Sample records for providing patient education

  1. Provider documentation of patient education: a lean investigation

    Directory of Open Access Journals (Sweden)

    Jean P. Shipman, MSLS, AHIP, FMLA


    Full Text Available Purpose: The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU requirements. Methods: Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results: Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR materials, while available, have technical access barriers. Conclusions: Providers’ EHR skills and knowledge levels contribute to non-standardized patient education delivery.

  2. The Internet: friend or foe when providing patient education? (United States)

    Anderson, Amy Shelton; Klemm, Paula


    The Internet has changed how patients with cancer learn about and cope with their disease. Newly diagnosed patients with cancer often have complex educational and informational needs related to diagnosis and treatment. Nurses frequently encounter time and work-related constraints that can interfere with the provision of patient education. They are challenged to educate patients in an environment of rapidly expanding and innovative computer technology. Barriers that hinder nurses in integrating educational Internet resources into patient care include lack of training, time constraints, and inadequate administrative support. Advantages of Internet use for patient education and support include wide-ranging and current information, a variety of teaching formats, patient empowerment, new communication options, and support 24 hours a day, seven days a week. Pitfalls associated with Internet use for patients with cancer include inaccurate information, lack of access, poor quality of online resources, and security and privacy issues. Nurses routinely use computer technology in the workplace and follow rigorous security and privacy standards to protect patient information. Those skills can provide the foundation for the use of online sources for patient teaching. Nurses play an important role in helping patients evaluate the veracity of online information and introducing them to reliable Internet resources.

  3. Involving Medical Students in Providing Patient Education for Real Patients: A Scoping Review. (United States)

    Vijn, Thomas W; Fluit, Cornelia R M G; Kremer, Jan A M; Beune, Thimpe; Faber, Marjan J; Wollersheim, Hub


    Studies suggest that involving students in patient education can contribute to the quality of care and medical education. Interventions and outcomes in this field, however, have not yet been systematically reviewed. The authors examined the scientific literature for studies on interventions and outcomes of student-provided patient education. Four databases (MEDLINE, EMBASE, ERIC, PsycINFO) were searched for studies reporting patient education, undergraduate medical students, and outcomes of patient education, published between January 1990 and October 2015. Facilitators of and barriers to educational interventions were assessed using the Learning Transfer System Inventory. The learning yield, impact on quality of care, and practical feasibility of the interventions were rated by patients, care professionals, researchers, and education professionals. The search resulted in 4991 hits. Eighteen studies were included in the final synthesis. Studies suggested that student-provided patient education improved patients' health knowledge, attitude, and behavior (nine studies), disease management (three studies), medication adherence (one study), and shared decision-making (one study). In addition, involving students in patient education was reported to enhance students' patient education self-efficacy (four studies), skills (two studies), and behavior (one study), their relationships with patients (two studies), and communication skills (two studies). Our findings suggest that student-provided patient education-specifically, student-run patient education clinics, student-provided outreach programs, student health coaching, and clerkships on patient education-has the potential to improve quality of care and medical education. To enhance the learning effectiveness and quality of student-provided patient education, factors including professional roles for students, training preparation, constructive supervision, peer support on organizational and individual levels, and

  4. [Comprehensibility of patient education in orthopaedic rehabilitation: a qualitative study on patients and providers]. (United States)

    Nagl, M; Ullrich, A; Farin, E


    An important requirement for achieving postulated goals in the context of patient education is that patient education be conducted in a way that the patients can understand it. It is the objective of this explorative study to examine how patients and providers evaluate the comprehensibility and patients' comprehension of patient education under routine conditions during orthopaedic rehabilitation. Furthermore, we aim to explore the influencing factors that patients and providers describe as conducive and counterproductive to the comprehensibility of patient education, and the ideas or desires they have as to how patient education can be made more comprehensible. We conducted guided focus groups with 50 patients with chronic back pain or osteoarthritis aged between 22 and 71 years (M=50.4, SD=9.4) and 35 patient education providers aged between 26 and 61 years (M=44.9, SD=9.8) in a total of 9 orthopaedic rehabilitation centres. Qualitative analyses of the interview transcripts were conducted according to Mayring's content analytic approach using Atlas.ti software. Patients and providers evaluate patient education as generally comprehensible. The involvement of patients in patient education is reported by both patients and providers as the main conducive factor. Patients describe poor (e. g. superficial or contradictory) information as counterproductive regarding comprehensibility, while providers tend to mention patients' lack of motivation and of taking personal responsibility as hindering patients' comprehension. Patients' and providers' proposals and ideas can be organized in the topics patient education (e. g. stronger reference to patients' everyday life), providers (e. g. improving providers' tutoring skills), information (e. g. more information), patient involvement (e. g. stronger consideration of patients' interests), organization (e. g. smaller groups), and goal clarification (e. g. consideration of patients' expectations). Our results reveal that good

  5. The importance of pharmacist providing patient education in oncology. (United States)

    Avery, Mia; Williams, Felecia


    The world's increasing diversity requires health care professionals to adjust delivery methods of teaching to accommodate different cultural values and beliefs. The ability to communicate effectively across languages and various cultural practices directly affects patient education outcomes. Pharmacist should be aware of varying modalities and considerations when counseling a patient diagnosed with cancer and undergoing chemotherapy. In more recent years, the medical profession has seen an increase in patient outcomes due to using the multidisciplinary team approach and has benefited by implementing Medication Therapy Management (MTM) programs at various institutions. For the clinical pharmacist, this would mean documentation for these services should be precise and accurate based on the specific patients needs. There are several factors involved in the care and therapy of the patient with cancer. Clinical oncology pharmacist should be aware of the ever-changing role in oncology and be able to implement new practices at their facility for better patient outcomes. © The Author(s) 2014.

  6. Content of Orthopedic Patient Education Provided by Nurses in Seven European Countries. (United States)

    Charalambous, Andreas; Papastavrou, E; Valkeapää, K; Zabalegui, A; Ingadóttir, B; Lemonidou, C; Fatkulina, N; Jouko, K; Leino-Kilpi, H


    Patients' and their significant others' education during the perioperative phase is an important and challenging aspect of care. This study explored the content of education provided by nurses to arthroplasty patients and their significant others. Data were collected with the Education of Patients-NURSE content (EPNURSE-Content), Received Knowledge of Hospital Patient (RKhp), and Received Knowledge of Significant Other (RKso) scales. The results showed that the content of education emphasized biophysiological and functional needs, differed between countries, and was related to how physically demanding nurses found their job to be and the amount of education provided. There is congruence between the received knowledge of patients and their significant others in relation to the content of education provided by nurses. The findings can support nurses in developing aid material for patients and significant others explaining the nature of education and advising them what to expect and how to optimize their participation in the process.

