful sampling. Ten patients from M.S. society who had passed group training were included in the study. The group training was done through seven sessions weekly and voluntarily. The participants were interviewed using in-depth interview. The average time of each interview was between 30-50 minutes which has been recorded digitally and moved to a compact disc to transcribe and analysis. The data analyzed using 7-step Colaizzi method. The data were transformed into 158 codes, 12 sub-concepts and 4 main concepts including emotional consequences, communication, quality of life and needs. M.S can lead to multiple problems in patients such as somatic, behavioral, emotional and social disorders. Group psychotherapy is one of the methods which can decrease these problems and improve rehabilitation of the patients. Group discussion helps patients to overcome adverse feelings, behaviors and thoughts and guides them to move in a meaningful life. It also can improve quality of life and mental health of the patients.

Uptake of genetic counselling services by patients with cystic fibrosis ...

African Journals Online (AJOL)

Background: Although cystic fibrosis (CF) is a common genetic condition, genetic counselling services appear to be underutilised by affected families. The aim of this study was to determine the uptake of genetic counselling and mutation testing for CF by relatives of affected individuals, and the impact of introducing ...

Lifestyle counseling in primary care: opportunities and challenges for changing practice.

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Sargeant, Joan; Valli, Michel; Ferrier, Suzanne; MacLeod, Heather

2008-01-01

Many patients today have health concerns related to lifestyle factors. This has created a situation where physicians are regularly confronted with the challenge of how to conduct lifestyle counseling with patients. Specific strategies can enable physicians to more effectively navigate this complex area of communication with patients, improving patient response in adopting healthy behaviours and increasing physician satisfaction with this task. To evaluate the impact of a lifestyle counseling workshop incorporating the motivational enhancement and transtheoretical models upon primary care clinicians' counseling practice patterns, especially communication and counseling skills, and attitudes toward lifestyle counseling. This study used a mixed method research design. Forty-three clinicians completed a post-workshop evaluation and identified intended changes to practice following the workshop. Twelve participated in interviews several months later to explore the kinds of changes made and influences upon them. Forty-one (95.3%) questionnaire respondents reported an intention to change their practice. Main changes reported were: asking more questions, listening more, assessing patients' readiness to change, tailoring counseling to patients' readiness to change. They seemed to have acquired and retained new knowledge and most were able to apply the new skills in their practices. Many reported feeling more comfortable and/or confident when interacting with patients in need of lifestyle change. But, time constraints, comfort with current skills, lack of self-efficacy, and fears of missing opportunities to influence patients, moderated participants' ability to adopt and maintain new approaches. While primary care clinicians can successfully learn specific lifestyle counseling skills and incorporate them into their practice following a two-hour evidence-based workshop, individual, educational and system factors can interfere.

Counseling about turbuhaler technique: needs assessment and effective strategies for community pharmacists.

Science.gov (United States)

Basheti, Iman A; Reddel, Helen K; Armour, Carol L; Bosnic-Anticevich, Sinthia Z

2005-05-01

Optimal effects of asthma medications are dependent on correct inhaler technique. In a telephone survey, 77/87 patients reported that their Turbuhaler technique had not been checked by a health care professional. In a subsequent pilot study, 26 patients were randomized to receive one of 3 Turbuhaler counseling techniques, administered in the community pharmacy. Turbuhaler technique was scored before and 2 weeks after counseling (optimal technique = score 9/9). At baseline, 0/26 patients had optimal technique. After 2 weeks, optimal technique was achieved by 0/7 patients receiving standard verbal counseling (A), 2/8 receiving verbal counseling augmented with emphasis on Turbuhaler position during priming (B), and 7/9 receiving augmented verbal counseling plus physical demonstration (C) (Fisher's exact test for A vs C, p = 0.006). Satisfactory technique (4 essential steps correct) also improved (A: 3/8 to 4/7; B: 2/9 to 5/8; and C: 1/9 to 9/9 patients) (A vs C, p = 0.1). Counseling in Turbuhaler use represents an important opportunity for community pharmacists to improve asthma management, but physical demonstration appears to be an important component to effective Turbuhaler training for educating patients toward optimal Turbuhaler technique.

Exploration of Nursing Faculty Members' Lived Experiences of Objective Structured Clinical Examination (OSCE) in Undergraduate Nursing Education

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Obizoba, Cordelia O.

2014-01-01

The purpose of this phenomenological study was to gain an understanding of nursing faculty members' lived experiences of Objective Structured Clinical Examination (OSCE) in undergraduate nursing education. As owners of their programs' curriculum, nursing faculties are charged with the responsibility of providing needed knowledge, skills, and…

Early counselling and support for patients with mild Alzheimer's disease and their caregivers: a qualitative study on outcome

DEFF Research Database (Denmark)

Sørensen, Lisbeth V; Waldorff, Frans B; Waldemar, Gunhild

2008-01-01

OBJECTIVES: The aim of this qualitative study was to identify and analyse the participants' experienced outcome of an intensive structured psychosocial intervention programme with tailored counselling, education and support groups for home-living patients with mild Alzheimer's disease...... with the challenges their partner's disease involved, and they were able to face everyday life and social relations with more serenity and competence. After the intervention, both patients and caregivers sought suitable support groups they could join as a permanent activity and caregivers sought permanent counselling...... revealed that patients found support groups relevant: they found it stimulating to be with peers, it supported their self-esteem, and it supported them in finding new ways of managing everyday life and social relations. During and after the intervention, caregivers were better able to cope...

[Effects of group psychological counseling on self-confidence and social adaptation of burn patients].

Science.gov (United States)

Dang, Rui; Wang, Yishen; Li, Na; He, Ting; Shi, Mengna; Liang, Yanyan; Zhu, Chan; Zhou, Yongbo; Qi, Zongshi; Hu, Dahai

2014-12-01

To explore the effects of group psychological counseling on the self-confidence and social adaptation of burn patients during the course of rehabilitation. Sixty-four burn patients conforming to the inclusion criteria and hospitalized from January 2012 to January 2014 in Xijing Hospital were divided into trial group and control group according to the method of rehabilitation, with 32 cases in each group. Patients in the two groups were given ordinary rehabilitation training for 8 weeks, and the patients in trial group were given a course of group psychological counseling in addition. The Rosenberg's Self-Esteem Scale was used to evaluate the changes in self-confidence levels, and the number of patients with inferiority complex, normal feeling, self-confidence, and over self-confidence were counted before and after treatment. The Abbreviated Burn-Specific Health Scale was used to evaluate physical function, psychological function, social relationship, health condition, and general condition before and after treatment to evaluate the social adaptation of patients. Data were processed with t test, chi-square test, Mann-Whitney U test, and Wilcoxon test. (1) After treatment, the self-confidence levels of patients in trial group were significantly higher than those in control group (Z = -2.573, P 0.05). (2) After treatment, the scores of psychological function, social relationship, health condition, and general condition were (87 ± 3), (47.8 ± 3.6), (49 ± 3), and (239 ± 10) points in trial group, which were significantly higher than those in control group [(79 ± 4), (38.3 ± 5.6), (46 ± 4), and (231 ± 9) points, with t values respectively -8.635, -8.125, -3.352, -3.609, P values below 0.01]. After treatment, the scores of physical function, psychological function, social relationship, health condition, and general condition in trial group were significantly higher than those before treatment (with t values from -33.282 to -19.515, P values below 0.05). The scores

Self-reported receipt of healthcare professional?s weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

OpenAIRE

Mogre, Victor; Wanaba, Peter; Apala, Peter; Nsoh, Jonas A.

2016-01-01

Background Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviours to lose weight. This study determined the association between self-reported receipt of healthcare professional?s weight management counselling and the weight management behaviours of type 2 diabetes patients. Methods This cross-sectional study was conducted among 378 type 2 ...

The use of global rating scales for OSCEs in veterinary medicine.

Directory of Open Access Journals (Sweden)

Emma K Read

Full Text Available OSCEs (Objective Structured Clinical Examinations are widely used in health professions to assess clinical skills competence. Raters use standardized binary checklists (CL or multi-dimensional global rating scales (GRS to score candidates performing specific tasks. This study assessed the reliability of CL and GRS scores in the assessment of veterinary students, and is the first study to demonstrate the reliability of GRS within veterinary medical education. Twelve raters from two different schools (6 from University of Calgary [UCVM] and 6 from Royal (Dick School of Veterinary Studies [R(DSVS] were asked to score 12 students (6 from each school. All raters assessed all students (video recordings during 4 OSCE stations (bovine haltering, gowning and gloving, equine bandaging and skin suturing. Raters scored students using a CL, followed by the GRS. Novice raters (6 R(DSVS were assessed independently of expert raters (6 UCVM. Generalizability theory (G theory, analysis of variance (ANOVA and t-tests were used to determine the reliability of rater scores, assess any between school differences (by student, by rater, and determine if there were differences between CL and GRS scores. There was no significant difference in rater performance with use of the CL or the GRS. Scores from the CL were significantly higher than scores from the GRS. The reliability of checklist scores were .42 and .76 for novice and expert raters respectively. The reliability of the global rating scale scores were .7 and .86 for novice and expert raters respectively. A decision study (D-study showed that once trained using CL, GRS could be utilized to reliably score clinical skills in veterinary medicine with both novice and experienced raters.

Dietary counselling effectively improves lipid levels in patients with endogenous hypertriglyceridemia: emphasis on weight reduction and alcohol limitation

NARCIS (Netherlands)

de Man, F. H.; van der Laarse, A.; Hopman, E. G.; Gevers Leuven, J. A.; Onkenhout, W.; Dallinga-Thie, G. M.; Smelt, A. H.

1999-01-01

To evaluate the short-term effect of dietary counselling in patients with endogenous hypertriglyceridemia and evaluate the effects of advised nutrient changes. A prospective dietary intervention study in patients with endogenous hypertriglyceridemia from January I st 1988 to December 31 st 1996

Comparison of standardized patients and real patients as an experiential teaching strategy in a nutrition counseling course for dietetic students.

Science.gov (United States)

Schwartz, Vicki S; Rothpletz-Puglia, Pamela; Denmark, Robert; Byham-Gray, Laura

2015-02-01

To compare the quality of communication and behavioral change skills among dietetic students having two nutrition encounters with either a real patient or a standardized patient in the simulation laboratory at Drexel University, Philadelphia, PA, United States. A retrospective analysis of video recordings (n=138) containing nutrition encounters of dietetic students (n=75) meeting with a standardized patient (SP) or a real patient (RP). Trained raters evaluated communication skills with the 28 item Calgary Cambridge Observation Guide (CCOG) and skills promoting behavior change using the 11 item Behavior Change Counseling Index (BECCI) tool. Using the CCOG, there was a significantly greater mean score in the SP group for the category of "Gathering Information" in encounter one (p=0.020). There were good to excellent ratings in all categories of the CCOG and the BECCI scores for the SP and the RP groups at both encounters. There was no significant differences in change scores from encounter one to encounter two between groups. Encounters with SPs and RPs are both effective strategies for dietetic students to demonstrate their communication and behavior change skills. Utilizing SPs is an effective experiential strategy for nutrition counseling curricula. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands

NARCIS (Netherlands)

Leensen, Monique C. J.; Groeneveld, Iris F.; van der Heide, Iris; Rejda, Tomas; van Veldhoven, Peter L. J.; van Berkel, Sietske; Snoek, Aernout; van Harten, Wim; Frings-Dresen, Monique H. W.; de Boer, Angela G. E. M.

2017-01-01

Objectives To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to

Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients : A prospective study in the Netherlands

NARCIS (Netherlands)

Leensen, Monique C.J.; Groeneveld, Iris F.; Heide, Iris Van Der; Rejda, Tomas; Van Veldhoven, Peter L.J.; Berkel, Sietske Van; Snoek, Aernout; van Harten, Willem H.; Frings-Dresen, Monique H.W.; Boer, Angela G.E.M.

2017-01-01

Objectives To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to

Patterns of nucleotide diversity and phenotypes of two domestication related genes (OsC1 and Wx) in indigenous rice varieties in Northeast India.

Science.gov (United States)

Choudhury, Baharul Islam; Khan, Mohammed Latif; Dayanandan, Selvadurai

2014-06-16

During the domestication of crops, individual plants with traits desirable for human needs have been selected from their wild progenitors. Consequently, genetic and nucleotide diversity of genes associated with these selected traits in crop plants are expected to be lower than their wild progenitors. In the present study, we surveyed the pattern of nucleotide diversity of two selected trait specific genes, Wx and OsC1, which regulate amylose content and apiculus coloration respectively in cultivated rice varieties. The analyzed samples were collected from a wide geographic area in Northeast (NE) India, and included contrasting phenotypes considered to be associated with selected genes, namely glutinous and nonglutinous grains and colored and colorless apiculus. No statistically significant selection signatures were detected in both Wx and OsC1gene sequences. However, low level of selection that varied across the length of each gene was evident. The glutinous type varieties showed higher levels of nucleotide diversity at the Wx locus (πtot = 0.0053) than nonglutinous type varieties (πtot = 0.0043). The OsC1 gene revealed low levels of selection among the colorless apiculus varieties with lower nucleotide diversity (πtot = 0.0010) than in the colored apiculus varieties (πtot = 0.0023). The results revealed that functional mutations at Wx and OsC1genes considered to be associated with specific phenotypes do not necessarily correspond to the phenotypes in indigenous rice varieties in NE India. This suggests that other than previously reported genomic regions may also be involved in determination of these phenotypes.

The Effects of Compliance with Nutritional Counselling on Body Composition Parameters in Head and Neck Cancer Patients under Radiotherapy

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D. Hopanci Bicakli

2017-01-01

Full Text Available Background. Radiotherapy (RT has been associated with increased risk of malnutrition in cancer patients, particularly in those with head and neck cancer (HNC. The aim of this prospective study was to evaluate the effects of compliance of patients with individual dietary counselling on body composition parameters in HNC patients under RT. Material and Methods. Sixty-nine consecutive patients (mean age: 61.0±13.8 were prospectively followed. Bioelectrical impedance analysis (BIA was performed to determine body composition parameters before, in the middle of, and at the end of RT. All patients received nutritional counselling and majority of them (94.6% received oral nutritional supplement (ONS during RT or chemoradiotherapy. If a patient consumed ≥75% of the recommended energy and protein intake via ONS and regular food, he/she was considered to be “compliant” (n=18, while those who failed to meet this criteria were considered to be “noncompliant” (n=30. Results. Body mass index, weight, fat percentage, fat mass, fat free mass, and muscle mass did not decrease significantly over time in compliant patients, but in noncompliant patients, all of these indices decreased significantly from baseline compared to the end of treatment (p<0.001. Hand grip strength did not differ significantly between the two groups at baseline and over time in each group. When retrospectively evaluated, heavy mucositis was less commonly observed in compliant than noncompliant patients (11.1% versus 88.9%, resp. (p<0.009. Conclusion. We conclude that body composition parameters were better in head and neck cancer patients considered as compliant with nutritional counselling than noncompliant ones during RT period.

Factors for Personal Counseling among Counseling Trainees

Science.gov (United States)

Byrne, J. Stephen; Shufelt, Brett

2014-01-01

The present study explored the use of counseling among counselor trainees and the characteristics of consumers and nonconsumers. Approximately 61% of those surveyed (n = 85) reported that they had received counseling, with the majority being mental health counseling trainees. Nonconsumers (n = 54) indicated that they coped with problems in other…

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

Science.gov (United States)

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Experiences of counselling in the emergency department during the waiting period: importance of family participation.

Science.gov (United States)

Paavilainen, Eija; Salminen-Tuomaala, Mari; Kurikka, Sirpa; Paussu, Paula

2009-08-01

To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Descriptive quantitative study. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.

Voluntary Counseling and Testing and Prevalence of HIV Infection ...

African Journals Online (AJOL)

Voluntary Counseling and Testing and Prevalence of HIV Infection Amongst Patients Booked for Surgical Operations. ... The effectiveness (yield) of lay counseling in HIV testing by resident doctors who have not ... AJOL African Journals Online.

Final data of an Italian multicentric survey about counseling for smoking cessation in patients with diagnosis of a respiratory disease.

Science.gov (United States)

Capelletto, Enrica; Rapetti, Simonetta Grazia; Demichelis, Sara; Galetta, Domenico; Catino, Annamaria; Ricci, Donata; Moretti, Anna Maria; Bria, Emilio; Pilotto, Sara; Bruno, Arianna; Valmadre, Giuseppe; Bandelli, Gian Piero; Trisolini, Rocco; Gianetta, Martina; Pacchiana, Maria Vittoria; Vallone, Stefania; Novello, Silvia

2018-03-01

Smoking is the major risk factor for cancer and several respiratory diseases. Quitting smoking at any point of life may increase the effectiveness of treatments and improve prognosis of patients with any pulmonary disease, including lung cancer. However, few institutions in Europe offer to patients adequate counseling for smoking cessation. Aim of this study was to investigate the level of counseling for smoking cessation offered by healthcare professionals to patients and their appreciation towards the intervention itself. Between January 2013 and February 2016, 490 patients, diagnosed with a respiratory diseases, were prospectively evaluated with an anonymous survey developed by WALCE (Women Against Lung Cancer in Europe). The majority of patients enrolled (76%) declared to have stopped smoking after the diagnosis of a respiratory disease, 17% to smoke less, 7% to continue smoking. Patients who reported to have never received any counseling for smoking cessation were 38%. Almost 73% of the other patients reported a positive judgment about the quality of healthcare's intervention. Despite these favorable considerations, 83% of patients have disclosed they simply quit smoking overnight without help, 5% have used electronic cigarettes, 5% nicotine replacement treatments, 4% dedicated books, 3% have attended a referral clinic. Considering all the smoking-related side effects, greater efforts should be made in order to better support patients in smoking cessation. Smoking should be considered as a real physical disorder and similar surveys should be encouraged with the aim to fight the 'stigma' of smoking that still exists among patients. © 2017 John Wiley & Sons Ltd.

Understanding the application of OSC policy 9.1 during a takeover transaction

International Nuclear Information System (INIS)

Hayduk, M.F.; Rasmuson, M.A.

1998-01-01

Legal aspects of ownership of publicly traded companies in Canada are explored, with particular emphasis on transactions involving 'related parties'. In this context, Policy 9.1 of the Ontario Securities Commission is examined. The policy seeks to enhance minority shareholder protection by providing for independent valuation, majority of minority approval, enhanced disclosure and review of substantial transactions by independent directors. This paper focuses on four types of transactions governed by Policy 9.1, i.e. insider bids, issuer bids, going private transactions, related party transactions and the recent proposed rule reformulation proposed by the Ontario Securities Commission (OSC)

Drug-food interaction counseling programs in teaching hospitals.

Science.gov (United States)

Wix, A R; Doering, P L; Hatton, R C

1992-04-01

The results of a survey to characterize drug-food interaction counseling programs in teaching hospitals and solicit opinions on these programs from pharmacists and dietitians are reported. A questionnaire was mailed to the pharmacy director and the director of dietary services at teaching hospitals nationwide. The questionnaire contained 33 questions relating to hospital characteristics, drug-food interaction counseling programs, and the standard calling for such programs issued by the Joint Commission on Accreditation of Healthcare Organizations. Of 792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of the pharmacists and dietitians (51.2%) did not consider their drug-food interaction counseling program to be formal; some had no program. The pharmacy department was involved more in program development than in the daily operation of such programs. The most frequent methods of identifying patients for counseling were using lists of patients' drugs and using physicians' orders. A mean of only five drugs were targeted per program. Slightly over half the respondents rated the Joint Commission standard less effective than other standards in its ability to improve patient care. A majority of teaching hospitals did not have formal drug-food interaction counseling programs. Pharmacists and dietitians did not view these programs as greatly beneficial and did not believe that the Joint Commission has clearly delineated the requirements for meeting its standard.