  7. Perception of therapeutic patient education in heart failure by healthcare providers. (United States)

    Garbacz, Laure; Juillière, Yves; Alla, François; Jourdain, Patrick; Guyon, Gaëlle; Coudane, Henry; Hervé, Christian; Claudot, Frédérique


    Care provider support for therapeutic patient education (TPE), its results and relationships with patients are factors in the setting up and sustainability of this practice. With a view to understanding the factors determining TPE care provider participation and favouring its development, the aim of this study was to describe the perception healthcare providers have of TPE in heart failure. A national survey by self-administered questionnaire was performed in 2013 in 61 Observatoire de l'INsuffisance cardiaque (ODIN; Heart Failure Observatory) centres participating in the I-CARE programme. The cardiologist in charge of each centre received five questionnaires: one for him/herself and four for other healthcare providers working with him/her. We received 116 responses out of the 305 questionnaires sent (38.0%). Almost all of the responders stated that the patients were more observant after TPE sessions (91.4%). According to the responders, patients were better informed thanks to TPE (53.9%); they stated that TPE had changed their relationships with patients (81.9%); they also felt that they were educating the patient's close family/friends at the same time as the patients (86.2%). The survey showed that TPE improves care relationships. Healthcare providers recognize that they have been working differently since the programme was set up, and want the patient's close family/friends to be involved in treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Educating Healthcare Providers Regarding LGBT Patients and Health Issues: The Special Case of Physician Assistants (United States)

    Compton, David A.; Whitehead, Michael B.


    Much is written about the availability of healthcare services among elements of the U.S. population, with a large proportion of the literature focusing on access. Although physical access is an overarching issue for many, educators must remember that a key factor in providing complete and competent healthcare is to understand the patient and any…

  9. Community Pharmacist-Provided Osteoporosis Screening and Education: Impact on Patient Knowledge

    Directory of Open Access Journals (Sweden)

    Andrea L. Brookhart


    Full Text Available Objective: To evaluate the impact pharmacist-provided screening and education had on patient knowledge of osteoporosis and preventive strategies. Methods: A prospective, randomized, controlled study was conducted at 16 locations of a national supermarket chain pharmacy in the Richmond, Virginia area. Women 30 years and older with no history of osteoporosis were enrolled in the study. Patients self-selected into the study by agreeing to the bone density screening, pharmacist-provided education, and completion of a knowledge survey. Subjects were randomized to complete the osteoporosis-related knowledge survey either before (Group A or after (Group B the screening and education session. The survey was developed after guideline and literature evaluation and was pretested with a group of patients for content and clarity. The survey evaluated knowledge of osteoporosis, risk factors for the disease, appropriate age for testing, and preventive strategies. Groups A and B were compared using t-tests. Results: A total of 110 women were enrolled in the study. The mean (±SD age was 52.5 ± 13.1 years in Group A (n=52 and 52.7 ± 11.5 years in Group B (n=58. Knowledge scores were higher in the group who received pharmacist-provided education prior to completing the survey in each category (knowledge of the disease, risk factors, preventive strategies, and appropriate age for testing and overall (p<0.001. Conclusions: Community pharmacist-provided osteoporosis screening and education increased patient knowledge about osteoporosis and preventive strategies. Community pharmacist involvement with increasing patient knowledge may empower patients to engage in prevention strategies to improve bone mass.   Type: Original Research

  10. Who Is Providing and Who Is Getting Asthma Patient Education: An Analysis of 2001 National Ambulatory Medical Care Survey Data (United States)

    Shah, Shaival S.; Lutfiyya, May Nawal; McCullough, Joel Emery; Henley, Eric; Zeitz, Howard Jerome; Lipsky, Martin S.


    Patient education in asthma management is important; however, there is little known about the characteristics of patients receiving asthma education or how often primary care physicians provide it. The objective of the study was to identify the characteristics of patients receiving asthma education. It was a cross-sectional study using 2001…

  11. Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder. (United States)

    Nelson, Travis M; Sheller, Barbara; Friedman, Clive S; Bernier, Raphael


    Autism Spectrum Disorder (ASD) is a condition which most dentists will encounter in their practices. Contemporary educational and behavioral approaches may facilitate successful dental care. A literature review was conducted for relevant information on dental care for children with ASD. Educational principles used for children with ASD can be applied in the dental setting. Examples include: parent involvement in identifying strengths, sensitivities, and goal setting; using stories or video modeling in advance of the appointment; dividing dental treatment into sequential components; and modification of the environment to minimize sensory triggers. Patients with ASD are more capable of tolerating procedures that they are familiar with, and therefore should be exposed to new environments and stimuli in small incremental steps. By taking time to understand children with ASD as individuals and employing principles of learning, clinicians can provide high quality dental care for the majority of patients with ASD. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  12. Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork. (United States)

    Clark, Phillip G


    Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

  13. Pediatrics Education in an AHEC Setting: Preparing Students to Provide Patient Centered Medicine (United States)

    Evans, Steven Owens


    Patient centered medicine is a paradigm of health care that seeks to treat the whole person, rather than only the illness. The physician must understand the patient as a whole by considering the patient's individual needs, social structure, socioeconomic status, and educational background. Medical education includes ways to train students in this…

  14. Use of on-demand video to provide patient education on spinal cord injury. (United States)

    Hoffman, Jeanne; Salzman, Cynthia; Garbaccio, Chris; Burns, Stephen P; Crane, Deborah; Bombardier, Charles


    Persons with chronic spinal cord injury (SCI) have a high lifetime need for ongoing patient education to reduce the risk of serious and costly medical conditions. We have addressed this need through monthly in-person public education programs called SCI Forums. More recently, we began videotaping these programs for streaming on our website to reach a geographically diverse audience of patients, caregivers, and providers. We compared information from the in-person forums to that of the same forums shown streaming on our website during a 1-year period. Both the in-person and Internet versions of the forums received high overall ratings from individuals who completed evaluation forms. Eighty-eight percent of online evaluators and 96% of in-person evaluators reported that they gained new information from the forum; 52 and 64% said they changed their attitude, and 61 and 68% said they would probably change their behavior or take some kind of action based on information they learned. Ninety-one percent of online evaluators reported that video is better than text for presenting this kind of information. Online video is an accessible, effective, and well-accepted way to present ongoing SCI education and can reach a wider geographical audience than in-person presentations.

  15. Rising Need for Health Education Among Renal Transplant Patients and Caregiving Competence in Care Providers. (United States)

    Xie, Jianfei; Ming, Yingzi; Ding, Siqing; Wu, Xiaoxia; Liu, Jia; Liu, Lifang; Zhou, Jianda


    Health education positively affects the efficacy of self-management and should be carried out according to the status of patients' needs, knowledge, and the competence of the primary caregivers. This study was to investigate the needs of health education knowledge in transplant patients and the competence of the primary caregivers. This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 351 renal transplantation patients and their primary caregivers. Three-hundred nine valid questionnaires were included in the analysis. The intensive care unit environment, stress coping strategies, the operation procedure, anesthesia and adverse reactions, and hand hygiene were the 5 most poorly understood aspects in health education. Stress coping strategies, at-home self-monitoring of health, pulmonary infection prevention, dietary needs, and anesthesia and other adverse reactions were the top 5 health education needs. Decision and self-efficacy were the weakest caregiving competence. Significant positive correlations were observed between health education knowledge level and caregiving competence in the primary caregivers. Marriage, education level, career, expense reimbursement, and residence significantly contributed to the health education demand questionnaire model, whereas gender, age, ethnic group, education level, career, and expense reimbursement significantly contributed to health education knowledge questionnaire model ( P decision-making and self-efficacy.

  16. Is patient education helpful in providing care for patients with rheumatoid arthritis? A qualitative study involving French nurses. (United States)

    Fall, Estelle; Chakroun, Nadia; Dalle, Nathalie; Izaute, Marie


    This French study explored nurses' involvement in patient education for patients with rheumatoid arthritis. The study design was qualitative. Semistructured interviews were conducted with 16 hospital nurses. Data analysis was performed according to Giorgi's descriptive phenomenological method, and supported by specific qualitative analysis software (Sphinx). The results showed the important role of hospital nurses in rheumatoid arthritis care. Patient education is a core part of nurses' work, allowing them to give patients information and emotional support. The interviewees displayed skills in helping patients learn to care for themselves. However, patient education mostly concerned patients who are already committed to their health care. Non-adherent patients warrant special attention; their acceptance of their disease, perceptions about disease and treatment, motivation, and autonomy should be specifically addressed. French nurses could benefit from more training, and could be aided by psychologists. Ambulatory services could also be developed for patient education in France, based on examples from other countries. © 2013 Wiley Publishing Asia Pty Ltd.

  17. Providing care for underserved patients: endodontic residents', faculty members', and endodontists' educational experiences and professional attitudes and behavior. (United States)

    Inglehart, Marita R; Schneider, Brady K; Bauer, Patricia A; Dharia, Maneet M; McDonald, Neville J


    In the United States, access to dental care is often challenging for patients from socioeconomically disadvantaged and/or minority populations and for patients with special health care needs (SHCN). The objectives of this study were to a) explore endodontic residents', endodontic faculty members', and private practice endodontists' perceptions of their education about treating underserved patients, along with their related attitudes and behavior, and b) to determine how their educational experiences were related to their attitudes and behavior concerning these patients. It was hypothesized that the quality of educational experiences related to these issues would correlate with the providers' professional attitudes and behavior. Survey data were collected from seventy-eight endodontic residents, forty-eight endodontic faculty members, and seventy-five endodontists in private practice. The residents reported themselves being better prepared to treat these patients than did the endodontists in private practice. The residents and faculty members had more positive attitudes towards patients with SHCN, developmental disabilities, and pro bono cases and were more confident when treating patients with developmental disabilities than private practitioners. However, the three groups did not differ in educational experiences and attitudes concerning patients from different ethnic/racial groups. The better the respondents' graduate education about certain patient groups had been, the more positive were their attitudes and behavior. Improving endodontic residents' education about treating underserved patients is likely to improve their attitudes and behavior related to providing much-needed care for these patients. These findings are a call-to-action for dental educators to ensure quality education is being provided about these issues in order to decrease access to care problems for underserved patients.

  18. Exploring sensitive boundaries in nursing education: attitudes of undergraduate student nurses providing intimate care to patients. (United States)

    Crossan, M; Mathew, T K


    Nursing students often feel challenged and intimidated to provide intimate care to patients in the health care setting. Student nurses in particular are faced with social, professional, academic and peer expectations and experience high levels of stress when providing this intimate care. Explore student nurses attitudes to providing intimate care. Year two and year three students of a three year undergraduate nursing programme completed a descriptive Nursing Students Intimate Care (NSIC) survey with open ended questions. This study discusses student responses to the question: Did you feel it was appropriate for a nurse to provide intimate care to a patient of the opposite sex? Three major themes were identified: societal and self-determined role expectations, comfort and discomfort providing intimate care, and age and gender of the carer and recipient. Student nurses face numerous challenges when having to provide intimate care to patients. These challenges are influenced by the age, gender, levels of comfort of the nurse and the patient and is related to the nature of intimate care being provided. Student nurses will benefit from pre-clinical simulated training experiences in providing intimate care. This training needs to specifically consider being sensitive to the needs of the patient, maintaining patient dignity, negotiating, accommodating and implementing plan of care while being competent and professional in their approach to providing intimate care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Beyond vulnerability: how the dual role of patient-health care provider can inform health professions education. (United States)

    Rowland, Paula; Kuper, Ayelet


    In order to prepare fully competent health care professionals, health professions education must be concerned with the relational space between patients and providers. Compassion and compassionate care are fundamental elements of this relational space. Traditionally, health professions educators and leaders have gone to two narrative sources when attempting to better under constructs of compassion: patients or providers. Rarely have there been explorations of the perspectives of those who consider themselves as both patients and providers. In this study, we interviewed nineteen health care providers who self-disclosed as having had a substantive patient experience in the health care system. We engaged with these participants to better understand their experience of having these dual roles. Anchored in Foucault's concepts of subjectivity and Goffman's symbolic interactionism, the interviews in this study reveal practices of moving between the two roles of patient and provider. Through this exploration, we consider how it is that providers who have been patients understand themselves to be more compassionate whilst in their provider roles. Rather than describing compassion as a learnable behaviour or an innate virtue, we theoretically engage with one proposed mechanism of how compassion is produced. In particular, we highlight the role of critical reflexivity as an underexplored construct in the enactment of compassion. We discuss these findings in light of their implications for health professions education.

  20. Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening (United States)

    Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.


    Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

  1. A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge. (United States)

    Waszak, Daria L; Mitchell, Ann M; Ren, Dianxu; Fennimore, Laura A


    The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%. This quality improvement project is the implementation of a nurse-delivered, evidence-based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual-modal (verbal and written) education with a patient teach-back to verify comprehension. Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication. Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Pregnancy and inflammatory bowel disease: Do we provide enough patient education? A British study of 1324 women. (United States)

    Carbery, Isabel; Ghorayeb, Jihane; Madill, Anna; Selinger, Christian P


    To examine patient knowledge and factors influencing knowledge about pregnancy in British women with inflammatory bowel disease (IBD). This is a post hoc analysis of a study of female members of Crohn's and Colitis United Kingdom, aged 18-45 years who were sent an online questionnaire recording patient demographics, education, employment, marital status, and disease characteristics. Disease related pregnancy knowledge was recorded using Crohn's and colitis pregnancy knowledge score (CCPKnow). Of 1324 responders, 776 (59%) suffered from Crohn's disease, 496 (38%) from ulcerative colitis and 52 (4%) from IBD-uncategorised. CCPKnow scores were poor (0-7) in 50.8%, adequate (8-10) in 23.6%, good (11-13) in 17.7% and very good (≥ 14) in 7.8%. Multiple linear regression analysis revealed that higher CCPKnow scores were independently associated with higher educational achievement (P pregnancy and IBD (P = 0.001). Knowledge was poor in 50%. Speaking with health-care professionals was a modifiable factor associated with better knowledge. This illustrates the importance of disease related pregnancy education.