Towards a rationalization of counselling in general practice

Science.gov (United States)

Rowland, Nancy; Irving, Jill

1984-01-01

While there is good evidence to show that counselling may be beneficial to those patients in general practice with non-organic problems, deployment of the available resources lacks standardization and rationalization. The Counselling in Medical Settings Working Party of the British Association for Counselling is pressing for standardized training and accreditation of counsellors so that general practitioners will feel more confident about taking on workers who will ultimately be incorporated into the NHS team. PMID:6512752

Respecting autonomous decision making among Filipinos: a re-emphasis in genetic counseling.

Science.gov (United States)

Cura, Jonathan Diego

2015-04-01

Family cohesiveness provides a unique cultural influence in the observance and expression of autonomy in terms of Filipino patients' decision making. With genetic counseling yet in its dawning practice in the Philippines, healthcare professionals (i.e., geneticists, practitioners) practicing genetic counseling and students in the pioneering genetic counseling program face the challenge of how to provide culturally appropriate measures in respecting Filipinos' autonomy. There is much deliberation with respect to identifying autonomous decision making among Filipino patients as counselees in genetic counseling. Cultural values influence how autonomy and bioethical principles are upheld. In a culturally-appropriate manner of identifying who makes health care and genetic counseling decisions, the sole focus on an individualistic perspective may be too western-based and may render genetic counseling less effective. The uniquely important cultural feature of family cohesiveness necessitates its incorporation into the practice of genetic counseling in the Philippines.

[Deficits in medical counseling in olfactory dysfunction].

Science.gov (United States)

Haxel, B R; Nisius, A; Fruth, K; Mann, W J; Muttray, A

2012-05-01

Olfactory dysfunctions are common with a prevalence of up to 20% in the population. An impaired sense of smell can lead to specific dangers, therefore, counseling and warning of hazardous situations to raise patient awareness is an important medical function. In this study 105 patients presenting to the University of Mainz Medical Centre with dysosmia were evaluated using a questionnaire. For quantification of the olfactory dysfunction a standardized olfactory test (Sniffin' Sticks) was used. Of the patients 46% were hyposmic and 40% were functionally anosmic. The median duration of the olfactory impairment was 10 months and the main causes of dysosmia were upper respiratory tract infections and idiopathic disorders. More than 90% of the patients consulted an otorhinolaryngologist and 60% a general practitioner before presenting to the University of Mainz Medical Center. More than two thirds of the patients conducted a professional activity, 95% of patients reported that they had not received any medical counseling and 6% of the subjects were forced to discontinue their profession because of olfactory dysfunction. In patients with olfactory dysfunctions appropriate diagnostics, including olfactometry should be performed. Furthermore, correct medical counseling concerning necessary additional arrangements (e.g. installation of smoke or gas detectors, precautions while cooking or for hygiene) has to be performed. For patients in a profession an analysis of the hazards at work is crucial.

The effects of Risk Factor-Targeted Lifestyle Counselling Intervention on working-age stroke patients' adherence to lifestyle change.

Science.gov (United States)

Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi

2017-09-01

Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.

A new computer-based counselling system for the promotion of physical activity in patients with chronic diseases--results from a pilot study.

Science.gov (United States)

Becker, Annette; Herzberg, Dominikus; Marsden, Nicola; Thomanek, Sabine; Jung, Hartmut; Leonhardt, Corinna

2011-05-01

To develop a computer-based counselling system (CBCS) for the improvement of attitudes towards physical activity in chronically ill patients and to pilot its efficacy and acceptance in primary care. The system is tailored to patients' disease and motivational stage. During a pilot study in five German general practices, patients answered questions before, directly and 6 weeks after using the CBCS. Outcome criteria were attitudes and self-efficacy. Qualitative interviews were performed to identify acceptance indicators. Seventy-nine patients participated (mean age: 64.5 years, 53% males; 38% without previous computer experience). Patients' affective and cognitive attitudes changed significantly, self-efficacy showed only minor changes. Patients mentioned no difficulties in interacting with the CBCS. However, perception of the system's usefulness was inconsistent. Computer-based counselling for physical activity related attitudes in patients with chronic diseases is feasible, but the circumstances of use with respect to the target group and its integration into the management process have to be clarified in future studies. This study adds to the understanding of computer-based counselling in primary health care. Acceptance indicators identified in this study will be validated as part of a questionnaire on technology acceptability in a subsequent study. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Adults' perceptions of genetic counseling and genetic testing.

Science.gov (United States)

Houfek, Julia Fisco; Soltis-Vaughan, Brigette S; Atwood, Jan R; Reiser, Gwendolyn M; Schaefer, G Bradley

2015-02-01

This study described the perceptions of genetic counseling and testing of adults (N = 116) attending a genetic education program. Understanding perceptions of genetic counseling, including the importance of counseling topics, will contribute to patient-focused care as clinical genetic applications for common, complex disorders evolve. Participants completed a survey addressing: the importance of genetic counseling topics, benefits and negative effects of genetic testing, and sharing test results. Topics addressing practical information about genetic conditions were rated most important; topics involving conceptual genetic/genomic principles were rated least important. The most frequently identified benefit and negative effect of testing were prevention/early detection/treatment and psychological distress. Participants perceived that they were more likely to share test results with first-degree than other relatives. Findings suggest providing patients with practical information about genetic testing and genetic contributions to disease, while also determining whether their self-care abilities would be enhanced by teaching genetic/genomic principles. Copyright © 2014 Elsevier Inc. All rights reserved.

User evaluation of patient counselling, combining nurse consultation and eHealth in hand eczema.

Science.gov (United States)

Mollerup, Annette; Harboe, Gitte; Johansen, Jeanne D

2016-04-01

This study reports the findings from a user evaluation of a counselling programme for hand eczema patients in which face-to-face encounters were supplemented with user access to a new website. Patients treated for hand eczema in two different settings were included consecutively. Website utilization was examined by use of the transaction log. Comparisons were made between participants who used the website and those who did not. The patients' perspectives were explored by the use of interviews. Among potential website users (n = 140), 88 patients (63%) had an average of 5.1 site visits. At follow-up, the website users had improved more in quality of life (p = 0.014), current burden of disease (p = 0.053), and itching (p = 0.042). The website users reported more changes in habits than did the non-website users (p = 0.024). No differences in clinical severity of hand eczema were found. The interviewees were generally satisfied with the counselling and the website. The strict log-on procedures were considered to be an obstacle to using the site. The consecutive inclusion of participants was considered to be a barrier to engagement in the dialogue forum. The website users benefited from the website, although this was not substantiated by clinical measurements. The trial design partly hampered website utilization. An initial feasibility study could have been warranted. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of the FOCUS (Feedback on Counseling Using Simulation) instrument for assessment of client-centered nutrition counseling behaviors.

Science.gov (United States)

Henry, Beverly W; Smith, Thomas J

2010-01-01

To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise. Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern university-10 Caucasian, 1 African-American-for the simulated counseling sessions, in which the Feedback on Counseling Using Simulation (FOCUS) instrument was applied in 2 SP scenarios (cardiovascular disease and diabetes). FOCUS ratings of student-counselors by 4 SPs during 22 sessions were compared with ratings from a 3-member panel of experts who independently viewed the 22 videotaped sessions. Quantitative analysis of instrument validity included inter-rater reliability by computing generalizability coefficients, Pearson correlations, and Spearman rank-order correlations. FOCUS criteria encompassed relevant dimensions of nutrition counseling based in a client-centered perspective. The critical points of information gathering and counseling behaviors showed internal consistency overall and good inter-rater reliability with the cardiovascular disease scenario. For both scenarios, pooled ratings of 3 experts agreed with ratings carried out by SPs. Initial findings suggest that the FOCUS instrument with client-centered criteria may enhance evaluation of counseling skills in SP exercises, meriting further study with larger groups.

Improved OSC Amtec generator design to meet goals of JPL's candidate Europa Orbiter mission

International Nuclear Information System (INIS)

Schock, A.; Noravian, H.; Or, C.; Kumar, V.

1998-01-01

The preceding paper (Paper IECEC.98.244) described OSC's initial designs of AMTEC (Alkali Metal Thermal-to-Electrical Conversion) power systems, consisting of one or two generators, each with 2, 3, or 4 General Purpose Heat Source (GPHS) modules and with 16 refractory AMTEC cells containing 5 Beta Alumina Solid Electrolyte (BASE) tubes; and presented the effect of heat input and voltage output on the generator's BOM evaporator and clad temperatures and on its EOM system efficiency and power output. Comparison of the computed results with JPL's goals for the Europa Orbiter mission showed that all of the initial 16-cell design options yielded either excessive evaporator and clad temperatures or insufficient EOM power to satisfy the JPL-specified mission goals. The present paper describes modified OSC generator designs with different numbers of AMTEC cells, cell diameters, cell lengths, cell materials, BASE tube lengths, and number of tubes per cell. These efforts succeeded in identifying generator designs with only half the number of AMTEC cells which -- for the same assumptions -- can produce EOM power outputs substantially in excess of JPL's goals for NASA's Europa Orbiter mission while operating well below the prescribed BOM limits on evaporator and clad temperature; and revealed that lowering the emissivity of the generator's housing to raise the cells' condenser temperatures can achieve substantial additional performance improvement. Finally, the paper culminates in programmatic recommendations

The efficacy of motivational counseling and SMS-reminders on daily sitting time in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Esbensen, Bente Appel; Thomsen, Tanja; Hetland, Merete L

2015-01-01

group receiving usual care. The intervention includes: 1) individual motivational counseling (in total 3 sessions) on reduction of daily sitting time in combination with 2) individual Short Text Message Service (SMS) reminders over a 16-week intervention period. Primary outcome is change in daily...... that SB can be reduced by behavioural interventions in healthy populations. However, it remains unexplored whether it is valid for patients with RA also. Therefore, the aim of this trial is to investigate the efficacy of an individually tailored, theory-based motivational counseling intervention......, and finally to assess the cost-effectiveness of the intervention. METHODS/DESIGN: For this parallel group randomized trial, 150 patients with RA and at least 5 hours of sitting time per day, will be recruited from a rheumatology outpatient clinic, and block-randomized to the intervention group or the control...

The influence of a patient-counseling course on the communication apprehension, outcome expectations, and self-efficacy of first-year pharmacy students.

Science.gov (United States)

Rogers, Erica R; King, Sean R

2012-10-12

To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course. First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters. Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion. Communication apprehension may be decreased and self-efficacy for communication increased in first-year PharmD students through a 15-week Nonprescription Drugs/Patient-Counseling course using small-group practice sessions, case studies, and role-play exercises in conjunction with classroom lectures.

[Pharmaceutical counseling of non-conventional dosage forms concerning the health-literacy and the patient adherence in public medication dispensing -Questionnaire surveys in Hungarian community pharmacies.

Science.gov (United States)

Somogyi, O; Zelko, R

Although the non-conventional dosage forms (e.g. modified release per oral systems or transdermal patches) have more significant advantages than other conventional dosage forms, the pa- tients have to apply them correctly in their home medicine using to reach the effective and safe therapy. A guideline of relevant application instructions contribute to development of an effective pharmaceutical counseling in community pharmacies. The counseling and advices can improve the patients' knowledge concerning application rules of different new dosage forms (health- literacy) with patient adherence. Finally it will result more effective and safer therapies. The aim of our Hungarian questionnaire surveys was to explore the patients' drug application habits or application errors and improve special verbal counseling of mentioned non-conventional dosage forms in community pharmacies. Understandable patient information leaflets were developed about application rules and besides the levels of patients' reading comprehension was evaluated in case of the leaflet of medicinal patches. The results show that a properly developed text is useful for the majority of patients but they need the verbal explanation as well, moreover there is a demand for the verbal counseling in community pharmacies. The most common application errors were explored and the most effective instructions or application rules were collected for the pharmacists and patients concerning the modified release tablets or capsules and transdermal patches.

Current attitudes and practices of obesity counselling by health care providers.

Science.gov (United States)

Petrin, Christine; Kahan, Scott; Turner, Monique; Gallagher, Christine; Dietz, William H

Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity. Obesity (77%), obesity-related diseases (79%), or obesity-related risk factors (71%) prompt HCPs to offer obesity counselling; 59% of HCPs wait for the patient to broach the subject of their weight. Increased blood pressure (89%) and heart disease risks (90%) are the most common themes in counselling. Across all HCPs except NPs "exercise" is discussed more frequently than "physical activity" (85% vs 81%), "diet" more frequently than "eating habits" (77% vs 75%), and "obesity" more frequently than "unhealthy weight" (60% vs 45%). NPs are more likely to discuss physical activity, eating habits, and unhealthy weight instead. To improve counselling for obesity, HCPs reported needing more time (70%), training in obesity management (53%), improved reimbursement (53%), and better tools to help patients recognise obesity risks (50%). Obesity-related diseases, risk factors, or obesity alone predict obesity counselling amongst HCPs. Better training in weight management and tools to help patients recognise risks appear to be key elements in helping patients compare the risks of what they may consider invasive therapy against the risks of continued obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Investigating the condition of medical counseling and some of clinical aspects for fasting in holy month of Ramadan from the perspective of diabetic and hypertensive patients

Directory of Open Access Journals (Sweden)

Ahmad Mahmoudian

2015-06-01

Full Text Available Introduction: Although fasting has many benefits for health, it can be dangerous for patients. So it is necessary that physicians have adequate information about clinical aspects of fasting and they should advice patients. Therefore in this study we analyses the condition of physicians counseling about fasting from the perspective of patients. Methods:In this descriptive analytical cross-sectional study, patients with diabetes and hypertension who were going to doctors in Isfahan in holy month of Ramadan of 2012 and 2013 completed the questionnaires. A valid self-regulation questionnaire including patient`s satisfaction from the quality of physicians counseling about fasting (In the area of education, evaluation of the patient condition, communication /relationship with patients, caring for diseases in holy Ramadan and the incidence of symptoms in fasting had been used with  = 0.76. The patients completed the questionnaire after visit. The data was analyzed by Independent t-test, chi-square, Regression, one-way ANOVA in the19 spss software. Results: 285 patients, 199(69.8% female and 86(30.2% male, were selected. The mean satisfaction score of counseling was 70.50 ±13.23. The highest score (75.36±14.16 was referred to counseling of physician, and the least score (66.09±18.84 to patient assessment by physician. Mean score of Patients' satisfaction of specialists was higher than of general practitioner (p-value

Counselling in infertility: individual, couple and group interventions.

Science.gov (United States)

Van den Broeck, Uschi; Emery, Marysa; Wischmann, Tewes; Thorn, Petra

2010-12-01

Infertility is considered a biopsychosocial crisis and infertility counselling is recommended as an integral part of a multidisciplinary approach. This article will outline the theoretical background and describe common interventions used in infertility counselling for individuals, couples and in a group setting. This article summarizes the proceedings of the first campus workshop of the Special interest group of Psychology and Counselling of the European Society for Human Reproduction and Embryology (ESHRE). Infertility counselling offers the opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully when fertility impairments have been diagnosed. The Heidelberg Fertility Consultation Service is presented as a framework for individual and couples counselling and highlights important issues in counselling patients. For group work a number of steps to set up a group within an infertility framework are discussed. In recent years, infertility counselling has become a specialist form of counselling requiring professional expertise and qualification. Key issues and common interventions are presented to raise awareness for the specific counselling needs of individuals and couples experiencing infertility and undergoing medical treatment. Mental health professionals new to the field of reproductive technologies as well as those in other areas of mental health counselling clients with fertility disorders can benefit from the topics addressed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Moral counselling: a method in development.

Science.gov (United States)

de Groot, Jack; Leget, Carlo

2011-01-01

This article describes a method of moral counselling developed in the Radboud University Medical Centre Nijmegen (The Netherlands). The authors apply insights of Paul Ricoeur to the non-directive counselling method of Carl Rogers in their work of coaching patients with moral problems in health care. The developed method was shared with other health care professionals in a training course. Experiences in the course and further practice led to further improvement of the method.

Counseling on Early Childhood Caries transmission by dentists.

Science.gov (United States)

Milgrom, Peter; Huebner, Colleen E; Mancl, Lloyd; Garson, Gayle; Grembowski, David

2013-01-01

High levels of Streptococcus mutans on teeth of young children are predictive of Early Childhood Caries (ECC). Transmission from mother-to-child is common and studies have demonstrated treatment of the mother results in less ECC. The objective of this study was to determine how dentists have adopted the practice of counseling about ECC. In 2006 as part of a larger study on dental care for pregnant women, we surveyed 829 general dentists in Oregon. The questionnaire contained questions to capture the extent to which general dentists have adopted counseling pregnant women about ECC transmission, to describe personal and practice characteristics, and examine how dentists' views on the ease of adopting of new procedures related to ECC counseling. Multivariate logistic regression was used to identify separate and additive effects of demographic and practice characteristics, attitudes, and beliefs. The adjusted odds of a dentist who strongly believed in the link between mothers and babies and provided ECC counseling were 1.60 (95% CI 1.3-2.0, P<0.01). The odds of a dentist who reported discussing ECC with staff members and provided counseling were 2.7 (95% CI 1.7-4.3, P<0.01). Male dentists were less likely to counsel patients than female dentists (Adjusted OR=0.5, 95% CI 0.3-1.0, p<0.05). The strongest predictors of counseling patients about ECC were dentists' belief in the evidence of caries transmission and dentists' discussion of ECC during staff meetings. © 2012 American Association of Public Health Dentistry.

Indigenous counseling: A needed area in school counseling in Nigeria

African Journals Online (AJOL)

Indigenous counselling has not been given attention in Nigeria's school counselling programme. This counselling gap was created by European colonialism, which succeeded in developing in the minds of the African that anything indigenous is local, unscientific and unorthodox. Indigenous counselling is one of the ...

Virginia Tech's Cook Counseling Center receives international counseling accreditation

OpenAIRE

DeLauder, Rachel

2010-01-01

The Virginia Tech Thomas E. Cook Counseling Center has been accredited by the International Association of Counseling Services, Inc., an organization of United States, Canadian, and Australian counseling agencies based in Alexandria, Va.

Communication skills of medical students during the OSCE: Gender-specific differences in a longitudinal trend study.

Science.gov (United States)

Graf, Joachim; Smolka, Robert; Simoes, Elisabeth; Zipfel, Stephan; Junne, Florian; Holderried, Friederike; Wosnik, Annette; Doherty, Anne M; Menzel, Karina; Herrmann-Werner, Anne

2017-05-02

Communication skills are essential in a patient-centred health service and therefore in medical teaching. Although significant differences in communication behaviour of male and female students are known, gender differences in the performance of students are still under-reported. The aim of this study was to analyse gender differences in communication skills of medical students in the context of an OSCE exam (OSCE = Objective Structured Clinical Examination). In a longitudinal trend study based on seven semester-cohorts, it was analysed if there are gender differences in medical students' communication skills. The students (self-perception) and standardized patients (SP) (external perception) were asked to rate the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests in SPSS 21. Across all ratings in the self- and the external perception, there was a significant gender difference in favour of female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception between 2011 and 2014. It is important to consider if gender-specific teaching should be developed, considering the reported differences between female and male students.