  3. Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training. (United States)

    Long, Ann C; Engelberg, Ruth A; Downey, Lois; Kross, Erin K; Reinke, Lynn F; Cecere Feemster, Laura; Dotolo, Danae; Ford, Dee W; Back, Anthony L; Curtis, J Randall


    Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. To examine the association of race/ethnicity or socioeconomic status with patients' and families' ratings of end-of-life care and communication about end-of-life care provided by physicians-in-training. As a component of a randomized trial evaluating a program designed to improve clinician communication about end-of-life care, patients and patients' families completed preintervention survey data regarding care and communication provided by internal medicine residents and medical subspecialty fellows. We examined associations between patient and family race or socioeconomic status and ratings they gave trainees on two questionnaires: the Quality of End-of-Life Care (QEOLC) and Quality of Communication (QOC). Patients from racial/ethnic minority groups, patients with lower income, and patients with lower educational attainment gave trainees higher ratings on the end-of-life care subscale of the QOC (QOCeol). In path models, patient educational attainment and income had a direct effect on outcomes, while race/ethnicity did not. Lower family educational attainment was also associated with higher trainee ratings on the QOCeol, while family non-white race was associated with lower trainee ratings on the QEOLC and general subscale of the QOC. Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.

  4. Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care. (United States)

    Moeller, Andrew; Webber, Jordan; Epstein, Ian


    Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains. Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t-test for paired samples. Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions. Senior residents in a Canadian internal medicine training program perceived significant benefits in medical education experience, ability to deliver healthcare, and resident wellness after implementation of duty hour reform.

  5. Provider recommendations for patient-reported muscle symptoms on statin therapy: Insights from the Understanding Statin Use in America and Gaps in Patient Education survey. (United States)

    Jacobson, Terry A; Khan, Abdullah; Maki, Kevin C; Brinton, Eliot A; Cohen, Jerome D

    Statin-associated muscle symptoms are reported by 10% to 29% of patients in clinical practice and are a major determinant of statin nonadherence, discontinuation, and switching. Little is known about what advice patients receive from their providers when dealing with these symptoms. The objective of the study was to assess patient's reports of provider advice when experiencing new or worsened muscle symptoms while taking a statin. Data were analyzed from the Understanding Statin Use in America and Gaps in Education survey, a self-administered internet-based survey of 10,138 adults with a reported history of high cholesterol and statin use. Of the respondents, 60% of former statin users (n = 1220) reported ever experiencing new or worsened muscle pain on a statin, in contrast to 25% of current users (n = 8918; P < .001). Former statin users reported stopping more statins because of muscle symptoms (mean ± standard deviation, 2.2 ± 1.7) compared with current users (mean 1.6 ± 1.5, P < .0001). For those with muscle-related symptoms while on a statin, participants reported that providers most often suggested switching to another statin (33.8%), stopping the statin (15.9%), continuing the statin with further monitoring of muscle symptoms (12.2%), reducing the statin dose (9.8%), or getting a blood test for signs of muscle damage (9.2%). A lower percentage were advised to add either vitamin D (7.0%) or coenzyme Q10 (5.8%), or to switch to nonstatin therapy (6.1%) or red yeast rice (2.6%). This study highlights patient experience with statin-associated muscle symptoms and the strategies recommended by providers in managing these symptoms. More research is needed to develop patient-centric and evidence-based approaches to managing statin-associated muscle symptoms, which is especially important in light of recent data showing increased cardiovascular risk among those who discontinue statin therapy. Copyright © 2017 National Lipid Association. Published by

  6. Epidemiological multicentre study on the education provided to patients with type 2 diabetes mellitus in the Spanish Health Care System. The Forma2 study. (United States)

    García-Donaire, J A; Franch-Nadal, J; Rodríguez-Fortúnez, P; Labrador-Barba, E; Orera-Peña, M L; Rodríguez de Miguel, M


    The purpose of the present study was to characterize the education that patients with type 2 diabetes mellitus receive, and to identify differences as regards the presence of insulin therapy or not. This crossover, multicentre and descriptive study involved 1066 Spanish physicians who completed a questionnaire on Internet. The physicians that responded had a mean of 26.0 years of experience in healthcare, and mainly worked in a walk-in clinic in an urban area. Physicians rated the level of patient knowledge about their disease on a 5.0 point-scale. Fifty percent of them indicated that they spent between 15 and 30min in educating patients at the time of diagnosis. Previous control with HbA1c>9%, presence of microvascular complications, and a low socio-cultural level, were factors associated with spending more time in education. This is the first study designed to evaluate the education provided to patients with type 2 diabetes mellitus from Spain. The time spent and the individualization of the education are important factors associated with better long-term control of the disease, and thus with the effectiveness of the clinical management. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Readability of neurosurgery-related patient education materials provided by the American Association of Neurological Surgeons and the National Library of Medicine and National Institutes of Health. (United States)

    Schmitt, Paul J; Prestigiacomo, Charles J


    Most professional organizations now provide patient information material, and not all of this material is appropriate for the average American adult to comprehend. The National Institutes of Health (NIH) and the United States Department of Health and Human Services recommend that patient education materials be written at the sixth-grade level. Our aim was to assess the readability of neurosurgery-related patient education material and compare it with The American Medical Association, NIH, and United States Department of Health and Human Services recommendations. Materials provided by the American Association of Neurologic Surgeons (AANS) and the U.S. National Library of Medicine (NLM) and National Institutes of Health were assessed with the Flesch-Kincaid grade level and Flesch Reading Ease score with Microsoft Office Word software. None of the articles had Flesch-Kincaid grade levels at or below the sixth-grade level. All articles on the AANS Conditions and Treatments section were written at or above the ninth-grade level; three of the AANS Camera-Ready Fact Sheets and four of the NIH/NLM articles were written between the seventh- and eighth-grade levels. Current patient education material provided by the AANS is written well above the recommended level. Material from the NLM and NIH performed better, but was still above the recommended sixth-grade level. Education materials should contain information relevant to patients' conditions, be accurate in the information they present, and be written with the average patient in mind. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Providing Continuing Education for International Nurses. (United States)

    Case, Debra L


    In an increasingly globalized world, providing continuing education (CE) for nurses is becoming a more common opportunity for U.S. educators. It is important for educators to provide CE programs in a culturally competent and sensitive environment. The challenges involved include effective communication, appropriate teaching methodologies, contextually appropriate content, and awareness of cultural-specific needs and customs. Copyright 2015, SLACK Incorporated.