Effectiveness and cost effectiveness of counselling in primary care.

Science.gov (United States)

Bower, P; Rowland, N; Mellor, C l; Heywood, P; Godfrey, C; Hardy, R

2002-01-01

Counsellors are prevalent in primary care settings. However, there are concerns about the clinical and cost-effectiveness of the treatments they provide, compared with alternatives such as usual care from the general practitioner, medication or other psychological therapies. To assess the effectiveness and cost effectiveness of counselling in primary care by reviewing cost and outcome data in randomised controlled trials, controlled clinical trials and controlled patient preference trials of counselling interventions in primary care, for patients with psychological and psychosocial problems considered suitable for counselling. The original search strategy included electronic searching of databases (including the CCDAN Register of RCTs and CCTs) along with handsearching of a specialist journal. Published and unpublished sources (clinical trials, books, dissertations, agency reports etc.) were searched, and their reference lists scanned to uncover further controlled trials. Contact was made with subject experts and CCDAN members in order to uncover further trials. For the updated review, searches were restricted to those databases judged to be high yield in the first version of the review: MEDLINE, EMBASE, PSYCLIT and CINAHL, the Cochrane Controlled Trials register and the CCDAN trials register. All controlled trials comparing counselling in primary care with other treatments for patients with psychological and psychosocial problems considered suitable for counselling. Trials completed before the end of June 2001 were included in the review. Data were extracted using a standardised data extraction sheet. The relevant data were entered into the Review Manager software. Trials were quality rated, using CCDAN criteria, to assess the extent to which their design and conduct were likely to have prevented systematic error. Continuous measures of outcome were combined using standardised mean differences. An overall effect size was calculated for each outcome with 95

Paediatrician knowledge, attitudes, and counselling patterns on teen driving.

Science.gov (United States)

Weiss, Jeffrey C; O'Neil, Joseph; Shope, Jean T; O'Connor, Karen G; Levin, Rebecca A

2012-02-01

Motor vehicle crashes (MVCs) are the leading cause of death among teenagers. Little is known about the content of US paediatrician counselling about teen driving. To examine US paediatrician knowledge, attitudes, and counselling patterns regarding teen driving. A random sample questionnaire was mailed to American Academy of Pediatrics members in 2009 (n=1606; response=875 (55%)). Analysis was limited to 596 paediatricians who provide adolescent checkups. Questions addressed counselling and attitudes towards roles in promoting safe driving. Logistic regression assessed the relationship between counselling topics and practice characteristics. Most (89%) respondents provide some counselling about driving. Two topics commonly discussed by paediatricians were seatbelts (87%) and alcohol use (82%). Less frequently discussed were: cell phones (47%), speeding (43%), and dangers of transporting teen passengers (41%). Topics rarely discussed were: night driving (21%), graduated driver licensing laws (13%), safe cars (9%), driver education (9%), fatigue (25%), and parental limit setting (23%). Only 10% ever recommend a parent-teen driver agreement. Paediatricians who had a patient injured or killed in an MVC were more likely to discuss night driving (OR=2.86). Physicians caring for a high proportion of adolescents (OR=1.83) or patients with private insurance (OR=1.85) counsel more about the risks of driving with teen passengers. Paediatricians in the USA support counselling on teen driving during routine office visits, but omit many important risk factors. Few recommend parent-teen driver agreements. Methods that help clinicians efficiently and effectively counsel families about teen driving should be developed.

34 CFR 106.36 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling... Programs or Activities Prohibited § 106.36 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the counseling or...

Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial.

Science.gov (United States)

Periasamy, Ummavathy; Mohd Sidik, Sherina; Rampal, Lekhraj; Fadhilah, Siti Irma; Akhtari-Zavare, Mehrnoosh; Mahmud, Rozi

2017-05-15

Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia. A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on 'Managing Patients on Chemotherapy' by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses. In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial Ƞ 2  = 0.66), psychological (p = 0.001, partial Ƞ 2  = 0.65), social relationships (p = 0.001, partial Ƞ 2  = 0.30), and environment (p = 0.001, partial Ƞ 2  = 0.67) and decrease in the anxiety (p = 0.000; partial Ƞ 2  = 0.23), depression (p = 0.000; partial Ƞ 2  = 0.40). The module on 'Managing Patients on Chemotherapy' along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy

Development and implementation of an objective structured clinical examination to provide formative feedback on communication and interpersonal skills in geriatric training.

Science.gov (United States)

O'Sullivan, Patricia; Chao, Serena; Russell, Matthew; Levine, Sharon; Fabiny, Anne

2008-09-01

Teaching and assessment of communication and interpersonal skills, one of the American Council for Graduate Medical Education-designated core competencies, is an important but difficult task in the training of physicians. Assessment of trainees offers an opportunity to provide explicit feedback on their skills and encourages learning. This article describes a pilot study in which clinician-educators affiliated with the geriatrics training programs at Beth Israel Deaconess Medical Center and Boston University Medical Center designed and piloted a novel Objective Structured Clinical Examination (OSCE) to assess the communication and interpersonal skills of medical, dental, and geriatric psychiatry fellows. The OSCE consisted of three stations where geriatricians and standardized patients evaluated candidates using specifically designed checklists and an abbreviated version of the Master Interview Rating Scale. Communication skills were assessed through performance of specific "real life" clinical tasks, such as obtaining a medical history, explaining a diagnosis and prognosis, giving therapeutic instructions, and counseling. Interpersonal skills were assessed through the effect of the communication between doctor and standardized patient on fostering trust, relieving anxiety, and establishing a therapeutic relationship. This pilot study demonstrated that the OSCE format of assessment provides a valid means of evaluating the communication and interpersonal skills of interdisciplinary geriatric trainees and provides a valuable forum for formative assessment and feedback. Given that geriatricians and non geriatricians involved in elder care both need communication and interpersonal skills, this novel OSCE can be used for assessment of these skills in trainees in diverse healthcare subspecialties.

Provider self-disclosure during contraceptive counseling.

Science.gov (United States)

McLean, Merritt; Steinauer, Jody; Schmittdiel, Julie; Chan, Pamela; Dehlendorf, Christine

2017-02-01

Provider self-disclosure (PSD) - defined as providers making statements regarding personal information to patients - has not been well characterized in the context of contraceptive counseling. In this study, we describe the incidence, content and context of contraceptive PSD. This mixed methods analysis used data from the Provider-Patient Contraceptive Counseling study, for which 349 family planning patients were recruited from 2009 to 2012 from six clinics in the San Francisco Bay Area. Audio-recordings from their visits were analyzed for the presence or absence of PSD, and those visits with evidence of PSD were analyzed using qualitative methods. The associations of patient and provider demographics and patient satisfaction measures, obtained from survey data, with PSD were analyzed using bivariable and multivariable analyses. Thirty-seven percent of providers showed evidence of PSD during at least one visit, and PSD occurred in 9% of clinic visits. Fifty-four percent of PSD statements were about intrauterine devices. About half of PSD statements occurred prior to the final selection of the contraceptive method and appeared to influence the choice of method. In post-visit surveys, all patients who reported receiving PSD considered it to be appropriate, and patient-reported PSD was not statistically associated with measures of patient satisfaction. This study provides some support for the appropriateness of PSD during family planning encounters, at least as practiced during the sampled visits. Further research could explore whether this counseling strategy has an impact on patients' ability to identify the best contraceptive methods for them. In this study, PSD did not have a demonstrated negative effect on the provider-patient relationship. In almost half of visits, PSD appeared to influence patients' choice of a method; whether this influence is beneficial needs further research. Copyright © 2017 Elsevier Inc. All rights reserved.

45 CFR 618.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling... Activities Prohibited § 618.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the counseling or guidance of...

45 CFR 2555.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling... Activities Prohibited § 2555.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the counseling or guidance of...

32 CFR 196.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling... Programs or Activities Prohibited § 196.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the counseling or...

Evaluation of HIV counselling and testing, self-disclosure, social support and sexual behaviour change among a rural sample of HIV reactive patients in South Africa

Directory of Open Access Journals (Sweden)

E Sethosa

2005-09-01

Full Text Available The aim of this study was to evaluate HIV counselling and testing, self-disclosure, social support and sexual behavior change among HIV reactive patients among a rural sample of HIV reactive patients in South Africa. The sample consisted at the post-test counselling exit interview of 55 participants (41 women and 14 men who tested HIV-positive conveniently selected from a rural hospital and at five months follow-up at their homes 47. Results indicated that most patients had an HIV test because of medical reasons. At follow-up only 36% had disclosed their HIV status and half of the participants had had sex without condoms in the past three weeks. Major reason for not disclosing of their HIV status were being afraid of negative reactions, fear of discrimination, fear of violence, concerns about confidentiality and not yet ready. Social support was found to be significantly related to disclosure of HIV status, while counselling context and content and counselling satisfaction were not related with HIV disclosure.

Alternate service delivery models in cancer genetic counseling: a mini-review

Directory of Open Access Journals (Sweden)

Adam Hudson Buchanan

2016-05-01

Full Text Available Demand for cancer genetic counseling has grown rapidly in recent years as germline genomic information has become increasingly incorporated into cancer care and the field has entered the public consciousness through high-profile celebrity publications. Increased demand and existing variability in the availability of trained cancer genetics clinicians place a priority on developing and evaluating alternate service delivery models for genetic counseling. This mini-review summarizes the state of science regarding service delivery models such as telephone counseling, telegenetics and group counseling. Research on comparative effectiveness of these models in traditional individual, in-person genetic counseling has been promising for improving access to care in a manner acceptable to patients. Yet, it has not fully evaluated the short- and long-term patient- and system-level outcomes that will help answer the question of whether these models achieve the same beneficial psychosocial and behavioral outcomes as traditional cancer genetic counseling. We propose a research agenda focused on comparative effectiveness of available service delivery models and how to match models to patients and practice settings. Only through this rigorous research can clinicians and systems find the optimal balance of clinical quality, ready and secure access to care, and financial sustainability. Such research will be integral to achieving the promise of genomic medicine in oncology.

Genetic and family counselling for schizophrenia: Where do we ...

African Journals Online (AJOL)

Background: Recent genetic findings have led to profound changes in genetic and family counselling for schizophrenia patients and their families. Objectives: The article gives an overview of the present knowledge regarding the genetic and family counselling for schizophrenia. Method: Literature searches were performed ...

Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling.

Science.gov (United States)

Vadstrup, Eva S; Frølich, Anne; Perrild, Hans; Borg, Eva; Røder, Michael

2011-12-07

Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R). In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12) within the rehabilitation group and 5.6 points (p = 0.03) points among individual counselling participants.In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04). No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01) and 0.34 points within the individual counselling group (p group cardiovascular distress decreased 0.25 points (p = 0.01). A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling programme

Health-related quality of life and self-related health in patients with type 2 diabetes: Effects of group-based rehabilitation versus individual counselling

Directory of Open Access Journals (Sweden)

Vadstrup Eva S

2011-12-01

Full Text Available Abstract Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36 and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R. Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12 within the rehabilitation group and 5.6 points (p = 0.03 points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04. No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01 and 0.34 points within the individual counselling group (p p = 0.01. Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling

Counselling low-back-pain patients in secondary healthcare: a randomised trial addressing experienced workplace barriers and physical activity.

Science.gov (United States)

Jensen, Lone Donbæk; Maribo, Thomas; Schiøttz-Christensen, Berit; Madsen, Finn Hjorth; Gonge, Bigitte; Christensen, Michael; Frost, Poul

2012-01-01

To assess if counselling by an occupational physician (OP) addressing experienced workplace barriers and physical activity integrated as a part of low-back pain (LBP) outpatient treatment influences pain, function and sick leave. Randomised controlled trial in the secondary healthcare sector with 3 months' follow-up. The participants were LBP patients who, independently of sick-leave status, expressed concerns about the ability to maintain their current job. Patients referred for surgery were excluded. The intervention consisted of two counselling sessions conducted by an OP addressing both workplace barriers and leisure-time physical activity. A workplace visit was performed if required. Pain, function and duration of sick leave due to LBP were primary outcomes. A reduction in bodily pain and improvement in physical function both measured by the 36-item short-form health survey questionnaire in favour of the intervention group was found. The change in pain score was found to be clinically relevant. The risk of sick leave for at least 8 weeks due to LBP was significantly reduced in the intervention group. Two secondary outcomes, Fear Avoidance Beliefs about physical activity and maximum oxygen uptake, supported compliance and adherence to the part of the intervention focusing on enhanced physical activity. Two short counselling sessions by an OP combining advice on meeting workplace barriers and enhancing physical activity had a substantial effect on important prognostic factors for LBP patients with moderate to severe symptoms diagnosed in outpatient rheumatological clinics. Current Controlled Trials ISRCTN13071157.

Group versus individual family planning counseling in Ghana: a randomized, noninferiority trial.

Science.gov (United States)

Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J

2013-08-01

Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana. Copyright © 2013 Elsevier Inc. All rights reserved.

Genetic counselling, BRCA1/2 status and clinico-pathologic characteristics of patients with ovarian cancer before 50 years of age

Directory of Open Access Journals (Sweden)

Cvelbar Mirjam

2017-05-01

Full Text Available In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years.

Counselling low-back-pain patients in secondary healthcare: a randomised trial addressing experienced workplace barriers and physical activity

DEFF Research Database (Denmark)

Jensen, Lone Donbæk; Maribo, Thomas; Schiøttz-Christensen, Berit

2012-01-01

OBJECTIVE: To assess if counselling by an occupational physician (OP) addressing experienced workplace barriers and physical activity integrated as a part of low-back pain (LBP) outpatient treatment influences pain, function and sick leave. METHODS: Randomised controlled trial in the secondary...... healthcare sector with 3 months' follow-up. The participants were LBP patients who, independently of sick-leave status, expressed concerns about the ability to maintain their current job. Patients referred for surgery were excluded. The intervention consisted of two counselling sessions conducted by an OP......-form health survey questionnaire in favour of the intervention group was found. The change in pain score was found to be clinically relevant. The risk of sick leave for at least 8 weeks due to LBP was significantly reduced in the intervention group. Two secondary outcomes, Fear Avoidance Beliefs about...

[Dietary counseling in obesity].

Science.gov (United States)

Meyer, Nathalie; Haslebacher, Yvonne; Teuscher-Sick, Patricia; Fischer, Beatrice

2013-02-01

Information on weight management and a healthy eating is accessible to anyone. However, recommendations are inconsistent. This often leads to confusion rather than to real changes in eating behavior. The principle of a long-term weight reduction is based on the idea of achieving negative energy balance with a healthy, balanced and slightly hypocaloric diet. The regimen is neither supposed to be rigid nor should it ban any food products or food products. Changes in eating patterns come about step by step and the counseling approach should be based on the patient's habits and capabilities. The basic requirement to successfully treat obese patients is their own motivation Therefore, the timing of launching the therapy needs to be well chosen. Apart from goals directly concerning weight loss, goals related to well-being, general health and exercise should be set and pursued. However, the main focus should be on changes of dietary behavior. Dietary counseling is preferably embedded in a multidisciplinary treatment concept.

Psychology, Counseling Psychology, and Professional Counseling: Shared Roots, Challenges, and Opportunities

Directory of Open Access Journals (Sweden)

Peggy Brady-Amoon

2017-02-01

Full Text Available Psychology, counseling psychology, and professional counseling are at a crossroad. The growing movement to establish professional counseling as a distinct profession, based on an increasingly narrow definition of professional identity, is particularly relevant to counseling psychologists and professional counselors and has implications for the broader field of psychology. A brief systematic historical analysis of these professional specialties in the U.S. provides the context to examine current challenges, including proposed restriction of master’s level training, licensure or other authorization to practice, and employment to graduates of programs accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP. These restrictions reduce services to the public and threaten the viability of counseling psychology and professional counseling in the U.S. These challenges also have significant implications for counseling psychologists in Europe and internationally given similar efforts. Going beyond a call to action, the article concludes with recommendations for counseling psychologists and allied professionals to address shared challenges, maximize shared opportunities, and foster enhanced intra- and inter-professional collaboration and cooperation.

Translation and adaption of the Genetic Counseling Outcome Scale (GCOS-24) to Danish

DEFF Research Database (Denmark)

Diness, Birgitte Rode; Overbeck, Gritt; Duelund, T.

2013-01-01

Background and aim: The ability to measure patient outcomes from genetic counselling is a prerequisite for evidencebased development of practice. The Genetic Counselling Outcome Scale (GCOS-24) is a recently developed patient reported outcome measure. The aim of this project was to develop a Danish...... perception of genetic counseling and genetic conditions and led to adjustments of the original translation, leading to development of a tool better-suited to the target population. We would recommend the described approach when attempting translation of patient reported outcome measures...

Counseling the pregnant adolescent.

Science.gov (United States)

Dibiasi, V; Sturgis, S H

1980-07-01

Approaches employed in counseling pregnant adolescents at the Crittenton Clinic in Boston are described. Concentrating on concrete issues of management of the pregnancy -- supplying information and exploring the pros and cons of various alternatives are advocated; probing into the psychological and emotional background of the pregnant adolescent is discouraged. Counseling about contraceptives and taking into account each individual situation are considered essential. Case studies are reviewed and figures representing the attitudes and contraceptive use of patients 1 year after abortion are presented. It is considered important to establish a trusting relationship with the adolescent, which will increase the likelihood that she will return for follow-up and additional help if she needs it.

Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial.

Science.gov (United States)

King, M; Marston, L; Bower, P

2014-07-01

Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.

Counseling activity in single-session online counseling with adolescents: an adherence study.

Science.gov (United States)

Chardon, Lydia; Bagraith, Karl S; King, Robert John

2011-09-01

While online counseling is increasingly utilized, little is known about what counseling work takes place in the online environment. The aim of this study was to quantify online counseling activity by determining counselors' adherence to the widely used model in which they had been trained. Transcripts (n=85) of online counseling with adolescents were evaluated, using a standardized and psychometrically sound instrument. We found that, while counseling in 53% of transcripts progressed through each of the key stages of counseling, the focus of most sessions was information gathering; and goal exploration and action planning were typically superficial and often absent. Possible reasons for low counseling depth are discussed and recommendations made for the further development of online counseling.

14 CFR 1253.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling materials. 1253.425 Section 1253.425 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE... § 1253.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall...

38 CFR 23.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling materials. 23.425 Section 23.425 Pensions, Bonuses, and Veterans' Relief DEPARTMENT... Activities Prohibited § 23.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A...

13 CFR 113.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling materials. 113.425 Section 113.425 Business Credit and Assistance SMALL BUSINESS... Activities Prohibited § 113.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A...

Process Predictors of the Outcome of Group Drug Counseling

Science.gov (United States)

Crits-Christoph, Paul; Johnson, Jennifer E.; Connolly Gibbons, Mary Beth; Gallop, Robert

2013-01-01

Objective: This study examined the relation of process variables to the outcome of group drug counseling, a commonly used community treatment, for cocaine dependence. Method: Videotaped group drug counseling sessions from 440 adult patients (23% female, 41% minority) were rated for member alliance, group cohesion, participation, self-disclosure,…

Psychotherapeutic Counseling and Pregnancy Rates in In Vitro Fertilization

OpenAIRE

Poehl, Michaela; Bichler, Katherina; Wicke, Veronika; Dörner, Veronika; Feichtinger, Wilfried

1999-01-01

Purpose:Since the Austrian propagation bill of July 1, 1992, was passed into law, Austrian physicians are committed to offer psychological counseling to women before performing assisted reproductive techniques, unless refused by the patient. The acceptance of psychotherapeutic counseling (PSITCO) and its influence on pregnancy rate were carefully reviewed.

Customer interest in and experience with various types of pharmacy counselling - a qualitative study.

Science.gov (United States)

Kaae, Susanne; Traulsen, Janine M; Nørgaard, Lotte S

2014-12-01

Despite pharmacists' extensive knowledge in the optimization of patients' medical treatments, community pharmacies are still fighting to earn patients' trust with respect to medicinal counselling at the counter. The aim was to investigate how patients perceive pharmacy counselling at the present time, in order to develop the patient-pharmacy relationship for the benefit of both patients and pharmacies. Short semi-structured interviews were carried out with pharmacy customers by pharmacy internship students. One hundred and eight customers in 35 independent pharmacies across Denmark were interviewed during the spring of 2011. Customers were interviewed about their expectations of pharmacies in general and their experiences with medical counselling in particular. Customers perceive community pharmacies very differently in terms of both expectations of and positive experiences with counselling. They appear to be in favour of pharmacy counselling with respect to over-the-counter medicine and first-time prescription medicine in contrast to refills. Customers find it difficult to express the health-care role of pharmacies even when experiencing and appreciating it. Lack of appreciation of pharmacy counselling for refill prescription medicine and the difficulty in defining the role of pharmacies might stem from the difficulties that customers have in understanding medicine and thus the role of counselling services with respect to medicine. The pharmacy staff does not seem to realize these barriers. For pharmacies to encourage customer interest in pharmacy counselling, the staff should start taking the identified barriers into account when planning communication strategies. © 2012 John Wiley & Sons Ltd.

24 CFR 3.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Counseling and use of appraisal and counseling materials. 3.425 Section 3.425 Housing and Urban Development Office of the Secretary, Department... Activities Prohibited § 3.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A...

29 CFR 36.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Counseling and use of appraisal and counseling materials. 36... in Education Programs or Activities Prohibited § 36.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of...

31 CFR 28.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling materials. 28.425 Section 28.425 Money and Finance: Treasury Office of the Secretary of the....425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not...

10 CFR 1042.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling materials... on the Basis of Sex in Education Programs or Activities Prohibited § 1042.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

49 CFR 25.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 25.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

18 CFR 1317.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Counseling and use of appraisal and counseling materials. 1317.425 Section 1317.425 Conservation of Power and Water Resources... Activities Prohibited § 1317.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A...

Breaking HIV News to Clients: SPIKES Strategy in Post-Test Counseling Session

Directory of Open Access Journals (Sweden)

Hamid Emadi-Koochak

2016-05-01

Full Text Available Breaking bad news is one of the most burdensome tasks physicians face in their everyday practice. It becomes even more challenging in the context of HIV+ patients because of stigma and discrimination. The aim of the current study is to evaluate the quality of giving HIV seroconversion news according to SPIKES protocol. Numbers of 154 consecutive HIV+ patients from Imam Khomeini Hospital testing and counseling center were enrolled in this study. Patients were inquired about how they were given the HIV news and whether or not they received pre- and post-test counseling sessions. Around 51% of them were men, 80% had high school education, and 56% were employed. Regarding marital status, 32% were single, and 52% were married at the time of the interview. Among them, 31% had received the HIV news in a counseling center, and only 29% had pre-test counseling. SPIKES criteria were significantly met when the HIV news was given in an HIV counseling and testing center (P.value<0.05. Low coverage of HIV counseling services was observed in the study. SPIKES criteria were significantly met when the HIV seroconversion news was given in a counseling center. The need to further train staff to deliver HIV news seems a priority in the field of HIV care and treatment.

22 CFR 146.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Counseling and use of appraisal and counseling... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 146.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

22 CFR 229.425 - Counseling and use of appraisal and counseling materials.

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2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Counseling and use of appraisal and counseling... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 229.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

45 CFR 86.36 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.36 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

6 CFR 17.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 17.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on...

10 CFR 5.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling materials... in Education Programs or Activities Prohibited § 5.425 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the...

Less counseling on Early Childhood Caries transmission by dentists

Science.gov (United States)

Milgrom, Peter; Huebner, Colleen E.; Mancl, Lloyd; Garson, Gayle; Grembowski, David

2013-01-01

Objective High levels of Streptococcus mutans on teeth of young children are predictive of Early Childhood Caries (ECC). Transmission from mother-to-child is common and studies have demonstrated treatment of the mother results in less ECC. The objective of this study was to determine how dentists have adopted the practice of counseling about ECC. Methods In 2006 as part of a larger study on dental care for pregnant women, we surveyed 829 general dentists in Oregon. The questionnaire contained questions to capture the extent to which general dentists have adopted counseling pregnant women about ECC transmission, to describe personal and practice characteristics, and examine how dentists' views on the ease of adopting of new procedures related to ECC counseling. Multivariate logistic regression was used to identify separate and additive effects of demographic and practice characteristics, attitudes, and beliefs. Results The adjusted odds of a dentist who strongly believed in the link between mothers and babies and provided ECC counseling were 1.60 (95% CI 1.3-2.0, P<0.01). The odds of a dentist who reported discussing ECC with staff members and provided counseling were 2.7 (95% CI 1.7-4.3, P<0.01). Male dentists were less likely to counsel patients than female dentists (Adjusted OR = 0.5, 95% CI 0.3-1.0, p<0.05). Conclusions The strongest predictors of counseling patients about ECC were dentists' belief in the evidence of caries transmission and dentists' discussion of ECC during staff meetings. PMID:22970775

Enhancement of daily physical activity increases physical fitness of outclinic COPD patients : Results of an exercise counseling program

NARCIS (Netherlands)

Hospes, Gieneke; Bossenbroek, Linda; ten Hacken, Nick H. T.; van Hengel, Peter; de Greef, Mathieu H. G.

Objective: To investigate whether a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity in outclinic Chronic Obstructive Pulmonary Disease (COPD) patients who do not participate in a rehabilitation program in a controlled way. Methods: 35

[Development of a standardized guide for optimizing drug adherence information to be dispensed during a pharmaceutical counseling with a multiple myeloma patient: Initial validation].

Science.gov (United States)

Favier-Archinard, Camille; Leguelinel-Blache, Géraldine; Dubois, Florent; Le Gall, Tanguy; Bourquard, Pascal; Passemard, Nadège; Tora, Sandrine; Rey, Aurélie; Rossi, Marie; Chevallier, Thierry; Cousin, Christelle; Favier, Mireille

2018-05-01

The safety of the community treatment with oral anticancer therapies is a strong theme of the cancer plan 2014-2019. The objective of this study was to develop a Pharmaceutical Counseling Guide to improve medication adherence in patients treated for multiple myeloma with oral anticancer therapies. A multidisciplinary professional working group selected a list of relevant medication adherence-related items that served as the framework for the design of the pharmaceutical counseling support materials in patient-accessible language. The readability, understanding and memorization of the information were validated in ten patients treated for myeloma. Twelve items were selected for treatment information (5 items), treatment planning (5 items), and adverse drug effects (2 items). A pharmacist guide, a patient guide, a medication schedule, and three self-questionnaires to evaluate medication knowledge and understanding of patients were developed. The patient test resulted in changes in these documents. This study carried out the initial validation of documents to standardize the pharmaceutical counseling for patients treated for myeloma so that it can be reproduced from one patient to another regardless of the pharmacist, by standardizing the information issued. This study needs to be completed by a final validation in myeloma patients, free from oral anticancer therapies. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Declining Counseling Research in Counseling Psychology Journals: Is the Sky Falling?

Science.gov (United States)

Lichtenberg, James W.

2011-01-01

Scheel et al. note a rather precipitous decline over the past 30 years in the number and proportion of counseling-related research articles appearing in "Journal of Counseling Psychology" ("JCP") and "The Counseling Psychologist" ("TCP"). Certainly, counseling psychology as a field has changed over its 65-year history, and a great deal of that…

Do the Five A’s Work When Physicians Counsel About Weight Loss?

Science.gov (United States)

Alexander, Stewart C.; Cox, Mary E.; Boling Turer, Christy L.; Lyna, Pauline; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Pollak, Kathryn I.

2012-01-01

BACKGROUND AND OBJECTIVES More than two thirds of Americans are overweight or obese. Physician counseling may help patients lose weight; however, physicians perceive these discussions as somewhat futile and time-consuming. An effective and efficient tool for smoking cessation is the Five A’s (Ask, Advise, Assess, Assist, and Arrange). We studied the effectiveness of the Five A’s in weight-loss counseling. METHODS We audiorecorded primary care encounters between 40 physicians and 461 of their overweight or obese patients. All were told the study was about preventive health, not weight specifically. Encounters were coded for physician use of the Five A’s. Patients’ motivation and confidence were assessed before and immediately after the encounter. Three months later, we assessed patient change in dietary fat intake, exercise, and weight. RESULTS Generalized linear models were fit adjusting for patient clustering within physician. Physicians used at least one of the Five A’s often (83%). Physicians routinely Ask and Advise patients to lose weight; however, they rarely Assess, Assist, or Arrange. Assist and Arrange were related to diet improvement, whereas Advise was associated with increases in motivation and confidence to change dietary fat intake and confidence to lose weight. CONCLUSIONS Similar to smoking cessation counseling, physicians routinely Asked and Advised patients to lose weight; however, they rarely Assessed, Assisted, or Arranged. Given the potential impact of using all of these counseling tools on changing patient behavior, physicians should be encouraged to increase their use of the Five A’s when counseling patients to lose weight. PMID:21380950

Upgrading physical activity counselling in primary care in the Netherlands

NARCIS (Netherlands)

Verwey, R.; Weegen, S. van der; Spreeuwenberg, M.; Tange, H.; Weijden, T.T. van der; Witte, L.

2016-01-01

The systematic development of a counselling protocol in primary care combined with a monitoring and feedback tool to support chronically ill patients to achieve a more active lifestyle. An iterative user-centred design method was used to develop a counselling protocol: the Self-management Support

Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

Science.gov (United States)

Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

2017-10-01

Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

Evaluation of a multi-methods approach to the collection and dissemination of feedback on OSCE performance in dental education.

Science.gov (United States)

Wardman, M J; Yorke, V C; Hallam, J L

2018-05-01

Feedback is an essential part of the learning process, and students expect their feedback to be personalised, meaningful and timely. Objective Structured Clinical Examination (OSCE) assessments allow examiners to observe students carefully over the course of a number of varied station types, across a number of clinical knowledge and skill domains. They therefore present an ideal opportunity to record detailed feedback which allows students to reflect on and improve their performance. This article outlines two methods by which OSCE feedback was collected and then disseminated to undergraduate dental students across 2-year groups in a UK dental school: (i) Individual written feedback comments made by examiners during the examination, (ii) General audio feedback recorded by groups of examiners immediately following the examination. Evaluation of the feedback was sought from students and staff examiners. A multi-methods approach utilising Likert questionnaire items (quantitative) and open-ended feedback questions (qualitative) was used. Data analysis explored student and staff perceptions of the audio and written feedback. A total of 131 students (response rate 68%) and 52 staff examiners (response rate 83%) completed questionnaires. Quantitative data analysis showed that the written and audio formats were reported as a meaningful source of feedback for learning by both students (93% written, 89% audio) and staff (96% written, 92% audio). Qualitative data revealed the complementary nature of both types of feedback. Written feedback gives specific, individual information whilst audio shares general observations and allows students to learn from others. The advantages, limitations and challenges of the feedback methods are discussed, leading to the development of an informed set of implementation guidelines. Written and audio feedback methods are valued by students and staff. It is proposed that these may be very easily applied to OSCEs running in other dental schools. �

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes.

Science.gov (United States)

Nawaz, Haq; Petraro, Paul V; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M

2016-01-01

The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

Science.gov (United States)

Nawaz, Haq; Petraro, Paul V.; Via, Christina; Ullah, Saif; Lim, Lionel; Wild, Dorothea; Kennedy, Mary; Phillips, Edward M.

2016-01-01

Background The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits. Results A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11). Conclusion Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits. PMID:27507540

Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes

Directory of Open Access Journals (Sweden)

Haq Nawaz

2016-08-01

Full Text Available Background: The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating. Physicians report poor training and lack of confidence in counseling patients on lifestyle changes. Objective: To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents. Methods: Training included didactics (six sessions/year, distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents’ progress including Objective Structured Clinical Examinations (OSCEs, self-assessments, and logs of personal health habits. Results: A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents’ discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01. Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76% compared with plural for resident, preventive medicine residents (80%. However, this difference did not reach statistical significance (p=0.11. Conclusion: Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Effect of didactic lectures on obesity documentation and counseling among internal medicine residents.

Science.gov (United States)

Ren, Vicky; Ellison, Kathleen; Miller, Jonathan; Busireddy, Kiran; Vickery, Erin; Panda, Mukta; Qayyum, Rehan

2016-01-01

Screening adult patients for obesity and offering appropriate counseling and treatment for weight loss is recommended. However, many healthcare providers feel ill-equipped to address this topic. We examined whether didactic presentations lead to increased obesity documentation and counseling among internal medicine (IM) residents. We reviewed medical records of patients seen at the IM Resident Continuity Clinic during April 2015. Residents were provided feedback at two didactic presentations during May 2015. To examine the effect of this intervention, we repeated medical record review during June 2015. For both reviews, we abstracted patient-specific (i.e., age, body mass index [BMI], race, sex, and number of comorbid diagnoses) and resident-specific (i.e., sex and training level) data as well as evidence of obesity documentation and counseling. We used logistic regression models to examine the effect of intervention on obesity documentation and counseling, adjusting for patient- and resident-specific variables. Of the 278 patients with BMI≥30 kg/m(2), 139 were seen before and 139 after the intervention. Intervention had no effect on obesity documentation or counseling with or without adjustment for confounding variables (both P>0.05). In adjusted post-hoc analyses, each additional comorbidity increased the odds of obesity documentation by 8% (OR=1.08; 95% CI=1.05-1.11; Pdidactic presentations were unable to increase obesity documentation or weight loss counseling. Future research to identify effective interventions is needed.

Smoking behavior among hospital staff still influences attitudes and counseling on smoking

DEFF Research Database (Denmark)

Willaing, Ingrid; Ladelund, Steen

2004-01-01

as a risk factor. Nonsmokers might overestimate smoking as a risk factor. Nonsmokers gave patients advice on smoking cessation significantly more often than did current smokers (ex-smokers, OR=2.5, 95% CI=1.8-3.4; never-smokers, OR=1.5, 95% CI=1.1-2.0). Ex-smokers and smokers felt significantly more...... qualified to counsel patients about smoking than did never-smokers (ex-smokers, OR=1.8, 95% CI=1.3-2.5; smokers, OR=1.4, 95% CI=1.0-1.9). Individual smoking behavior among hospital staff was strongly associated with smoking-related knowledge, attitudes, and counseling practices. Lack of self......-related counseling, smoking-related counseling practices, and self-rated qualifications for counseling were main outcome measures. Health professionals who were current smokers systematically underestimated the health consequences of smoking and differed significantly from nonsmokers in their assessments of smoking...

38 CFR 21.3100 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.3100.... Chapter 35 Counseling § 21.3100 Counseling. (a) Purpose of counseling. The purpose of counseling is to...)) (b) Availability of counseling. Counseling assistance is available for— (1) Identifying and removing...

Evaluation of pharmacists' educational and counselling impact on patients' clinical outcomes in a diabetic setting

Directory of Open Access Journals (Sweden)

Winifred Aitalegbe Ojieabu

2017-01-01

Full Text Available Background: Nigeria had the highest number of people living with diabetes mellitus in the African region in year 2013. Previous researchers have found that patients with knowledge of their diseases including their treatment methods have a high likelihood to succeed in managing the disease conditions. Many pharmaceutical care programmes which have been successfully applied in various countries to enhance clinical outcomes and health-related quality of life are not very common in Nigeria. Objective: This study was to evaluate pharmacist's educational and counselling impact on diabetic patients' outcomes in a diabetic setting. Materials and Methods: The 4-month randomised controlled study involved 150 elderly Type 2 diabetic patients. Sociodemographic and clinical parameters were measured. We educated and counselled the 75 patients in our intervention group at least four times during the study period, but the control group was deprived of the pharmacist's intervention. Results: Female to male participants was in the ratio of 9:6 and 9:5 in both control and intervention groups, respectively. Majority (>40% of the patients in both groups had primary education. Baseline and 4-month mean fasting blood sugar in the control group was 162.2 ± 69.1 and 159.9 ± 57.2, respectively (P = 0.825, whereas the intervention group had 156.7 ± 30.5 and 131.8 ± 40.4, respectively (P < 0.001. Mean systolic blood pressure in both groups was 146.4 ± 13.9 and 133.8 ± 18.5 (P < 0.001, respectively. Adherence levels to medication taking in both groups were 42.7%:94.7%, respectively (P = 0.001. Conclusion: This study encourages the inclusion of clinical pharmacists into multidisciplinary healthcare groups in hospital and clinic settings as well as incorporation of this type of intervention into diabetic management programmes for optimal patients' outcomes.

7 CFR 15a.36 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling... Education Programs and Activities Prohibited § 15a.36 Counseling and use of appraisal and counseling materials. (a) Counseling. A recipient shall not discriminate against any person on the basis of sex in the...

Online Counseling: Reviewing the Literature from a Counseling Psychology Framework

Science.gov (United States)

Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.; Day, Susan X.

2005-01-01

This article reviews the online-counseling literature with an emphasis on current applications and considerations for future research. It focuses on primary themes of counseling psychology including the history of process-outcome research and multiculturalism. It explores current gaps in the literature from a counseling psychology framework,…

Introduction to the Major Contribution: Counseling Psychology and Online Counseling

Science.gov (United States)

Mallen, Michael J.; Vogel, David L.

2005-01-01

This article introduces the Major Contribution, which focuses on online counseling. Several acronyms and terms are presented to familiarize the reader with distance-communication technology, including a definition of online counseling. The authors show how counseling psychology provides a framework for specific questions related to the theory,…

The Ghosts of Counseling Psychology: Is Counseling Research Really Dead?

Science.gov (United States)

Murdock, Nancy L.

2011-01-01

Scheel et al. offer an interesting analysis on the publication rate of counseling-related research articles in counseling psychology's two major journals. In this reaction to their work, the author considers various aspects of their results and contemplates possible explanations for the decline of counseling-related publications. The author…

36 CFR 1211.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling materials. 1211.425 Section 1211.425 Parks, Forests, and Public Property NATIONAL... Education Programs or Activities Prohibited § 1211.425 Counseling and use of appraisal and counseling...

Interactive "Video doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings

OpenAIRE

Gilbert, P; Ciccarone, D; Gansky, SA; Bangsberg, DR; Clanon, K; McPhee, SJ; Calderón, SH; Bogetz, A; Gerbert, B

2008-01-01

Background Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide “prevention with positives” in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based...

Personalized Genetic Risk Counseling to Motivate Diabetes Prevention

OpenAIRE

Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.

2012-01-01

OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top an...

[Counselling versus cognitive group therapy for tinnitus. A retrospective study of their efficacy].