  9. Patient-Provider Communication: the Rise of Patient Engagement. (United States)

    Jenerette, Coretta M; Mayer, Deborah K


    To describe the changing dynamics of patient-provider communication with proposals for optimizing this important relationship. Current research, national programs and guidelines from the National Cancer Institute, the Commission on Cancer, the Institute of Medicine, and the Oncology Nursing Society. There are important opportunities to apply evidence-based strategies to optimize patient-provider communication that will result in improved health outcomes. Oncology nurses across all areas of practice, including clinical care, research, and education, can play a significant role in achieving the goal of positive health outcomes by addressing challenges that inhibit effective patient-provider communication. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. An Analysis of Oppression and Health Education for Underserved Populations in the United States: The Issues of Acculturation, Patient-Provider Communication, and Health Education (United States)

    Weaver, Shannon; Gull, Bethany; Ashby, Jeanie; Kamimura, Akiko


    The oppression of underserved populations is pervasive throughout the history of the United States (U.S.), especially in health care. Brazilian educator Paulo Freire's controversial ideas about systems of power can be aptly applied to health care. This paper focuses specifically on arguably the most medically underserved group in the U.S.…

  11. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care. (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B


    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  12. Influenza Vaccination among Pregnant Women: Patient Beliefs and Medical Provider Practices

    National Research Council Canada - National Science Library

    Stark, Lauren M; Power, Michael L; Turrentine, Mark; Samelson, Renee; Siddiqui, Maryam M; Paglia, Michael J; Strassberg, Emmie R; Kelly, Elizabeth; Murtough, Katie L; Schulkin, Jay


    ...% of patients reported receiving a recommendation. Age, education, a medical provider's recommendation, and educational materials were found to positively influence patient beliefs about the influenza...

  13. [Collaboration patients-health care providers]. (United States)

    Grezet-Bento de Carvalho, Angela; Griesser, Anne-Claude; Hertz, Silvana; Constantin, Michèle; Forni, Michel; Blagojevic, Stina; Bouchardy, Christine; Vlastos, Georges


    Breast cancer is the most common cancer in women. Daily suffering of patients and their relatives is often ignored or underestimated. Scientific advances focus on medical treatments and survival and very little on the psychosocial impact of the disease. The shared expertise between breast cancer patients and health care providers is an innovative and promising approach aiming to provide better quality of life and care. The participation of patients permits to bring together professionals around common goals and to promote multidisciplinary disease management, networking and global care. Focusing on very concrete problems highlighted from patients' expertise also improves research, medical training, and health policy standards.

  14. Audiences and Providers of Distance Education (United States)

    Nazarinia Roy, R. Roudi; Schumm, Walter R.


    As noted by Moore (2007, xxiii), the fifth section of the second edition of the "Handbook of Distance Education" focused on "some of the main consumers and suppliers of distance education programs," including elementary and secondary education, community colleges, universities, the corporate sector, continuing professional…

  15. Providers' roles in enhancing patients' adherence to pain self management. (United States)

    Dorflinger, Lindsey; Kerns, Robert D; Auerbach, Stephen M


    Practice guidelines and empirical research related to pain management encourage clinicians to take active roles in providing education about self management and promoting adoption of a self-management approach. The purpose of the study was to review the relevant literature, summarize aspects of the patient-provider interaction that influence patient engagement in self management for chronic pain, and outline practice recommendations in this area. Review of the literature on aspects of the patient-provider interaction that promote engagement in pain self-management was used. Findings are synthesized into recommendations for providers. Patients benefit from a biopsychosocial and patient-centered approach. Patients are more likely to fully disclose when providers respond empathically, which can improve conceptualization and treatment. Patient education and motivation play important roles in engaging patients in self management. Self management is influenced in part by the patient-provider communication process. Suggestions for communication strategies to facilitate patient engagement in self-management techniques, including empathic discussion of barriers and motivation enhancement, are provided.

  16. Providing Culturally Sensitive Care for Transgender Patients (United States)

    Maguen, Shira; Shipherd, Jillian C.; Harris, Holly N.


    Culturally sensitive information is crucial for providing appropriate care to any minority population. This article provides an overview of important issues to consider when working with transgender patients, including clarification of transgender terminology, diagnosis issues, identity development, and appropriate pronoun use. We also review…

  17. The comparison of the effects of education provided by nurses on the quality of life in patients with congestive heart failure (CHF) in usual and home-visit cares in Iran. (United States)

    Mehralian, Hossein; Salehi, Shahriar; Moghaddasi, Jafar; Amiri, Masoud; Rafiei, Hossin


    Quality of life (QOL) can be considered as a quality indicator of health care systems and nurses can play an important role to improve QOL in patients with congestive heart failure (CHF). The aim of this study was to determine the effects of education provided by nurses on the QOL in patients with CHF in home-visit care compared to usual care. In a single-blind randomized controlled trial conducted from September 2011 to June 2012, 110 patients with CHF were randomly assigned into two groups. While patients in group I were received usual education at the time of hospital discharge, patients in Group II, in addition to usual education, were received special education regards to their illness by nurses who visited patients in their homes. The 36-item short-form (SF-36) questionnaire was used to evaluate the patient's QOL at the time of discharge and also six months after hospital discharge. At the time of hospital discharge, mean score of all 8 sub-score of SF-36 questionnaire was 63.4±7.8 in patients of group II and 61.1±6.4 in patients of group I, respectively (P> 0.05). QOL was decreased in group I and increased in group II compared to the time of hospital discharge. After six months, mean score of QOL was higher in group II than in group I. QOL of patients with CHF were decreased after hospital discharge. Education provided by nurses in home-visit care could improve the QOL in patients with CHF, based on the findings of this study.

  18. Providing sexual information to ostomy patients. (United States)

    Gloeckner, M R; Starling, J R


    Forty patients with a permanent colostomy, ileostomy, or ileal conduit were interviewed. Besides changes in sexual performance postoperatively, the authors specifically attempted to determine answers to other sexual variables such as attractiveness, appliance problems, and partner reactions. The extent of information provided to patients on sexuality prior to the permanent ostomy was also examined. There was a significant but predictable incidence of male impotence and female dyspareunia after surgery. Despite innumerable sexual variables, other than performance, which these patients faced postoperatively, 42 per cent received no information regarding sexuality at the time of ostomy surgery. most patients (97.5 per cent) stated that sexuality, including variables other than performance, should be discussed primarily by the surgeon prior to permanent ostomy surgery. The enterostomal therapist has an important role in the total patient adjustment in the long-term postoperative period.

  19. The Challenge of Providing Gifted Education

    Directory of Open Access Journals (Sweden)

    Sharon Dole


    Full Text Available Introduction to Volume 4, No of Global Education Review Although there is a lack of universal consensus on a definition of giftedness there is some agreement that giftedness involves multiple qualities, not just intellectual ones. Gifted education programs vary both among and within countries and who is served in these programs depends largely on the definitions used. The topics explored in this issue include perceptions and policies of gifted education in cultures and countries across the globe; the presumed dichotomy of equity and excellence in countries as different in ideologies as the United States and China; underrepresentation of culturally diverse students, a problem that has plagued the field for decades; gifted education in rural communities; and using a virtual environment for students to pose and share mathematical problems.