Science.gov (United States)

Schmidt, A; Lins, U; Wetscher, I; Welzl-Müller, K; Weichbold, V

2004-03-01

Both counselling and group therapy have been recommended for supporting patients with chronic tinnitus. It is unclear which of these treatments is superior. This retrospective study aimed at comparing relief from tinnitus distress following counselling with that following cognitive group therapy. Distress relief was also compared to the distress level of the waiting group patients. Tinnitus distress was assessed through the Tinnitus Questionnaire (TQ, Goebel and Hiller) at three different times: before treatment (in waiting list patients: at initial contact) and at 3 and 6 months after initial assessment. Data from 21 patients per group were included in the analysis. The initial tinnitus distress scores were similar in all groups (about 48 TQ points out of a maximum of 84). After 3 months, both counselling subjects and group therapy participants exhibited a significant distress reduction of 13 TQ points, which remained stable after 6 months. Patients on the waiting list experienced no distress relief over time. Results from our data demonstrate the need for a future prospective study on the comparison of efficacy of counselling vs cognitive group therapy.

Does the diagnosis of breast or ovarian cancer trigger referral to genetic counseling?

Science.gov (United States)

Powell, C Bethan; Littell, Ramey; Hoodfar, Elizabeth; Sinclair, Fiona; Pressman, Alice

2013-03-01

Kaiser Permanente Northern California is a large integrated health care delivery system in the United States that has guidelines for referring women with newly diagnosed BRCA1-and BRCA2-associated cancers for genetic counseling. This study assesses adherence to genetic counseling referral guidelines within this health system. Chart review was performed to identify patients with cancer who met the following pathology-based Kaiser Permanente Northern California guidelines for referral for genetic counseling: invasive breast cancer, younger than age 40; nonmucinous epithelial ovarian, fallopian tube, or peritoneal cancer, younger than age 60; women with synchronous or metachronous primary cancers of the breast and ovaries; and male breast cancer. We assessed compliance with referral guidelines. An electronic notice was sent to the managing physician of patients with newly diagnosed cancer to assess the feasibility of this intervention. A total of 340 patients were identified with breast cancer at younger than age 40 or with ovarian, peritoneal, or tubal cancer between January and June, 2008. Upon chart review, 105 of these patients met pathology-based criteria for referral to genetic counseling, of whom 47 (45%) were referred within the 2-year study period. Of the 67 subjects with breast cancer, 40 subjects (60%) were referred. In contrast, only 7 (21%) of 33 patients with ovarian cancer were referred (P < 0.001). A pilot study was performed to test the feasibility of notifying managing oncologists with an electronic letter alerting them of eligibility for genetic referral of patients with new diagnosis (n = 21). In the 3 to 6 months after this notification, 12 of these 21 patients were referred for counseling including 5 of 7 patients with a diagnosis of ovarian cancer. There is a missed opportunity for referring patients to genetic counseling, especially among patients with ovarian cancer. A pilot study suggests that alerting treating physicians is a feasible

A patient safety objective structured clinical examination.

Science.gov (United States)

Singh, Ranjit; Singh, Ashok; Fish, Reva; McLean, Don; Anderson, Diana R; Singh, Gurdev

2009-06-01

There are international calls for improving education for health care workers around certain core competencies, of which patient safety and quality are integral and transcendent parts. Although relevant teaching programs have been developed, little is known about how best to assess their effectiveness. The objective of this work was to develop and implement an objective structured clinical examination (OSCE) to evaluate the impact of a patient safety curriculum. The curriculum was implemented in a family medicine residency program with 47 trainees. Two years after commencing the curriculum, a patient safety OSCE was developed and administered at this program and, for comparison purposes, to incoming residents at the same program and to residents at a neighboring residency program. All 47 residents exposed to the training, all 16 incoming residents, and 10 of 12 residents at the neighboring program participated in the OSCE. In a standardized patient case, error detection and error disclosure skills were better among trained residents. In a chart-based case, trained residents showed better performance in identifying deficiencies in care and described more appropriate means of addressing them. Third year residents exposed to a "Systems Approach" course performed better at system analysis and identifying system-based solutions after the course than before. Results suggest increased systems thinking and inculcation of a culture of safety among residents exposed to a patient safety curriculum. The main weaknesses of the study are its small size and suboptimal design. Much further investigation is needed into the effectiveness of patient safety curricula.

Translation and Adaptation of the Genetic Counselling Outcome Scale (GCOS-24) for Use in Denmark

DEFF Research Database (Denmark)

Diness, Birgitte Rode; Overbeck, Gritt; Hjortshøj, Tina Duelund

2017-01-01

Outcome measurement in clinical genetics is challenging. Robust outcome measures are needed to provide evidence to support service development within genetic counseling. The Genetic Counselling Outcome Scale (GCOS-24), a Patient Reported Outcome Measure (PROM), was developed in English...... and validated with clinical genetics patients in the British NHS. This study reports the translation and adaptation of the GCOS-24 for use in Denmark. GCOS-24 was translated and back translated, supervised by an expert committee. Feedback on the first version was collected from genetic counseling patients...

Counseling in teacher education

DEFF Research Database (Denmark)

Mølgaard, Dorthe Busk

Counseling is about supporting and challenging students in making decisions, being adaptive, seeing opportunities and acquiring self-knowledge. Literaturesearch of articles about counseling research in nordic teacher education 2008-2013 shows no results. We started a participant-orientated pilotp......Counseling is about supporting and challenging students in making decisions, being adaptive, seeing opportunities and acquiring self-knowledge. Literaturesearch of articles about counseling research in nordic teacher education 2008-2013 shows no results. We started a participant......-orientated pilotproject about counseling in teacher education. The aim was to acquire knowledge about how students perceive counseling. This knowledge could help uncover potential areas of development for counselingpractice. In the pilotproject it is tested if the chosen method is suitable for bigger qualitative study....... The study is a qualitative questionnaire survey. The “lifeworld” is central, therefore a phenomenological and hermeneutical approach was chosen, where the student’s perception of the counseling is studied. Central themes: Setting of the counseling and progress of the counselingcourse, content and shape...

[Implementation of bedside training and advanced objective structured clinical examination (OSCE) trial to learn and confirm about pharmacy clinical skills].

Science.gov (United States)

Tokunaga, Jin; Takamura, Norito; Ogata, Kenji; Setoguchi, Nao; Sato, Keizo

2013-01-01

Bedside training for fourth-year students, as well as seminars in hospital pharmacy (vital sign seminars) for fifth-year students at the Department of Pharmacy of Kyushu University of Health and Welfare have been implemented using patient training models and various patient simulators. The introduction of simulation-based pharmaceutical education, where no patients are present, promotes visually, aurally, and tactilely simulated learning regarding the evaluation of vital signs and implementation of physical assessment when disease symptoms are present or adverse effects occur. A patient simulator also promotes the creation of training programs for emergency and critical care, with which basic as well as advanced life support can be practiced. In addition, an advanced objective structured clinical examination (OSCE) trial has been implemented to evaluate skills regarding vital signs and physical assessments. Pharmacists are required to examine vital signs and conduct physical assessment from a pharmaceutical point of view. The introduction of these pharmacy clinical skills will improve the efficacy of drugs, work for the prevention or early detection of adverse effects, and promote the appropriate use of drugs. It is considered that simulation-based pharmaceutical education is essential to understand physical assessment, and such education will ideally be applied and developed according to on-site practices.

The effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare) on readmission rates in a multicultural population of internal medicine patients.

Science.gov (United States)

Karapinar-Carkit, Fatma; Borgsteede, Sander D; Zoer, Jan; Siegert, Carl; van Tulder, Maurits; Egberts, Antoine C G; van den Bemt, Patricia M L A

2010-02-16

Medication errors occur frequently at points of transition in care. The key problems causing these medication errors are: incomplete and inappropriate medication reconciliation at hospital discharge (partly arising from inadequate medication reconciliation at admission), insufficient patient information (especially within a multicultural patient population) and insufficient communication to the next health care provider. Whether interventions aimed at the combination of these aspects indeed result in less discontinuity and associated harm is uncertain. Therefore the main objective of this study is to determine the effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare) on readmission rates in patients discharged from the internal medicine department. An experimental study is performed at the internal medicine ward of a general teaching hospital in Amsterdam, which serves a multicultural population. In this study the effects of the COACH program is compared with usual care using a pre-post study design. All patients being admitted with at least one prescribed drug intended for chronic use are included in the study unless they meet one of the following exclusion criteria: no informed consent, no medication intended for chronic use prescribed at discharge, death, transfer to another ward or hospital, discharge within 24 hours or out of office hours, discharge to a nursing home and no possibility to counsel the patient.The intervention consists of medication reconciliation, patient counselling and communication between the hospital and primary care healthcare providers.The following outcomes are measured: the primary outcome readmissions within six months after discharge and the secondary outcomes number of interventions, adherence, patient's attitude towards medicines, patient's satisfaction with medication information, costs, quality of life and finally satisfaction of general practitioners

Interactive "Video Doctor" counseling reduces drug and sexual risk behaviors among HIV-positive patients in diverse outpatient settings.

Directory of Open Access Journals (Sweden)

Paul Gilbert

2008-04-01

Full Text Available Reducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide "prevention with positives" in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors.We conducted a parallel groups randomized controlled trial (December 2003-September 2006 at 5 San Francisco area outpatient HIV clinics. Eligible patients (HIV-positive English-speaking adults completed an in-depth computerized risk assessment. Participants reporting substance use or sexual risks (n = 476 were randomized in stratified blocks. The intervention group received tailored risk-reduction counseling from a "Video Doctor" via laptop computer and a printed Educational Worksheet; providers received a Cueing Sheet on reported risks. Compared with control, fewer intervention participants reported continuing illicit drug use (RR 0.81, 95% CI: 0.689, 0.957, p = 0.014 at 3 months; and RR 0.65, 95% CI: 0.540, 0.785, p<0.001 at 6 months and unprotected sex (RR 0.88, 95% CI: 0.773, 0.993, p = 0.039 at 3 months; and RR 0.80, 95% CI: 0.686, 0.941, p = 0.007 at 6 months. Intervention participants reported fewer mean days of ongoing illicit drug use (-4.0 days vs. -1.3 days, p = 0.346, at 3 months; and -4.7 days vs. -0.7 days, p = 0.130, at 6 months than did controls, and had fewer casual sex partners at (-2.3 vs. -1.4, p = 0.461, at 3 months; and -2.7 vs. -0.6, p = 0.042, at 6 months.The Positive Choice intervention achieved significant cessation of illicit drug use and unprotected sex at the group-level, and modest individual-level reductions in days of ongoing drug use and number of casual sex partners compared with the

Performance of OSC's initial Amtec generator design, and comparison with JPL's Europa Orbiter goals

International Nuclear Information System (INIS)

Schock, A.; Noravian, H.; Or, C.; Kumar, V.

1998-01-01

The procedure for the analysis (with overpotential correction) of multitube AMTEC (Alkali Metal Thermal-to-Electrical Conversion) cells described in Paper IECEC 98-243 was applied to a wide range of multicell radioisotope space power systems. System design options consisting of one or two generators, each with 2, 3, or 4 stacked GPHS (General Purpose Heat Source) modules, identical to those used on previous NASA missions, were analyzed and performance-mapped. The initial generators analyzed by OSC had 8 AMTEC cells on each end of the heat source stack, with five beta-alumina solid electrolyte (BASE) tubes per cell. The heat source and converters in the Orbital generator designs are embedded in a thermal insulation system consisting of Min-K fibrous insulation surrounded by graded-length molybdenum multifoils. Detailed analyses in previous Orbital studies found that such an insulation system could reduce extraneous heat losses to about 10%. For the above design options, the present paper presents the system mass and performance (i.e., the EOM system efficiency and power output and the BOM evaporator and clad temperatures) for a wide range of heat inputs and load voltages, and compares the results with JPL's preliminary goals for the Europa Orbiter mission to be launched in November 2003. The analytical results showed that the initial 16-cell generator designs resulted in either excessive evaporator and clad temperatures and/or insufficient power outputs to meet the JPL-specified mission goals. The computed performance of modified OSC generators with different numbers of AMTEC cells, cell diameters, cell lengths, cell materials, BASE tube lengths, and number of tubes per cell are described in Paper IECEC.98.245 in these proceedings

Online genetic counseling from the providers' perspective: counselors' evaluations and a time and cost analysis

Science.gov (United States)

Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Langen, Irene M

2016-01-01

Telemedicine applications are increasingly being introduced in patient care in various disciplines, including clinical genetics, mainly to increase access to care and to reduce time and costs for patients and professionals. Most telegenetics reports describe applications in large geographical areas, showing positive patients' and professionals' satisfaction. One economic analysis published thus far reported lower costs than in-person care. We hypothesized that telegenetics can also be beneficial from the professional's view in relatively small geographical areas. We performed a pilot study in the Northern Netherlands of 51 home-based online counseling sessions for cardiogenetic and oncogenetic cascade screening, and urgent prenatal counseling. Previously, we showed patient satisfaction, anxiety, and perceived control of online counseling to be comparable to in-person counseling. This study focuses on expectations, satisfaction, and practical evaluations of the involved counselors, and the impact in terms of time and costs. Most counselors expected disadvantages of online counseling for themselves and their patients, mainly concerning insufficient non-verbal communication; few expected advantages for themselves. Afterwards, counselors additionally raised the disadvantage of insufficient verbal communication, and reported frequent technical problems. Their overall mean telemedicine satisfaction itemscore was 3.38 before, and 2.95 afterwards, being afterwards slightly below the minimum level we set for a satisfactory result. We estimated reduced time and costs by online counseling with about 8% and 10–12%, respectively. We showed online genetic counseling to be effective, feasible and cost-efficient, but technical improvements are needed to increase counselors' satisfaction. PMID:26785833

Pilot Study on the Influence of Nutritional Counselling and Implant Therapy on the Nutritional Status in Dentally Compromised Patients

Science.gov (United States)

Wöstmann, Bernd; Simon, Teresa; Neuhäuser-Berthold, Monika; Rehmann, Peter

2016-01-01

Objectives To investigate the impact of implant-prosthetic rehabilitation combined with nutritional counseling on the nutritional status of patients with severely reduced dentitions. Design An explorative intervention study including an intra-individual comparison of 20 patients with severely reduced dentitions in terms of nutrition- and quality of life-related parameters recorded at baseline and at six and twelve months after implant-prosthetic rehabilitation. Participants Twenty patients from the Department of Prosthetic Dentistry of Justus-Liebig University of Giessen, with an mean age of 63 years, who had fewer than ten pairs of antagonists. Measurements The baseline data collection included dental status, a chewing ability test, laboratory parameters, anthropometric data (body mass index), energy supply, a 3-day dietary record, an analysis of the oral health-related quality of life (OHRQoL) with the OHIP-G14, the Mini-Mental Status (MMS) and Mini Nutritional Assessment (MNA). Six months after implantation and prosthetic rehabilitation, individual nutritional counseling was performed by a dietician. Data were again collected and analyzed. A final follow-up was conducted 12 months after prosthetic rehabilitation. Results Despite the highly significant improvement in masticatory ability and OHRQoL after implant-prosthetic rehabilitation, no significant changes were observed regarding MNA, anthropometric data or energy supply. Except for cholinesterase (p = 0.012), ferritin (p = 0.003), folic acid (p = 0.019) and vitamin A (p = 0.004), no laboratory parameter changed significantly during the investigation period. In addition, no general significant differences were observed for nutrient intake or food choice. Conclusion The present study does not confirm the assumption that the implant-prosthetic rehabilitation of patients with severely reduced residual dentitions with or without an individual nutritional counseling influences nutritional status. PMID:26821352

Trainees versus Staff: Exploring Counseling Outcomes in a College Counseling Center

Science.gov (United States)

Ilagan, Guy; Vinson, Mike; Sharp, Julia L.; Havice, Pamela; Ilagan, Jill

2014-01-01

Investigators compared counseling outcomes among nonpaid graduate-level trainees and professional staff at a college counseling center. Counseling outcomes for 331 college student participants were measured using the Outcome Questionnaire 45.2 (OQ45.2), employing a pretest--posttest design. The two groups of service providers did not differ…

The 'reformation' of counselling

Directory of Open Access Journals (Sweden)

G.A. Lotter

2001-08-01

Full Text Available Although the Reformation took place some four hundred years ago, one area in which reformation is really needed today is the counselling of people. Since Wilhelm Wundt started the “study of the mind” in 1879, William James and Sigmund Freud followed and secular psychology gradually has developed to take the “front seat”; hence moving Biblical counselling, which has been practised since the times of the New Testament, to the “back burner”. This development had been going on for the greater part of the 20th century, up to the publication of Competent to Counsel by Jay E. Adams in 1970. In the model for counselling suggested by Adams, the principles of the Reformation of the sixteenth century, Soli Deo Gloria, Soli Scriptura, Soli Fidei, Sola Gratia, etc. were again implemented in assisting and counselling people with personal and interpersonal problems. The epistomological and anthropological approach of secular psychology differs radically from that of Biblical principles, thus necessitating a new “reformation” of counselling. Within this new form counselling, inter alia, implies the following: the Word of God has its rightful place, sin has to be taken seriously and the work of the Holy Spirit should be recognised. In this article it is proposed that the “reformation” of counselling was started by scholars with a Biblical Reformational approach and that this method of counselling followed the parameters of the Reformation of the sixteenth century. This “reformation” developed into a new direction in counselling and still continues today with fascinating new frontiers opening up for Biblical counselling.

A randomized nutrition counseling intervention in pediatric leukemia patients receiving steroids results in reduced caloric intake.

Science.gov (United States)

Li, Rhea; Donnella, Hayley; Knouse, Phillip; Raber, Margaret; Crawford, Karla; Swartz, Maria C; Wu, Jimin; Liu, Diane; Chandra, Joya

2017-02-01

Quality of life in survivors of pediatric acute lymphocytic leukemia (ALL) can be compromised by chronic diseases including increased risk of second cancers, cardiovascular disease, and diabetes. Overweight or obesity further increases these risks. Steroids are a component of chemotherapy for ALL, and weight gain is a common side effect. To impact behaviors associated with weight gain, we conducted a randomized nutrition counseling intervention in ALL patients on treatment. ALL patients on a steroid-based treatment regimen at the MD Anderson Children's Cancer Hospital were recruited and randomized into control or intervention groups. The control group received standard care and nutrition education materials. The intervention group received monthly one-on-one nutrition counseling sessions, consisting of a baseline and 12 follow-up visits. Anthropometrics, dietary intake (3-day 24-hr dietary recalls) and oxidative stress measures were collected at baseline, 6 months, and postintervention. Dietary recall data were analyzed using the Nutrition Data System for Research. Twenty-two patients (median age 11.5 years), all in the maintenance phase of treatment, were recruited. The intervention group (n = 12) reported significantly lower calorie intake from baseline to 12-month follow-up and significant changes in glutamic acid and selenium intake (P < 0.05). Waist circumference was significantly associated with calorie, vitamin E, glutamic acid, and selenium intake. A year-long dietary intervention was effective at reducing caloric intake in pediatric ALL patients receiving steroid-based chemotherapy, indicating that this is a modality that can be built upon for obesity prevention and management. © 2016 Wiley Periodicals, Inc.

Characteristics of US Health Care Providers Who Counsel Adolescents on Sports and Energy Drink Consumption

OpenAIRE

Xiang, Nan; Wethington, Holly; Onufrak, Stephen; Belay, Brook

2014-01-01

Objective. To examine the proportion of health care providers who counsel adolescent patients on sports and energy drink (SED) consumption and the association with provider characteristics. Methods. This is a cross-sectional analysis of a survey of providers who see patients ≤17 years old. The proportion providing regular counseling on sports drinks (SDs), energy drinks (EDs), or both was assessed. Chi-square analyses examined differences in counseling based on provider characteristics. Multi...

Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.

Science.gov (United States)

Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M

2013-10-01

To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.

A near-peer teaching program designed, developed and delivered exclusively by recent medical graduates for final year medical students sitting the final objective structured clinical examination (OSCE

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Sobowale Oluwaseun

2011-03-01

Full Text Available Abstract Background The General Medical Council states that teaching doctors and students is important for the care of patients. Our aim was to deliver a structured teaching program to final year medical students, evaluate the efficacy of teaching given by junior doctors and review the pertinent literature. Methods We developed a revision package for final year medical students sitting the Objective Structured Clinical Examination (OSCE. The package was created and delivered exclusively by recent medical graduates and consisted of lectures and small group seminars covering the core areas of medicine and surgery, with a focus on specific OSCE station examples. Students were asked to complete a feedback questionnaire during and immediately after the program. Results One hundred and eighteen completed feedback questionnaires were analysed. All participants stated that the content covered was relevant to their revision. 73.2% stated that junior doctors delivered teaching that is comparable to that of consultant - led teaching. 97.9% stated the revision course had a positive influence on their learning. Conclusions Our study showed that recent medical graduates are able to create and deliver a structured, formal revision program and provide a unique perspective to exam preparation that was very well received by our student cohort. The role of junior doctors teaching medical students in a formal structured environment is very valuable and should be encouraged.

Randomized comparison of group versus individual genetic education and counseling for familial breast and/or ovarian cancer.

Science.gov (United States)

Calzone, Kathleen A; Prindiville, Sheila A; Jourkiv, Oxana; Jenkins, Jean; DeCarvalho, Maria; Wallerstedt, Dawn B; Liewehr, David J; Steinberg, Seth M; Soballe, Peter W; Lipkowitz, Stan; Klein, Pamela; Kirsch, Ilan R

2005-05-20

An efficient approach to education and counseling before BRCA1 and BRCA2 mutation testing is necessary for effective utilization of testing in the community. Education and counseling, when delivered individually, are limited by a shortage of trained health care providers as well as by financial and time constraints. The purpose of this study was to determine whether pretest education and counseling for breast cancer genetics in a group setting is equivalent to that provided on an individual basis. One hundred forty-two patients at high risk for harboring a BRCA mutation were randomly assigned to group or individual education and counseling sessions. Group education was followed by brief individual counseling. Knowledge and Impact of Events Scales (IES) were administered at baseline and after education and counseling and at 1 week and 3, 6, and 12 months. Satisfaction with education and counseling was measured at completion of the session. Preferred method of education and counseling was solicited at 3 months. There was no difference in knowledge or IES scores between groups. When stratified by genetic test results, knowledge scores showed no difference. Regardless of group, post-test IES scores in patients with positive results were higher than patients with negative or uninformative results but returned to baseline by 12 months. Participants were equally satisfied with either method they were assigned. Significantly more time was spent per patient in individual sessions (1.25 hours) than in group education (0.74 hours). Our data suggest that group education and counseling may confer similar benefits compared with traditional individual sessions. Additional investigation of this approach in larger numbers of patients is warranted.

Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality

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Carol W. Runyan, MPH, PhD

2016-01-01

Full Text Available Introduction: A youth’s emergency department (ED visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling. Methods: In this quality improvement project drawing on the Counseling on Access to Lethal Means (CALM model, we trained 16 psychiatric emergency clinicians to provide lethal means counseling with parents of patients under age 18 receiving care for suicidality and discharged home from a large children’s hospital. Through chart reviews and follow-up interviews of parents who received the counseling, we examined what parents recalled, their reactions to the counseling session, and actions taken after discharge. Results: Between March and July 2014, staff counseled 209 of the 236 (89% parents of eligible patients. We conducted follow-up interviews with 114 parents, or 55% of those receiving the intervention; 48% of those eligible. Parents had favorable impressions of the counseling and good recall of the main messages. Among the parents contacted at follow up, 76% reported all medications in the home were locked as compared to fewer than 10% at the time of the visit. All who had indicated there were guns in the home at the time of the visit reported at follow up that all were currently locked, compared to 67% reporting this at the time of the visit. Conclusion: Though a small project in just one hospital, our findings demonstrate the feasibility of adding a counseling protocol to the discharge process within a pediatric psychiatric emergency service. Our positive findings suggest that further study, including a randomized control trial in more facilities, is warranted.

Las Organizaciones de la Sociedad Civil (OSC) y la agenda internacional del desarrollo: escenario latinoamericano

OpenAIRE

Revilla Blanco, María Luisa

2012-01-01

En este artículo se analiza la acción de las organizaciones de la sociedad civil latinoamericanas: su evolución y el papel que juegan en la definición de la agenda internacional del desarrollo desde América Latina. Para ello, me detendré en los siguientes puntos: 1. Los hitos más importantes en la generación de consensos sobre los contenidos de esa agenda de desarrollo en lo que va de siglo y el reconocimiento del papel de las OSC. 2. La situación de América Latina en este contexto. ...

38 CFR 21.7100 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.7100... Bill-Active Duty) Counseling § 21.7100 Counseling. A veteran or servicemember may receive counseling from VA before beginning training and during training. (a) Purpose. The purpose of counseling is (1) To...

Effect of therapeutic class on counseling in community pharmacies.

Science.gov (United States)

Vainio, Kirsti K; Airaksinen, Marja S A; Hyykky, Tarja T; Enlund, K Hannes

2002-05-01

To assess the effect and importance of the therapeutic class of a drug as a determinant for verbal counseling by community pharmacists. Direct external observations (n = 1431) of pharmacist-customer interactions at the point of delivery of prescription medicines were conducted in 7 community pharmacies in Finland. Trained observers noted whether the pharmacist provided information on directions for use, mode of action, and adverse effects. To examine factors associated with counseling, a multiple logistic regression analysis was constructed, with the dependent variable being counseling of any of the 3 observed topics. In addition to therapeutic class, other independent variables were the pharmacy; pharmacist's age, gender, and degree; and the customer's age, gender, previous use of medicine, and question asking. Provision of counseling differed significantly according to therapeutic classes. Counseling on any of the 3 observed topics was most likely to be provided for customers with antibiotics (80%) and least likely for customers with gynecologic preparations (18%). Differences between therapeutic classes remained statistically significant when the effects of the other variables were controlled for. Other significant predictors for any verbal counseling were the pharmacy, customer's previous use of the medicine, and question asking. Therapeutic class is an important variable that should be included in further studies and considered when comparing studies on patient counseling in community pharmacies.

Characteristics of US Health Care Providers Who Counsel Adolescents on Sports and Energy Drink Consumption

Directory of Open Access Journals (Sweden)

Nan Xiang

2014-01-01

Full Text Available Objective. To examine the proportion of health care providers who counsel adolescent patients on sports and energy drink (SED consumption and the association with provider characteristics. Methods. This is a cross-sectional analysis of a survey of providers who see patients ≤17 years old. The proportion providing regular counseling on sports drinks (SDs, energy drinks (EDs, or both was assessed. Chi-square analyses examined differences in counseling based on provider characteristics. Multivariate logistic regression calculated adjusted odds ratios (aOR for characteristics independently associated with SED counseling. Results. Overall, 34% of health care providers regularly counseled on both SEDs, with 41% regularly counseling on SDs and 55% regularly counseling on EDs. On adjusted modeling regular SED counseling was associated with the female sex (aOR: 1.44 [95% CI: 1.07–1.93], high fruit/vegetable intake (aOR: 2.05 [95% CI: 1.54–2.73], family/general practitioners (aOR: 0.58 [95% CI: 0.41–0.82] and internists (aOR: 0.37 [95% CI: 0.20–0.70] versus pediatricians, and group versus individual practices (aOR: 0.59 [95% CI: 0.42–0.84]. Modeling for SD- and ED-specific counseling found similar associations with provider characteristics. Conclusion. The prevalence of regular SED counseling is low overall and varies. Provider education on the significance of SED counseling and consumption is important.

Frequently Asked Questions about Genetic Counseling

Science.gov (United States)

... a decision about testing. Interpret the results of genetic tests and medical data. Provide counseling or refer individuals and families to support services. Serve as patient advocates. Explain possible treatments or preventive ... What is a genetic consultation? [ghr.nlm.nih.gov] Top of page ...

Ethical issues in genetic counselling with special reference to haemoglobinopathies.

Science.gov (United States)

Muthuswamy, Vasantha

2011-10-01

Genetic counselling is provided in places where genetic tests are carried out. The process involves pre-test counselling as well as post-test counselling to enable the individuals to face the situation and take appropriate decisions with the right frame of mind. Major ethical principles which govern the attitudes and actions of counsellors include: respect for patient autonomy, non-maleficence, beneficence, or taking action to help benefit others and prevent harm, both physical and mental, and justice, which requires that services be distributed fairly to those in need. Other moral issues include veracity, the duty to disclose information or to be truthful, and respect for patient confidentiality. Nondirective counselling, a hallmark of this profession, is in accordance with the principle of individual autonomy. High prevalence of haemoglobinopathies with availability of good and sensitive carrier detection tests and prenatal diagnostic techniques makes these good candidates for population screening of carriers along with genetic counselling for primary prevention of the disease. Screening of the extended family members of the affected child, high risk communities and general population screening including antenatal women are the main target groups for planning a Haemoglobinopathy control programme. A critical mass of trained genetic counsellors who have understanding of the ethical issues and its appropriate handling with the required sensitivity is needed in India.

Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis

Directory of Open Access Journals (Sweden)

Elwyn Glyn

2010-05-01

Full Text Available Abstract Background Patient outcomes are poorly affected by lifestyle advice in general practice. Promoting lifestyle behavior change require that nurses shift from simple advice giving to a more counseling-based approach. The current study examines which barriers nurses encounter in lifestyle counseling to patients with type 2 diabetes. Based on this information we will develop an implementation strategy to improve lifestyle behavior change in general practice. Method In a qualitative semi-structured study, twelve in-depth interviews took place with nurses in Dutch general practices involved in diabetes care. Specific barriers in counseling patients with type 2 diabetes about diet, physical activity, and smoking cessation were addressed. The nurses were invited to reflect on barriers at the patient and practice levels, but mainly on their own roles as counselors. All interviews were audio-recorded and transcribed. The data were analyzed with the aid of a predetermined framework. Results Nurses felt most barriers on the level of the patient; patients had limited knowledge of a healthy lifestyle and limited insight into their own behavior, and they lacked the motivation to modify their lifestyles or the discipline to maintain an improved lifestyle. Furthermore, nurses reported lack of counseling skills and insufficient time as barriers in effective lifestyle counseling. Conclusions The traditional health education approach is still predominant in primary care of patients with type 2 diabetes. An implementation strategy based on motivational interviewing can help to overcome 'jumping ahead of the patient' and promotes skills in lifestyle behavioral change. We will train our nurses in agenda setting to structure the consultation based on prioritizing the behavior change and will help them to develop social maps that contain information on local exercise programs.

Comparison of methods used for estimating pharmacist counseling behaviors.

Science.gov (United States)

Schommer, J C; Sullivan, D L; Wiederholt, J B

1994-01-01

To compare the rates reported for provision of types of information conveyed by pharmacists among studies for which different methods of estimation were used and different dispensing situations were studied. Empiric studies conducted in the US, reported from 1982 through 1992, were selected from International Pharmaceutical Abstracts, MEDLINE, and noncomputerized sources. Empiric studies were selected for review if they reported the provision of at least three types of counseling information. Four components of methods used for estimating pharmacist counseling behaviors were extracted and summarized in a table: (1) sample type and area, (2) sampling unit, (3) sample size, and (4) data collection method. In addition, situations that were investigated in each study were compiled. Twelve studies met our inclusion criteria. Patients were interviewed via telephone in four studies and were surveyed via mail in two studies. Pharmacists were interviewed via telephone in one study and surveyed via mail in two studies. For three studies, researchers visited pharmacy sites for data collection using the shopper method or observation method. Studies with similar methods and situations provided similar results. Data collected by using patient surveys, pharmacist surveys, and observation methods can provide useful estimations of pharmacist counseling behaviors if researchers measure counseling for specific, well-defined dispensing situations.

Customer interest in and experience with various types of pharmacy counselling - a qualitative study

DEFF Research Database (Denmark)

Kaae, Susanne; Traulsen, Janine M; Nørgaard, Lotte S

2014-01-01

of counselling services with respect to medicine. The pharmacy staff does not seem to realize these barriers. CONCLUSIONS: For pharmacies to encourage customer interest in pharmacy counselling, the staff should start taking the identified barriers into account when planning communication strategies....... counselling at the present time, in order to develop the patient-pharmacy relationship for the benefit of both patients and pharmacies. DESIGN: Short semi-structured interviews were carried out with pharmacy customers by pharmacy internship students. SETTING AND PARTICIPANTS: One hundred and eight customers...... in 35 independent pharmacies across Denmark were interviewed during the spring of 2011. MAIN VARIABLES STUDIED: Customers were interviewed about their expectations of pharmacies in general and their experiences with medical counselling in particular. RESULTS: Customers perceive community pharmacies very...

Prenatal Genetic Counseling (For Parents)

Science.gov (United States)

... Videos for Educators Search English Español Prenatal Genetic Counseling KidsHealth / For Parents / Prenatal Genetic Counseling What's in ... can they help your family? What Is Genetic Counseling? Genetic counseling is the process of: evaluating family ...

44 CFR 19.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling materials. 19.425 Section 19.425 Emergency Management and Assistance FEDERAL... Basis of Sex in Education Programs or Activities Prohibited § 19.425 Counseling and use of appraisal and...

28 CFR 54.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling materials. 54.425 Section 54.425 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 54.425 Counseling and use of...

Islamic approach in counseling.

Science.gov (United States)

Hanin Hamjah, Salasiah; Mat Akhir, Noor Shakirah

2014-02-01

A religious approach is one of the matters emphasized in counseling today. Many researchers find that there is a need to apply the religious element in counseling because religion is important in a client's life. The purpose of this research is to identify aspects of the Islamic approach applied in counseling clients by counselors at Pusat Kaunseling Majlis Agama Islam Negeri Sembilan (PKMAINS). In addition, this research also analyses the Islamic approach applied in counseling at PKMAINS with reference to al-Quran and al-Sunnah. This is a qualitative research in the form of case study at PKMAINS. The main method used in this research is interview. The research instrument used is interview protocol. The respondents in this study include 9 counselors who serve in one of the counseling centers in Malaysia. This study also uses questionnaire as an additional instrument, distributed to 36 clients who receive counseling service at the center. The findings of the study show that the Islamic approach applied in counseling at PKMAINS may be categorized into three main aspects: aqidah (faith), ibadah (worship/ultimate devotion and love for God) and akhlaq (moral conduct). Findings also show that the counseling in these aspects is in line with Islamic teachings as contained in al-Quran and al-Sunnah.

Counseling and exercise intervention for smoking reduction in patients with schizophrenia: a feasibility study.

Science.gov (United States)

Bernard, Paquito Philippe Noel; Esseul, Elodie Christine; Raymond, Laurent; Dandonneau, Loic; Xambo, Jean-Jacques; Carayol, Marion Sara; Ninot, Gregory Jean-Marie Guilyn

2013-02-01

Smoking cessation is possible for individuals with schizophrenia but the relapse rate is high. It is necessary to develop more flexible approaches to help these patients. The aim of this study was to examine the feasibility of an intervention approach that integrates counseling and exercise for participants with schizophrenia or schizoaffective disorder. A single group prospective design was used in this study. A sample of inpatients with schizophrenia or schizoaffective disorder participated in a program called "oxygen group", a program combining five sessions of smoking reduction counseling and three sessions of moderate intensity exercise over an 8-week period. Tobacco consumption, motivation, carbon monoxide level, anxiety and depression, smoking self-efficacy, nicotine dependence and waist circumference were measured pre- and post-intervention. Participants reported their satisfaction with the study characteristics after completion of the intervention. Smoking consumption and CO level were assessed at 6-week post-intervention follow-up. Twelve individuals (mean age 45.7±10.8years) were recruited. Participant attendance was 81.3%. There were no dropouts. Significant decreases were found for tobacco consumption (P=.04) and CO rate (P=.003) at the end of the intervention and were maintained at 6-week follow-up. Compared to baseline levels, there were no changes in depression and anxiety. Smoking cessation motivation increased significantly. This intervention appears feasible and acceptable to patients with schizophrenia and there were promising findings regarding smoking reduction. Larger trials to test the intervention are warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.

Science.gov (United States)

Skolasky, Richard L; Maggard, Anica M; Li, David; Riley, Lee H; Wegener, Stephen T

2015-07-01

To determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. Prospective clinical trial. Academic medical center. Consecutive lumbar spine surgery patients (N=122) defined in our companion article (Part I) were assigned to a control group (did not receive HBCC, n=59) or HBCC group (received HBCC, n=63). Brief motivational interviewing-based HBCC versus control (significance, Pgroup did not show improvement compared with the control group. Thematic analysis identified 3 common barriers to engagement: (1) low self-efficacy because of lack of knowledge and support (62%); (2) anxiety related to fear of movement (57%); and (3) concern about pain management (48%). The influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement. Addressing these barriers should lead to greater improvements in rehabilitation engagement. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Using Technology to Enhance Teaching of Patient-Centered Interviewing for Early Medical Students.

Science.gov (United States)

Kaltman, Stacey; Talisman, Nicholas; Pennestri, Susan; Syverson, Eleri; Arthur, Paige; Vovides, Yianna

2018-06-01

Effective strategies for teaching communication skills to health professions students are needed. This article describes the design and evaluation of immersive and interactive video simulations for medical students to practice basic communication skills. Three simulations were developed, focusing on patient-centered interviewing techniques such as using open-ended questions, reflections, and empathic responses while assessing a patient's history of present illness. First-year medical students were randomized to simulation or education-as-usual arms. Students in the simulation arm were given access to three interactive video simulations developed using Articulate Storyline, an e-learning authoring tool, to practice and receive feedback on patient-centered interviewing techniques to prepare for their Observed Structured Clinical Examination (OSCE). Trained raters evaluated videos of two OSCE cases for each participant to assess specific communication skills used during the history of present illness component of the interview. Eighty-seven percent of the students in the simulation arm interacted with at least one simulation during the history of present illness. For both OSCE cases, students in the simulation arm asked significantly more open-ended questions. Students in the simulation arm asked significantly fewer closed-ended questions and offered significantly more empathic responses in one OSCE case. No differences were found for reflections. Students reported that the simulations helped improve their communication skills. The use of interactive video simulations was found to be feasible to incorporate into the curriculum and was appealing to students. In addition, students in the simulation arm displayed more behaviors consistent with the patient-centered interviewing model practiced in the simulations. Continued development and research are warranted.

40 CFR 5.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Counseling and use of appraisal and counseling materials. 5.425 Section 5.425 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.425 Counseling and use of...

The effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare on readmission rates in a multicultural population of internal medicine patients

Directory of Open Access Journals (Sweden)

van Tulder Maurits

2010-02-01

Full Text Available Abstract Background Medication errors occur frequently at points of transition in care. The key problems causing these medication errors are: incomplete and inappropriate medication reconciliation at hospital discharge (partly arising from inadequate medication reconciliation at admission, insufficient patient information (especially within a multicultural patient population and insufficient communication to the next health care provider. Whether interventions aimed at the combination of these aspects indeed result in less discontinuity and associated harm is uncertain. Therefore the main objective of this study is to determine the effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare on readmission rates in patients discharged from the internal medicine department. Methods/Design An experimental study is performed at the internal medicine ward of a general teaching hospital in Amsterdam, which serves a multicultural population. In this study the effects of the COACH program is compared with usual care using a pre-post study design. All patients being admitted with at least one prescribed drug intended for chronic use are included in the study unless they meet one of the following exclusion criteria: no informed consent, no medication intended for chronic use prescribed at discharge, death, transfer to another ward or hospital, discharge within 24 hours or out of office hours, discharge to a nursing home and no possibility to counsel the patient. The intervention consists of medication reconciliation, patient counselling and communication between the hospital and primary care healthcare providers. The following outcomes are measured: the primary outcome readmissions within six months after discharge and the secondary outcomes number of interventions, adherence, patient's attitude towards medicines, patient's satisfaction with medication information, costs, quality of

Does the patients′ educational level and previous counseling affect their medication knowledge?

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Abdulmalik M Alkatheri

2013-01-01

Conclusions: The education level of the patient and previous counseling are positively linked to medication knowledge. Knowledge of the medications′ side effects proved to be the most difficult task for the participants in this study, requiring the highest level of education, and was improved by previous counseling.

Standardized Patients to Teaching Medical Students about Intimate Partner Violence

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Heron, Sheryl L

2010-12-01

Full Text Available Objective: To use 360-degree evaluations within an Observed Structured Clinical Examination (OSCE to assess medical student comfort level and communication skills with intimate partner violence (IPV patients.Methods: We assessed a cohort of fourth year medical students’ performance using an IPV standardized patient (SP encounter in an OSCE. Blinded pre- and post-tests determined the students’ knowledge and comfort level with core IPV assessment. Students, SPs and investigators completed a 360-degree evaluation that focused on each student’s communication and competency skills. We computed frequencies, means and correlations.Results: Forty-one students participated in the SP exercise during three separate evaluation periods. Results noted insignificant increase in students’ comfort level pre-test (2.7 and post-test (2.9. Although 88% of students screened for IPV and 98% asked about the injury, only 39% asked about verbal abuse, 17% asked if the patient had a safety plan, and 13% communicated to the patient that IPV is illegal. Using Likert scoring on the competency and overall evaluation (1, very poor and 5, very good, the mean score for each evaluator was 4.1 (competency and 3.7 (overall. The correlations between trainee comfort level and the specific competencies of patient care, communication skill and professionalism were positive and significant (p<0.05.Conclusion: Students felt somewhat comfortable caring for patients with IPV. OSCEs with SPs can be used to assess student competencies in caring for patients with IPV. [West J Emerg Med. 2010; 11(5:500-505.

Outcomes from the implementation of a counselling model ...

African Journals Online (AJOL)

2015-07-02

Jul 2, 2015 ... One-third of antiretroviral treatment (ART)-eligible patients are estimated to be lost to care .... Information and Counselling Centre (ATICC) according .... patients whose last visit to the clinic or documented transfer .... recent systematic review reporting a range of 22–108 days,18 .... transition-state model.

County-level characteristics as predictors of dentists’ ECC counseling in the USA: a survey study

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2013-01-01

Background Transmission of Streptococcus mutans from mother-to-child can lead to Early Childhood Caries. A previous study identified characteristics and beliefs of general dentists about counseling pregnant women to reduce risk of infection and Early Childhood Caries. This study extends those findings with an analysis of county level factors. Methods In 2006, we surveyed 732 general dentists in Oregon, USA about dental care for pregnant women. Survey items asked about individual and practice characteristics. In the present study we matched those data to county level factors and used multinomial logistic regression to test the effects of the factors (i.e., dentist to population ratio, percentage of female dentists, percentage of females of childbearing age, and percentage of individuals living in poverty) on counseling behavior. Results County level factors were unrelated to counseling behavior when the models controlled for dentists' individual attitudes, beliefs, and practice level characteristics. The adjusted odds ratios for no counseling of pregnant patients (versus 100 percent counseling) were 1.1 (95% CI .8-1.7), 1.0 (1.0-1.1), 1.2 (.9-1.5), and 1.1 (1.0-1.2) for dentist/population ratio, percent female dentists, percent females of childbearing age, and percent in poverty, respectively Similar results were obtained when dentists who counseled some patients were compared to those counseling 100 percent of patients. Conclusions Community level factors do not appear to impact the individual counseling behavior of general dentists in Oregon, USA regarding the risk of maternal transmission of Early Childhood Caries. PMID:23688178

County-level characteristics as predictors of dentists' ECC counseling in the USA: a survey study.

Science.gov (United States)

Milgrom, Peter; Huebner, Colleen E; Mancl, Lloyd A; Chi, Donald L; Garson, Gayle; Grembowski, David

2013-05-20

Transmission of Streptococcus mutans from mother-to-child can lead to Early Childhood Caries. A previous study identified characteristics and beliefs of general dentists about counseling pregnant women to reduce risk of infection and Early Childhood Caries. This study extends those findings with an analysis of county level factors. In 2006, we surveyed 732 general dentists in Oregon, USA about dental care for pregnant women. Survey items asked about individual and practice characteristics. In the present study we matched those data to county level factors and used multinomial logistic regression to test the effects of the factors (i.e., dentist to population ratio, percentage of female dentists, percentage of females of childbearing age, and percentage of individuals living in poverty) on counseling behavior. County level factors were unrelated to counseling behavior when the models controlled for dentists' individual attitudes, beliefs, and practice level characteristics. The adjusted odds ratios for no counseling of pregnant patients (versus 100 percent counseling) were 1.1 (95% CI .8-1.7), 1.0 (1.0-1.1), 1.2 (.9-1.5), and 1.1 (1.0-1.2) for dentist/population ratio, percent female dentists, percent females of childbearing age, and percent in poverty, respectively Similar results were obtained when dentists who counseled some patients were compared to those counseling 100 percent of patients. Community level factors do not appear to impact the individual counseling behavior of general dentists in Oregon, USA regarding the risk of maternal transmission of Early Childhood Caries.

The Impact of Mental Illness on Uptake of Genetic Counseling for Hereditary Breast Cancer and Ovarian Cancer in a Multiethnic Cohort of Breast Cancer Patients.

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Ackerman, Marra G; Shapiro, Peter A; Coe, Austin; Trivedi, Meghna S; Crew, Katherine D

2017-09-01

We evaluated whether mental illness is a barrier to genetic counseling for hereditary breast and ovarian cancer (HBOC) in multiethnic breast cancer patients. We conducted a retrospective analysis of 308 women with newly diagnosed breast cancer and eligible for HBOC genetic testing seen in the breast clinic of an academic, urban medical center from 2007 to 2015. Uptake of genetic services and history of mental health disorder (MHD), defined as a psychiatric diagnosis or treatment with an antidepressant, mood stabilizer, anxiolytic, or antipsychotic medication, were ascertained by medical chart review. The mean age at breast cancer diagnosis was 56 years, with 44% non-Hispanic whites, 37% Hispanics, and 15% non-Hispanic blacks. Ninety-nine (32%) women met study criteria for MHD, 73% had a genetics referral, 57% had genetic counseling, and 54% completed BRCA testing. Uptake of genetic counseling services did not differ by race/ethnicity or presence of MHD. In multivariable analysis, younger age at diagnosis, Ashkenazi Jewish heritage, and family history of breast cancer were associated with HBOC genetic counseling. A relatively high proportion of breast cancer patients eligible for HBOC genetic testing were referred to a genetic counselor and referral status did not vary by MHD or race/ethnicity. © 2017 Wiley Periodicals, Inc.

Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

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Christoph Heesen

Full Text Available BACKGROUND: Prognostic counseling in multiple sclerosis (MS is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. OBJECTIVE: The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110 and their physicians (n = 6 and compared them with the estimates of OLAP. RESULTS: Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. CONCLUSION: While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic

Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

Science.gov (United States)

Heesen, Christoph; Gaissmaier, Wolfgang; Nguyen, Franziska; Stellmann, Jan-Patrick; Kasper, Jürgen; Köpke, Sascha; Lederer, Christian; Neuhaus, Anneke; Daumer, Martin

2013-01-01

Prognostic counseling in multiple sclerosis (MS) is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP) tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110) and their physicians (n = 6) and compared them with the estimates of OLAP. Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic estimates and clarify its usefulness for patients and physicians

Philosophical counselling: Towards a ‘new approach’ in pastoral care and counselling?

Directory of Open Access Journals (Sweden)

Daniel J. Louw

2011-05-01

Full Text Available The practice of pastoral counselling was dominated for several decades by the Rogerian techniques of empathetic listening. To a large extent, healing was predominately related to the realm of feelings (the affective dimension. Rational Emotive Therapy opened up other avenues. However, besides Logotherapy, the realm of meaning and its connectedness to world views and ideas (Plato: forms remained uncharted in many theories for pastoral care and counselling. In this article it was argued that philosophical counselling opens up new avenues for pastoral care and counselling. Philosophical counselling probes into the realm of different schemata of interpretation. A model for the making of a spiritual existential analysis was proposed in order to detect the impact of the Christian spiritual schema of interpretation on the dynamics of existential networking.

The efficacy of motivational counselling and SMS reminders on daily sitting time in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Thomsen, Tanja; Aadahl, Mette; Beyer, Nina

2017-01-01

biomarkers in patients with rheumatoid arthritis (RA). METHODS: In this randomised controlled trial 150 patients with RA were randomised to an intervention or a no-intervention control group. The intervention group received three individual motivational counselling sessions and short message service or text...... lipids, haemoglobin A1c, body weight, body mass index, waist circumference and waist-hip ratio. RESULTS: 75 patients were allocated to each group. Mean reduction in daily sitting time was -1.61 hours/day in the intervention versus 0.59 hours/day increase in the control group between-group difference -2.......20 (95% CI -2.72 to -1.69; pgroup. Most of the secondary outcomes were also in favour of the intervention. CONCLUSION: An individually tailored, behavioural intervention reduced daily sitting time in patients with RA and improved patient-reported outcomes...

38 CFR 21.6100 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.6100... Recipients Counseling § 21.6100 Counseling. General. A veteran requesting or being furnished assistance under this temporary program shall be provided professional counseling services by the Vocational...

Motivational interviewing in inflammatory bowel disease patients: a useful tool for outpatient counselling.

Science.gov (United States)

Mocciaro, Filippo; Di Mitri, Roberto; Russo, Giuseppina; Leone, Salvo; Quercia, Valerio

2014-10-01

Most inflammatory bowel disease patients miss follow-up visits and are non-adherent to therapy due to the lack of an engaging patient-physician relationship. Motivational interviewing is a patient-centred counselling method used to elicit/strengthen motivation towards change. The aim of this study was to assess the role of motivational interviewing in patients affected by inflammatory bowel disease. The study included consecutive patients with inflammatory bowel disease presenting for the first consultation (June 2012-February 2013). All consultations were carried out applying the motivational interviewing approach. After each consultation, patients filled out a questionnaire asking demographic data, and their past and current experience. Overall, 23 males (51.1%) and 22 females (48.9%), mean age 36.1±15.2 years, were enrolled. Before and after experiencing the motivational interviewing approach (mean visit duration 41.5±8.7min) "overall satisfaction rate", "physician's communication skills", and "perceived empathy" were 60% vs 100%, 40% vs 95.6%, and 40% vs 100%, respectively. Satisfaction was lower in patients affected by indeterminate colitis (p=0.004), and of younger age (p=0.02). The motivational interview approach is appreciated by inflammatory bowel disease patients. Despite being time-consuming, the motivational interview appears considerably worthwhile at the first visit and in younger patients. Motivational interviewing can help physicians to deal with their patients, moving from "cure" to "care". Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

43 CFR 41.425 - Counseling and use of appraisal and counseling materials.

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2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Counseling and use of appraisal and counseling materials. 41.425 Section 41.425 Public Lands: Interior Office of the Secretary of the Interior... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.425 Counseling and use of...

38 CFR 21.100 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.100... Counseling § 21.100 Counseling. (a) General. A veteran requesting or being furnished assistance under Chapter 31 shall be provided professional counseling services by Vocational Rehabilitation and Employment (VR...

38 CFR 21.7600 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.7600...) VOCATIONAL REHABILITATION AND EDUCATION Educational Assistance for Members of the Selected Reserve Counseling § 21.7600 Counseling. A reservist may receive counseling from VA before beginning training and during...

38 CFR 21.8100 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.8100... Vietnam Veterans-Spina Bifida and Covered Birth Defects Counseling § 21.8100 Counseling. An eligible child requesting or receiving services and assistance under this subpart will receive professional counseling by VR...

Teaching Genetic Counseling Skills: Incorporating a Genetic Counseling Adaptation Continuum Model to Address Psychosocial Complexity.

Science.gov (United States)

Shugar, Andrea

2017-04-01

Genetic counselors are trained health care professionals who effectively integrate both psychosocial counseling and information-giving into their practice. Preparing genetic counseling students for clinical practice is a challenging task, particularly when helping them develop effective and active counseling skills. Resistance to incorporating these skills may stem from decreased confidence, fear of causing harm or a lack of clarity of psycho-social goals. The author reflects on the personal challenges experienced in teaching genetic counselling students to work with psychological and social complexity, and proposes a Genetic Counseling Adaptation Continuum model and methodology to guide students in the use of advanced counseling skills.

Presymptomatic ALS genetic counseling and testing: Experience and recommendations.

Science.gov (United States)

Benatar, Michael; Stanislaw, Christine; Reyes, Eliana; Hussain, Sumaira; Cooley, Anne; Fernandez, Maria Catalina; Dauphin, Danielle D; Michon, Sara-Claude; Andersen, Peter M; Wuu, Joanne

2016-06-14

Remarkable advances in our understanding of the genetic contributions to amyotrophic lateral sclerosis (ALS) have sparked discussion and debate about whether clinical genetic testing should routinely be offered to patients with ALS. A related, but distinct, question is whether presymptomatic genetic testing should be offered to family members who may be at risk for developing ALS. Existing guidelines for presymptomatic counseling and testing are mostly based on small number of individuals, clinical judgment, and experience from other neurodegenerative disorders. Over the course of the last 8 years, we have provided testing and 317 genetic counseling sessions (including predecision, pretest, posttest, and ad hoc counseling) to 161 first-degree family members participating in the Pre-Symptomatic Familial ALS Study (Pre-fALS), as well as testing and 75 posttest counseling sessions to 63 individuals with familial ALS. Based on this experience, and the real-world challenges we have had to overcome in the process, we recommend an updated set of guidelines for providing presymptomatic genetic counseling and testing to people at high genetic risk for developing ALS. These recommendations are especially timely and relevant given the growing interest in studying presymptomatic ALS. © 2016 American Academy of Neurology.

38 CFR 21.9580 - Counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Counseling. 21.9580...) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Counseling § 21.9580 Counseling. An individual may receive counseling from VA before beginning training and during training. VA will apply the provisions of...

GPU-accelerated few-view CT reconstruction using the OSC and TV techniques

Energy Technology Data Exchange (ETDEWEB)

Matenine, Dmitri [Montreal Univ., QC (Canada). Dept. de Physique; Hissoiny, Sami [Ecole Polytechnique de Montreal, QC (Canada). Dept. de Genie Informatique et Genie Logiciel; Despres, Philippe [Centre Hospitalier Univ. de Quebec, QC (Canada). Dept. de Radio-Oncologie

2011-07-01

The present work proposes a promising iterative reconstruction technique designed specifically for X-ray transmission computed tomography (CT). The main objective is to reduce diagnostic radiation dose through the reduction of the number of CT projections, while preserving image quality. The second objective is to provide a fast implementation compatible with clinical activities. The proposed tomographic reconstruction technique is a combination of the Ordered Subsets Convex (OSC) algorithm and the Total Variation minimization (TV) regularization technique. The results in terms of image quality and computational speed are discussed. Using this technique, it was possible to obtain reconstructed slices of relatively good quality with as few as 100 projections, leading to potential dose reduction factors of up to an order of magnitude depending on the application. The algorithm was implemented on a Graphical Processing Unit (GPU) and yielded reconstruction times of approximately 185 ms per slice. (orig.)

Implementation and Operational Research: A Time-Motion Analysis of HIV Transmission Prevention Counseling and Antiretroviral Adherence Messages in Western Kenya.

Science.gov (United States)

Were, Martin C; Kessler, Jason; Shen, Changyu; Sidle, John; Macharia, Stephen; Lizcano, John; Siika, Abraham; Wools-Kaloustian, Kara; Kurth, Ann

2015-08-01

Shortages of health workers and large number of HIV-infected persons in Africa mean that time to provide antiretroviral therapy (ART) adherence and other messages to patients is limited. Using time-motion methodology, we documented the intensity and nature of counseling delivered to patients. The study was conducted at a rural and an urban HIV clinic in western Kenya. We recorded all activities of 190 adult patients on ART during their return clinic visits to assess type, frequency, and duration of counseling messages. Mean visit length for patients at the rural clinic was 44.5 (SD = 27.9) minutes and at urban clinic was 78.2 (SD = 42.1) minutes. Median time spent receiving any counseling during a visit was 4.07 minutes [interquartile range (IQR), 1.57-7.33] at rural and 3.99 (IQR, 2.87-6.25) minutes at urban, representing 11% and 8% of total mean visit time, respectively. Median time patients received ART adherence counseling was 1.29 (IQR, 0.77-2.83) minutes at rural and 1.76 (IQR, 1.23-2.83) minutes at urban (P = 0.001 for difference). Patients received a median time of 0.18 (0-0.72) minutes at rural and 0.28 (IQR, 0-0.67) minutes at urban clinic of counseling regarding contraception and pregnancy. Most patients in the study did not receive any counseling regarding alcohol/substance use, emerging risks for ongoing HIV transmission. Although ART adherence was discussed with most patients, time was limited. Reproductive counseling was provided to only half of the patients, and "positive prevention" messaging was minimal. There are strategic opportunities to enhance counseling and information received by clients within HIV programs in resource-limited settings.

Web-based objective structured clinical examination with remote standardized patients and Skype: resident experience.

Science.gov (United States)

Langenau, Erik; Kachur, Elizabeth; Horber, Dot

2014-07-01

Using Skype and remote standardized patients (RSPs), investigators sought to evaluate user acceptance of a web-based objective structured clinical examination (OSCE) among resident physicians. After participating in four web-based clinical encounters addressing pain with RSPs, 59 residents from different training programs, disciplines and geographic locations completed a 52-item questionnaire regarding their experience with Skype and RSPs. Open-ended responses were solicited as well. The majority of participants (97%) agreed or strongly agreed the web-based format was convenient and a practical learning exercise, and 90% agreed or strongly agreed the format was effective in teaching communication skills. Although 93% agreed or strongly agreed they could communicate easily with RSPs using Skype, 80% preferred traditional face-to-face clinical encounters, and 58% reported technical difficulties during the encounters. Open-ended written responses supported survey results. Findings from this study expose challenges with technology and human factors, but positive experiences support the continued investigation of web-based OSCEs as a synchronous e-learning initiative for teaching and assessing doctor-patient communication. Such educational programs are valuable but unlikely to replace face-to-face encounters with patients. This web-based OSCE program provides physician learners with additional opportunity to improve doctor-patient communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Preconditions needed for establishing a trusting relationship during health counselling - an interview study.

Science.gov (United States)

Eriksson, Irene; Nilsson, Kerstin

2008-09-01

To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Qualitative study. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.

Counselling considerations for chromosomal mosaicism detected by preimplantation genetic screening.