  20. Factors affecting Saudi hemodialysis patients' perception of healthcare providers' empathy. (United States)

    Al Onazi, Mariam; Al Jondeby, Mohamed; Azeem, Mubashar; Al Sayyari, Abdulla


    We aimed to assess the empathy level of healthcare providers as perceived by hemodialysis (HD) patients and its determinants. This survey included 100 hemodialysis patients from two major dialysis units in Riyadh, Saudi Arabia (Units A and B). Patients were asked to score their perception of empathy by health care providers in 13 areas using 1 to 5 Likert Scale. Unit "A" contained more patients with diabetic nephropathy than unit "A". Unit "B" contained a higher number of native Arabic speaking nurses and its patients had longer mean duration on dialysis compared to unit "A". The overall score given for doctors empathy was 81.6% (84.5% for Unit "A" doctors and 78.8% for Unit "B" doctors (P=0.01). The overall score given for nurses empathy was 73.6% (76.2% for Unit "A" nurses and 70.9% for Unit "B" nurses (P=0.002). Female patients' perception of empathy was significantly greater than male patients in 8 out of 13 questions. Older patients gave higher score than younger patients. Patients with lower educational level perceived higher empathy levels than patients with higher education. Significantly lower scores were given by patients who received their dialysis treatment at night. We observed no differences in scores in relation to patients' duration on dialysis, diabetic status or Charlson Co-morbidity Index (CCI). Empathy goes beyond the language barrier. Patients dialyzed in evening shifts perceive less empathy from healthcare workers. The higher scores given by older, female and less educated patients might simply reflect their lower expectation of empathy.

  1. Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits

    Directory of Open Access Journals (Sweden)

    Betsy Sleath


    Full Text Available Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients’ visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.

  2. Providing Educationally Relevant Occupational and Physical Therapy Services (United States)

    Laverdure, Patricia A.; Rose, Deborah S.


    As defined in the Individuals with Disabilities Education Improvement Act, occupational and physical therapists provide services to support students to access, participate, and progress in their educational program within the least restrictive educational environment. Educationally relevant occupational and physical therapy services in school…

  3. Provider and patient perception of psychiatry patient health literacy. (United States)

    Bacon, Opal; Vandenberg, Amy; May, Meghan E


    Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations. The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers' perception of patients' health literacy. We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS). Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared. Inadequate health literacy was identified in 31 out of 61 patients (50.8%) using 2 questions from the BHLS. Only 9 (29%) of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy. These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.

  4. Participating in patient education

    DEFF Research Database (Denmark)

    Kristiansen, Tine Mechlenborg; Antoft, Rasmus


    The paper builds on previous ethnographic research in Denmark focusing on the significance of participating in a locally developed patient education programme for everyday life (Kristiansen 2015). It presents a secondary analysis. Group based patient education can be understood as a health...... point is applied in order to illustrate two central status passages taking place at the locally developed patient education programme: 1) The status passage from novice to an experienced person with chronic illness, and 2) The transformation from adolescence to adulthood living with a chronic illness...... studies within the field of patient education and how it can enhance our understanding of the social practices at play and the identity transitions occurring as a result of the chronic illness itself and the participation at the programme. Further we reflect on potential practical implications of our...

  5. [Patient education, perioperative management, patient support groups]. (United States)

    Stöckli, M; Müller, B; Wagner, M


    In our division, highly qualified enterostomal therapists treat approximately 300 patients each year Patient care consists of extensive preoperative information, localization of the ideal stoma position and providing patient-education in stoma handling. A regular ambulatory consultation allows early recognition of typical stoma related complications and their effective treatment in a timely manner. Another important issue of our consulting service includes patients concerns, such as social integration and physical independence. The creation of a specialized center provides an efficient and continuous care of enterostomy patients and their relatives. Thus, initial fears and emotional crisis can be addressed and minimalized. It is our goal to provide individual and comprehensive service in order to accommodate our patients needs.

  6. The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study. (United States)

    Barnes, Andrew J; Xu, Haiyong; Tseng, Chi-Hong; Ang, Alfonso; Tallen, Louise; Moore, Alison A; Marshall, Deborah C; Mirkin, Michelle; Ransohoff, Kurt; Duru, O Kenrik; Ettner, Susan L


    At-risk drinking, defined as alcohol use that is excessive or potentially harmful in combination with select comorbidities or medications, affects about 10% of older adults in the United States and is associated with higher mortality. The Project SHARE intervention, which uses patient and provider educational materials, physician counseling, and health educator support, was designed to reduce at-risk drinking among this vulnerable population. Although an earlier study showed that this intervention was successful in reducing rates of at-risk drinking, it is unknown whether these reductions translate into improved health and health-related quality of life (HRQL). The aim of this study was to examine changes in health and HRQL of older adult at-risk drinkers resulting from a patient-provider educational intervention. A randomized controlled trial to compare the health and HRQL outcomes of patients assigned to the Project SHARE intervention vs. care as usual at baseline, 6- and 12-months post assignment. Control patients received usual care, which may or may not have included alcohol counseling. Intervention group patients received a personalized patient report, educational materials on alcohol and aging, a brief provider intervention, and a telephone health educator intervention. Current drinkers 60years and older accessing primary care clinics around Santa Barbara, California (N=1049). Data were collected from patients using baseline, 6- and 12-month mail surveys. Health and HRQL measures included mental and physical component scores (MCS and PCS) based on the Short Form-12v2 (SF-12v2), the SF-6D, which is also based on the SF-12, and the Geriatric Depression Scale (GDS). Adjusted associations of treatment assignment with these outcomes were estimated using generalized least squares regressions with random provider effects. Regressions controlled for age group, sex, race/ethnicity, marital status, education, household income, home ownership and the baseline value of

  7. Levels of Interaction Provided by Online Distance Education Models (United States)

    Alhih, Mohammed; Ossiannilsson, Ebba; Berigel, Muhammet


    Interaction plays a significant role to foster usability and quality in online education. It is one of the quality standard to reveal the evidence of practice in online distance education models. This research study aims to evaluate levels of interaction in the practices of distance education centres. It is aimed to provide online distance…

  8. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows. (United States)

    Jain, Parul; Slater, Michael D


    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.

  9. Providing truly patient-centred care

    African Journals Online (AJOL)


    communication, the provision of quality patient-centred care will always hang in the balance. Healthcare ... procedural aspects of the interpreting process that impacted most on the communication flow, rather than any ... in South Africa who suffer from a mental health disorder are not getting the care they need. (Kahn 2013).