Science.gov (United States)

Besser, Andria G; Mounts, Emily L

2017-04-01

The evolution of preimplantation genetic screening (PGS) for aneuploidy to blastocyst biopsy and more sensitive 24-chromosome screening techniques has resulted in a new diagnostic category of PGS results: those classified as mosaic. This diagnosis presents significant challenges for clinicians in developing policies regarding transfer and storage of such embryos, as well as in providing genetic counselling for patients prior to and following PGS. Given the high frequency of mosaic PGS results and the wide range of possible associated outcomes, there is an urgent need to understand how to appropriately counsel patients regarding such embryos. This is the first commentary to thoroughly address pre- and post-test genetic counselling recommendations, as well as considerations regarding prenatal screening and diagnosis. Current data on mosaic PGS results are summarized along with embryo selection considerations and potential outcomes of embryos diagnosed as mosaic. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

ORIGINAL ARTICLE Dietary Counseling in the Prevention and ...

African Journals Online (AJOL)

Ogunbodede

It is recommended, that dietary counseling in dental diseases should be comprehensive ... patients/clients should as a matter of routine be referred to dental nurses and dental hygienists ..... Obesity, diabetes, cardiovascular diseases, gout, etc.

Individualised dietary counselling for nutritionally at-risk older patients following discharge from acute hospital to home

DEFF Research Database (Denmark)

Munk, T; Tolstrup, U; Beck, A M

2016-01-01

Background: Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence...... for an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. Methods: A systematic review of randomised......% CI = 0.08-1.95, P = 0.03). Meta-analyses revealed no significant effect on physical function assessed using hand grip strength, and similarly on mortality. Narrative summation of effects on physical function using other instruments revealed inconsistent effects. Meta-analyses were not conducted on Qo...

Prenatal Diagnosis and Genetic Counseling for Mosaic Trisomy 13

Directory of Open Access Journals (Sweden)

Chih-Ping Chen

2010-03-01

Full Text Available Counseling parents of a fetus with trisomy 13 mosaicism remains difficult because of the phenotypic variability associated with the condition; some patients exhibit the typical phenotype of complete trisomy 13 with neonatal death, while others have few dysmorphic features and prolonged survival. This article provides a comprehensive review of the prenatal diagnosis and genetic counseling for mosaic trisomy 13, including confined placental mosaicism 13, mosaic trisomy 13 diagnosed at amniocentesis, and phylloid hypomelanosis in association with mosaic trisomy 13.

Genetic Counselling, BRCA1/2 Status and Clinico-pathologic Characteristics of Patients with Ovarian Cancer before 50 Years of Age

Science.gov (United States)

Cvelbar, Mirjam; Hocevar, Marko; Novakovic, Srdjan; Stegel, Vida; Perhavec, Andraz

2017-01-01

Abstract Background In Slovenia like in other countries, till recently, personal history of epithelial ovarian cancer (EOC) has not been included among indications for genetic counselling. Recent studies reported up to 17% rate of germinal BRCA1/2 mutation (gBRCA1/2m) within the age group under 50 years at diagnosis. The original aim of this study was to invite to the genetic counselling still living patients with EOC under 45 years, to offer gBRCA1/2m testing and to perform analysis of gBRCA1/2m rate and of clinico-pathologic characteristics. Later, we added also the data of previously genetically tested patients with EOC aged 45 to 49 years. Patients and methods All clinical data have to be interpreted in the light of many changes happened in the field of EOC just in the last few years: new hystology stage classification (FIGO), new hystology types and differentiation grades classification, new therapeutic possibilities (PARP inhibitors available, also in Slovenia) and new guidelines for genetic counselling of EOC patients (National Comprehensive Cancer Network, NCCN), together with next-generation sequencing possibilities. Results Compliance rate at the invitation was 43.1%. In the group of 27 invited or previously tested patients with EOC diagnosed before the age of 45 years, five gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within the group was 18.5%. There were 4 gBRCA1 and 1 gBRCA2 mutations detected. In the extended group of 42 tested patients with EOC diagnosed before the age of 50 years, 14 gBRCA1/2 mutations were found. The gBRCA1/2m detection rate within this extended, partially selected group was 33.3%. There were 11 gBRCA1 and 3 gBRCA2 mutations detected. Conclusions The rate of gBRCA1/2 mutation in tested unselected EOC patients under the age of 50 years was higher than 10%, namely 18.5%. Considering also a direct therapeuthic benefit of PARP inhibitors for BRCA positive patients, there is a double reason to offer genetic testing to

Behaviour change counselling--how do I know if I am doing it well? The development of the Behaviour Change Counselling Scale (BCCS).

Science.gov (United States)

Vallis, Michael

2013-02-01

The purpose of this article is to operationalize behaviour change counselling skills (motivation enhancement, behaviour modification, emotion management) that facilitate self-management support activities and evaluate the psychometric properties of an expert rater scale, the Behaviour Change Counselling Scale (BCCS). Twenty-one healthcare providers with varying levels of behaviour change counselling training interviewed a simulated patient. Videotapes were independently rated by 3 experts on 2 occasions over 6 months. Data on item/subscale characteristics, interrater and test-retest reliability, preliminary data on construct reliability, were reported. All items of the BCCS performed well with the exception of 3 that were dropped due to infrequent endorsement. Most subscales showed strong psychometric properties. Interrater and test-retest reliability coefficients were uniformly high. Competency scores improved significantly from pre- to posttraining. Behaviour change counselling skills to guide lifestyle interventions can be operationalized and assessed in a reliable and valid manner. The BCCS can be used to guide clinical training in lifestyle counselling by operationalizing the component skills and providing feedback on skill achieved. Further research is needed to establish cut scores for competency and scale construct and criterion validity. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

38 CFR 21.3102 - Required counseling.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Required counseling. 21.... Chapter 35 Counseling § 21.3102 Required counseling. (a) Child. The VA counseling psychologist will provide counseling and assist in preparing the educational plan only if the eligible child or his or her...

Adventure Counseling as an Adjunct to Group Counseling in Hospital and Clinical Settings

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Gillen, Mark C.; Balkin, Richard S.

2006-01-01

Adventure counseling has been thought of as a highly specialized application of group counseling skills in a wilderness environment. In fact, adventure counseling is based on a developmental theory of group, can be useful for a variety of clients, and can be thoughtfully integrated into clinical and hospital settings. This article describes the…

41 CFR 101-4.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Counseling and use of appraisal and counseling materials. 101-4.425 Section 101-4.425 Public Contracts and Property Management... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 101-4.425 Counseling and use...

Decision making and counseling around mammography screening for women aged 80 or older.

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Schonberg, Mara A; Ramanan, Radhika A; McCarthy, Ellen P; Marcantonio, Edward R

2006-09-01

Despite uncertain benefit, many women over age 80 (oldest-old) receive screening mammography. To explore decision-making and physician counseling of oldest-old women around mammography screening. Qualitative research using in-depth semi-structured interviews. Twenty-three women aged 80 or older who received care at a large academic primary care practice (13 had undergone mammography screening in the past 2 years) and 16 physicians at the same center. We asked patients and physicians to describe factors influencing mammography screening decisions of oldest-old women. We asked physicians to describe their counseling about screening to the oldest-old. Patients and/or physicians identified the importance of physician influence, patient preferences, system factors, and social influences on screening decisions. Although physicians felt that patient's health affected screening decisions, few patients felt that health mattered. Three types of elderly patients were identified: (1) women enthusiastic about screening mammography; (2) women opposed to screening mammography; and (3) women without a preference who followed their physician's recommendation. However, physician counseling about mammography screening to elderly women varies; some individualize discussions; others encourage screening; few discourage screening. Physicians report that discussions about stopping screening can be uncomfortable and time consuming. Physicians suggest that more data could facilitate these discussions. Some oldest-old women have strong opinions about screening mammography while others are influenced by physicians. Discussions about stopping screening are challenging for physicians. More data about the benefits and risks of mammography screening for women aged 80 or older could inform patients and improve provider counseling to lead to more rational use of mammography.

The Process and Experience of Online Group Counseling for Masters-Level Counseling Students

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Lopresti, Jason Michael

2010-01-01

The present study explored the process and experience of online group counseling using a text-based synchronous program, particularly addressing how the process compares to face-to-face group counseling. Six students in a masters-level group counseling class voluntarily chose to participate for eight sixty minute online sessions on a weekly basis,…

The politicization of abortion and the evolution of abortion counseling.

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Joffe, Carole

2013-01-01

The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation--head and heart counseling--departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade.

Counseling-Related Research in Counseling Psychology: Creating Bricks, Not Edifices

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Scheel, Michael J.; Berman, Margit; Friedlander, Myrna L.; Conoley, Collie W.; Duan, Changming; Whiston, Susan C.

2011-01-01

Three counseling psychology colleagues (Lichtenberg, 2011; Mallinckrodt, 2011; Murdock, 2011 [all this issue]) provide differing perspectives about the findings from our target article (Scheel et al., 2011) of the decline of published counseling-related research in our major journals. In this rejoinder we respond to each author's viewpoints…

Counseling Ethics Education Experience: An Interpretive Case Study of the First Year Master's Level Counseling Students

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Zakaria, Noor Syamilah

2013-01-01

Counseling ethics competency is an important part of counselor identity development as required by the counseling profession training standards, and counseling ethics education is one major component of knowledge acquisition in counseling profession. Counselor educators and counselor education training programs have a core responsibility to…

Non-attendance at counselling therapy in cocaine-using methadone-maintained patients: lessons learnt from an abandoned randomised controlled trial.

LENUS (Irish Health Repository)

Darker, C

2012-12-01

Recently, the authors commenced a randomised controlled trial to study the effectiveness of cognitive behavioural coping skills (CBCS) to reduce cocaine usage in methadone-maintained patients\\' in a clinical setting by assessing attendance at treatment sessions and outcomes in terms of cocaine use. However, recruitment into the study stopped when it became apparent that attendance at counselling sessions was poor.

15 CFR 8a.425 - Counseling and use of appraisal and counseling materials.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Counseling and use of appraisal and counseling materials. 8a.425 Section 8a.425 Commerce and Foreign Trade Office of the Secretary of Commerce... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 8a.425 Counseling and use of...

Contraceptive counseling for adolescents.

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Potter, Julia; Santelli, John S

2015-11-01

The majority of adolescents become sexually active during their teenage years, making contraceptive counseling an important aspect of routine adolescent healthcare. However, many healthcare providers express discomfort when it comes to counseling adolescents about contraceptive options. This Special Report highlights the evidence supporting age-appropriate contraceptive counseling for adolescents and focuses on best practices for addressing adolescents' questions and concerns about contraceptive methods.

Addiction Counseling Accreditation: CACREP's Role in Solidifying the Counseling Profession

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Hagedorn, W. Bryce; Culbreth, Jack R.; Cashwell, Craig S.

2012-01-01

In this article, the authors discuss the Council for Accreditation of Counseling and Related Educational Programs' (CACREP) role in furthering the specialty of addiction counseling. After sharing a brief history and the role of counselor certification and licensure, the authors share the process whereby CACREP developed the first set of…

Counseling Graduate Students.

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Caple, Richard B.

1995-01-01

Explores how the understanding of graduate students' special needs and circumstances enhances counseling of this population. Looks at stress factors, educational preparation, delayed gratification, achieving autonomy, intellectual development, and the counseling process. Emphasizes the importance of establishing trust in the therapeutic dialog so…

Predicting Factors of Drop Out Counseling Process in University Psychological Counseling and Guidance Center

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Omer OZER

2015-03-01

Full Text Available Objective: Objective: The purpose of this study is to evaluate the predicting factors the drop out the counseling process. Methods: The study group consists of 555 college students admitted to a Counseling and Guidance Center (CGC and participated in at least one session of counseling after the first view in the 2013-2014 academic year. As a data collection tool, an “Application Form” on the demographic information and the “Brief Symptom Inventory” was applied to the students; and independent samples t-test and binary logistic regression techniques were used in the analysis of the collected data. Results: According to the analysis results, the age of the students attending the counseling process was found to be higher than those who drop out, but no significant difference was found in their psychometric properties in terms of continuation of the counseling process. Only the age of clients and their previous psychiatric help history was found to predict the dropping out counseling process early. Conclusion: Drop outs are less frequently observed in clients having a previous psychiatric help experience. In addition, it was determined that older clients less frequently drop out the counseling process

General Counsel`s office FY 1995 site support program plan WBS 6.10.5

Energy Technology Data Exchange (ETDEWEB)

Moreno, S.R.

1994-09-01

The General Counsel`s office provides legal counsel to all levels of WHC management; administers the intellectual property program; coordinates all WHC investigative activity and supports WHC activities to ensure compliance with all applicable federal, state, and local laws, DOE directives, contractual provisions, and other requirements. In so doing, the Office of General Counsel supports the Hanford site mission of transforming the Hanford site into an environmentally attractive and economically sustainable community. This document briefs the FY95 site support plan.

Patient perspectives with abbreviated versus standard pre-test HIV counseling in the prenatal setting: a randomized-controlled, non-inferiority trial.

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Cohan, Deborah; Gomez, Elvira; Greenberg, Mara; Washington, Sierra; Charlebois, Edwin D

2009-01-01

In the US, an unacceptably high percentage of pregnant women do not undergo prenatal HIV testing. Previous studies have found increased uptake of prenatal HIV testing with abbreviated pre-test counseling, however little is known about patient decision making, testing satisfaction and knowledge in this setting. A randomized-controlled, non-inferiority trial was conducted from October 2006 through February 2008 at San Francisco General Hospital (SFGH), the public teaching hospital of the City and County of San Francisco. A total of 278 English- and Spanish-speaking pregnant women were randomized to receive either abbreviated or standard nurse-performed HIV test counseling at the initial prenatal visit. Patient decision making experience was compared between abbreviated versus standard HIV counseling strategies among a sample of low-income, urban, ethnically diverse prenatal patients. The primary outcome was the decisional conflict score (DCS) using O'Connor low-literacy scale and secondary outcomes included satisfaction with test decision, basic HIV knowledge and HIV testing uptake. We conducted an intention-to-treat analysis of 278 women--134 (48.2%) in the abbreviated arm (AA) and 144 (51.8%) in the standard arm (SA). There was no significant difference in the proportion of women with low decisional conflict (71.6% in AA vs. 76.4% in SA, p = .37), and the observed mean difference between the groups of 3.88 (95% CI: -0.65, 8.41) did not exceed the non-inferiority margin. HIV testing uptake was very high (97. 8%) and did not differ significantly between the 2 groups (99.3% in AA vs. 96.5% in SA, p = .12). Likewise, there was no difference in satisfaction with testing decision (97.8% in AA vs. 99.3% in SA, p = .36). However, women in AA had significantly lower mean HIV knowledge scores (78.4%) compared to women in SA (83.7%, pprocess, while associated with slightly lower knowledge, does not compromise patient decision making or satisfaction regarding HIV testing

Gestational diabetes mellitus: an evaluation of gynecologists' knowledge of guidelines and counseling behavior.

Science.gov (United States)

Schmitz, Sophie; Groten, Tanja; Schleussner, Ekkehard; Battefeld, Wilgard; Hillemanns, Peter; Schippert, Cordula; von Versen-Höynck, Frauke

2016-11-01

Knowledge of risks, adequate pre- and post-partum care, and counseling is essential to reduce short- and long-term consequences for women with gestational diabetes mellitus (GDM) and their offspring. Our study explored the current GDM guideline knowledge and practiced patient counseling of private gynecologists in Germany. A survey assessing the GDM guidelines and patient counseling was mailed to 775 practicing gynecologists. We evaluated the knowledge of maternal and offspring disease risks, counseling practice, and guideline awareness. Descriptive statistics were used to analyze the responses and Chi-Square or Fisher exact test to explore differences between groups. Of the 418 private gynecologists (54.1 % response rate) who responded, the majority was aware of obesity and GDM in the previous pregnancy as risk factors for GDM. To a lesser extent, risk factors like recurrent miscarriages and stillbirth were recalled. Eighty percent stated that GDM was associated with a higher risk for the development for hypertension and 96 % with type 2 diabetes in the mother. Respondents with knowledge of the current GDM guidelines were more often aware of the development of chronic diseases, counseled patients more frequently, and performed post-partum glucose screenings more regularly compared with private gynecologists with no knowledge of the guidelines. The majority of participants incorporated recent recommendations into their practice patterns for GDM. Providing private gynecologists with additional training may further improve care for women with GDM-affected pregnancies.

IMPACT OF NUTRITIONAL COUNSELLING ON BODY MASS INDEX (BMI AND NUTRIENT INTAKE OF THE NON - COMMUNICABLE DISEASE PATIENTS (NCD

Directory of Open Access Journals (Sweden)

Manisha Singh

2011-12-01

Full Text Available Good health is an important discussion of the quality of life. Health problem is a major concern in all over the world but especially in developing countries. Non-communicable diseases ( NCDs contribute the ill health. Diabetes, coronary heart disease, various forms of cancer, gastro intestinal disorder and various diseases of bones and joints are diet related NCDs. Nutritional counselling is one of the effective tools of changing the food habits of people. The data for this study is taken from the out patients services of Department of Endocrinology & Metabolism and Cardiology of Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi-5. Total 250 samples were included in the study. Age group 40 – 60 years were considered as study samples who attended the Endocrinology and Cardiology departments. Purposive sampling method was used in the study. Questionnaire cum interview method was adopted in the study. Anthropametric measurements were taken by using standard techniques. 24 hours diet recall method was also used in this study. Evaluation of councelling was done on basis of changes in BMI and nutrient intake. Result shows the positive impact of nutritional counselling in BMI and nutrient intake of NCD patients.

ATTITUDES OF MEDICAL STUDENTS, CLINICIANS AND SPORTS SCIENTISTS TOWARDS EXERCISE COUNSELLING

Directory of Open Access Journals (Sweden)

Abbyrhamy Gnanendran

2011-09-01

Full Text Available We compared the amount of exercise undertaken by medical students, clinicians, and sport scientists with the National Australian Physical Activity (NAPA Guidelines. A second aim was to compare attitudes to exercise counselling as preventive medicine between university- and clinic-based professionals. The research setting was a university medical school and a sports science sports medicine centre. A 20-item questionnaire was completed by 216 individuals (131 medical students, 43 clinicians and 37 sports scientists. Self-reported physical activity habits, exercise counselling practices and attitudes towards preventive medicine were assessed. The physical activity undertaken by most respondents (70% met NAPA Guidelines. General practitioners had significantly lower compliance rates with NAPA Guidelines than other professionals. More than half of clinicians and medical students (54% were less active now compared with levels of activity undertaken prior to graduate training. Most physicians (68% reported they sometimes discuss physical activity with patients. In contrast, the majority of non-medically qualified respondents (60% said they never discuss physical activity with their doctor. Most respondents (70% had positive attitudes to exercise counselling. Sports scientists and respondents who were highly active in childhood had more positive attitudes to exercise counselling than others. Health professionals in this study were more active than the general population, however healthy exercise habits tend to deteriorate after the commencement of medical training. Despite the important role of doctors in health promotion, the degree of exercise counselling to patients is low

Counseling through Images: Using Photography to Guide the Counseling Process and Achieve Treatment Goals

Science.gov (United States)

Ginicola, Misty M.; Smith, Cheri; Trzaska, Jessica

2012-01-01

Creative approaches to counseling help counselors to meet the needs of diverse populations. The utility of photography in counseling has been demonstrated through several case studies; however, clear implications of how photography relates to the counseling process have not been well delineated. The existing literature on phototherapy is reviewed…