  10. The Health-Care Provider's Perspective of Education Before Kidney Transplantation. (United States)

    Trivedi, Paraag; Rosaasen, Nicola; Mansell, Holly


    Adequate patient education is essential for preparing potential recipients for kidney transplantation. Health-care providers play a vital role in education and can identify gaps in patient understanding. To identify deficits in patient knowledge from the perspective of a transplant multidisciplinary care team and determine whether their perceptions align with patients who have previously undergone a transplant. An open call was advertised for health-care providers to attend a focus group discussion regarding the educational needs of pretransplant patients in 1 Canadian center. A predetermined, semistructured set of questions was used to collect the views of transplant caregivers. A moderator, assistant moderator, and research assistant facilitated the discussion, which was transcribed verbatim. Paper surveys were distributed to collect opinions of those unable to attend or uncomfortable to voice their opinion in an open forum. Qualitative analysis software was used to identify any emergent themes. Results were compared to a previous study undertaken in transplant recipients. Despite pre- and posttransplant education, specific themes emerged including misconceptions about the assessment process and time on the wait list and the surgery, incongruency between patient expectations and outcome, and confusion regarding medications. Health-care provider perceptions were remarkably consistent with transplant recipients. Health-care providers identified gaps in patient understanding indicating that transplant candidates may not be internalizing what is taught. Innovative educational approaches may be needed to provide more successful patient education. Similarities between health-care provider and patient perceptions suggest that care providers are a valuable source of information.

  11. Developing virtual patients for medical microbiology education. (United States)

    McCarthy, David; O'Gorman, Ciaran; Gormley, Gerry J


    The landscape of medical education is changing as students embrace the accessibility and interactivity of e-learning. Virtual patients are e-learning resources that may be used to advance microbiology education. Although the development of virtual patients has been widely considered, here we aim to provide a coherent approach for clinical educators. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Statistics Report on TEQSA Registered Higher Education Providers, 2016 (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2016


    This Statistics Report is the third release of selected higher education sector data held by the Australian Government Tertiary Education Quality and Standards Agency (TEQSA) for its quality assurance activities. It provides a snapshot of national statistics on all parts of the sector by bringing together data collected directly by TEQSA with data…

  13. Statistics Report on TEQSA Registered Higher Education Providers (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2015


    This statistics report provides a comprehensive snapshot of national statistics on all parts of the sector for the year 2013, by bringing together data collected directly by TEQSA with data sourced from the main higher education statistics collections managed by the Australian Government Department of Education and Training. The report provides…

  14. Electronic consultation system demonstrates educational benefit for primary care providers. (United States)

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S


    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  15. Patient safety curriculum in medical education. (United States)

    Lee, Young-Mee


    Since release of the Institute of Medicine (IOM) report, To Err Is Human: Building a Safer System, patient safety has emerged as a global concern in the provision of quality health care. In response to growing recognition of the importance of patient safety, some medical schools in other countries have created and/or implemented patient safety curricula. In Korea, however, patient safety medical curriculum has not been actively discussed by medical educators. The purpose of this article is to introduce patient safety concepts and the global efforts on patient safety medical education. Specifically, this article describes; 1) current concepts in patient safety, 2) global trends of patient safety movement and education, 3) contents, instructional and assessment methods of patient safety education for both undergraduate medical education and graduate medical education, suggested in the previous studies, 4) WHO Patient Safety Guide for Medical Curriculum developed by the Medical Education Team within the World Alliance for Patient Safety and 5) known barriers against patient safety education. Patient safety is a major priority for all healthcare providers. In reality, however, teaching and learning about patient safety in medical curriculum offers a challenge to all medical schools, especially, the health care environment is not favorable to physicians such as Korea. More attention and recognition about patient safety by all health personnel and medical educators is needed. In addition, the national conversation about medical errors and patient safety and how best to incorporate it to the existing curriculum should be discussed.

  16. Education for ECMO providers: Using education science to bridge the gap between clinical and educational expertise. (United States)

    Johnston, Lindsay; Williams, Susan B; Ades, Anne


    A well-organized educational curriculum for the training of both novice and experienced ECMO providers is critical for the continued function of an institutional ECMO program. ELSO provides guidance for the education for ECMO specialists, physicians and staff, which incorporates "traditional" instructor-centered educational methods, such as didactic lectures and technical skill training. Novel research suggests utilization of strategies that align with principles of adult learning to promote active learner involvement and reflection on how the material can be applied to understand existing and new constructs may be more effective. Some examples include the "flipped classroom," e-learning, simulation, and interprofessional education. These methodologies have been shown to improve active participation, which can be related to improvements in understanding and long-term retention. A novel framework for ECMO training is considered. Challenges in assessment and credentialing are also discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Provider Patient-Sharing Networks and Multiple-Provider Prescribing of Benzodiazepines. (United States)

    Ong, Mei-Sing; Olson, Karen L; Cami, Aurel; Liu, Chunfu; Tian, Fang; Selvam, Nandini; Mandl, Kenneth D


    Prescription benzodiazepine overdose continues to cause significant morbidity and mortality in the US. Multiple-provider prescribing, due to either fragmented care or "doctor-shopping," contributes to the problem. To elucidate the effect of provider professional relationships on multiple-provider prescribing of benzodiazepines, using social network analytics. A retrospective analysis of commercial healthcare claims spanning the years 2008 through 2011. Provider patient-sharing networks were modelled using social network analytics. Care team cohesion was measured using care density, defined as the ratio between the total number of patients shared by provider pairs within a patient's care team and the total number of provider pairs in the care team. Relationships within provider pairs were further quantified using a range of network metrics, including the number and proportion of patients or collaborators shared. The relationship between patient-sharing network metrics and the likelihood of multiple prescribing of benzodiazepines. Patients between the ages of 18 and 64 years who received two or more benzodiazepine prescriptions from multiple providers, with overlapping coverage of more than 14 days. A total of 5659 patients and 1448 provider pairs were included in our study. Among these, 1028 patients (18.2 %) received multiple prescriptions of benzodiazepines, involving 445 provider pairs (30.7 %). Patients whose providers rarely shared patients had a higher risk of being prescribed overlapping benzodiazepines; the median care density was 8.1 for patients who were prescribed overlapping benzodiazepines and 10.1 for those who were not (p benzodiazepines. Our findings demonstrate the importance of care team cohesion in addressing multiple-provider prescribing of controlled substances. Furthermore, we illustrate the potential of the provider network as a surveillance tool to detect and prevent adverse events that could arise due to fragmentation of care.

  18. Does self monitoring of blood glucose as opposed to urinalysis provide additional benefit in patients newly diagnosed with type 2 diabetes receiving structured education? The DESMOND SMBG randomised controlled trial protocol (United States)


    Background The benefit of self-monitoring of blood glucose (SMBG) in people with type 2 diabetes on diet or oral agents other than sulphonylureas remains uncertain. Trials of interventions incorporating education about self-monitoring of blood glucose have reported mixed results. A recent systematic review concluded that SMBG was not cost-effective. However, what was unclear was whether a cheaper method of self-monitoring (such as urine glucose monitoring) could produce comparable benefit and patient acceptability for less cost. Methods/Design The DESMOND SMBG trial is comparing two monitoring strategies (blood glucose monitoring and urine testing) over 18 months when incorporated into a comprehensive self-management structured education programme. It is a multi-site cluster randomised controlled trial, conducted across 8 sites (7 primary care trusts) in England, UK involving individuals with newly diagnosed Type 2 diabetes. The trial has 80% power to demonstrate equivalence in mean HbA1c (the primary end-point) at 18 months of within ± 0.5% assuming 20% drop out and 20% non-consent. Secondary end-points include blood pressure, lipids, body weight and psychosocial measures as well as a qualitative sub-study. Practices were randomised to one of two arms: participants attend a DESMOND programme incorporating a module on self-monitoring of either urine or blood glucose. The programme is delivered by accredited educators who received specific training about equipoise. Biomedical data are collected and psychosocial scales completed at baseline, and 6, 12, and 18 months post programme. Qualitative research with participants and educators will explore views and experiences of the trial and preferences for methods of monitoring. Discussion The DESMOND SMBG trial is designed to provide evidence to inform the debate about the value of self-monitoring of blood glucose in people with newly diagnosed type 2 diabetes. Strengths include a setting in primary care, a cluster

  19. Impact of Health Care Provider's Training on Patients ...

    African Journals Online (AJOL)

    Background: Comprehensive patient's health care provider's (HCP) communication usually increases patients' participation in their health management on childbirth. Objective: This is a quasi interventional study for assessing impact of health care providers (HCP) training on patient- provider's communication during ...

  20. Providing Access to Electronic Information Resources in Further Education (United States)

    Banwell, Linda; Ray, Kathryn; Coulson, Graham; Urquhart, Christine; Lonsdale, Ray; Armstrong, Chris; Thomas, Rhian; Spink, Sin; Yeoman, Alison; Fenton, Roger; Rowley, Jennifer


    This article aims to provide a baseline for future studies on the provision and support for the use of digital or electronic information services (EIS) in further education. The analysis presented is based on a multi-level model of access, which encompasses access to and availability of information and communication technology (ICT) resources,…

  1. Continuing education in geriatrics for rural health care providers in ...

    African Journals Online (AJOL)

    Population trends in developing countries show an increasing population of older adults (OAs), especially in rural areas. The purpose of this study was to explore the geriatrics continuing education needs of health care providers (HCPs) working in rural Uganda. The study employed a descriptive design to collect data from ...

  2. Simulation model for tracheotomy education for primary health-care providers. (United States)

    Dorton, LeighAnne H; Lintzenich, Catherine Rees; Evans, Adele K


    We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation. The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation. The outcome measurements included pre-course and post-course questionnaire and test scores, as well as observational data collected during recorded patient simulation sessions. Before the education and simulation, the subjects reported an average comfort level of 3.3 on a 5-point Likert scale across 10 categories in the questionnaire, which improved to 4.4 after the training (p tracheotomy tube types, misunderstanding of speaking valve physiology, and delayed recognition and treatment of a plugged or dislodged tracheotomy tube. There is a significant need for improved tracheotomy education among primary health-care providers. Incorporating patient simulation into a comprehensive tracheotomy educational program was effective in improving provider confidence, increasing provider knowledge, and teaching the skills necessary for managing patients with a tracheotomy.

  3. Health Care Provider Accommodations for Patients with Communication Disorders (United States)

    Burns, Michael I.; Baylor, Carolyn; Dudgeon, Brian J.; Starks, Helene; Yorkston, Kathryn


    Health care providers can experience increased diffculty communicating with adult patients during medical interactions when the patients have communication disorders. Meeting the communication needs of these patients can also create unique challenges for providers. The authors explore Communication Accommodation Theory (H. Giles, 1979) as a guide…

  4. Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management

    Directory of Open Access Journals (Sweden)

    Ayse Basak Cinar


    Full Text Available The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI, HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC or health education (HE. At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P>0.05. Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P=0.001. Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures.

  5. Patient education preferences in ophthalmic care

    Directory of Open Access Journals (Sweden)

    Rosdahl JA


    Full Text Available Jullia A Rosdahl, Lakshmi Swamy, Sandra Stinnett, Kelly W MuirDepartment of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USABackground: The learning preferences of ophthalmology patients were examined.Methods: Results from a voluntary survey of ophthalmology patients were analyzed for education preferences and for correlation with race, age, and ophthalmic topic.Results: To learn about eye disease, patients preferred one-on-one sessions with providers as well as printed materials and websites recommended by providers. Patients currently learning from the provider were older (average age 59 years, and patients learning from the Internet (average age 49 years and family and friends (average age 51 years were younger. Patients interested in cataracts, glaucoma, macular degeneration, and dry eye were older; patients interested in double vision and glasses were younger. There were racial differences regarding topic preferences, with Black patients most interested in glaucoma (46%, diabetic retinopathy (31%, and cataracts (28% and White patients most interested in cataracts (22%, glaucoma (22%, and macular degeneration (19%.Conclusion: Most ophthalmology patients preferred personalized education: one-on-one with their provider or a health educator and materials (printed and electronic recommended by their provider. Age-related topics were more popular with older patients, and diseases with racial risk factors were more popular with high risk racial groups.Keywords: patient education, eye disease, cataracts, macular degeneration, glaucoma, diabetic retinopathy

  6. Podcasting: contemporary patient education. (United States)

    Abreu, Daniel V; Tamura, Thomas K; Sipp, J Andrew; Keamy, Donald G; Eavey, Roland D


    Portable video technology is a widely available new tool with potential to be used by pediatric otolaryngology practices for patient and family education. Podcasts are media broadcasts that employ this new technology. They can be accessed via the Internet and viewed either on a personal computer or on a handheld device, such as an iPod or an MP3 player. We wished to examine the feasibility of establishing a podcast-hosting Web site. We digitally recorded pediatric otologic procedures in the operating room and saved the digital files to DVDs. We then edited the DVDs at home with video-editing software on a personal computer. Next, spoken narrative was recorded with audio-recording software and combined with the edited video clips. The final products were converted into the M4V file format, and the final versions were uploaded onto our hospital's Web site. We then downloaded the podcasts onto a high-quality portable media player so that we could evaluate their quality. All of the podcasts are now on the hospital Web site, where they can be downloaded by patients and families at no cost. The site includes instructions on how to download the appropriate free software for viewing the podcasts on a portable media player or on a computer. Using this technology for patient education expands the audience and permits portability of information. We conclude that a home computer can be used to inexpensively create informative surgery demonstrations that can be accessed via a Web site and transferred to portable viewing devices with excellent quality.

  7. Provider communication quality: influence of patients' weight and race. (United States)

    Wong, Michelle S; Gudzune, Kimberly A; Bleich, Sara N


    To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. We conducted a cross-sectional analysis with 2009-2010 medical expenditures panel survey-household component (N=25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management. (United States)

    Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J


    Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.

  9. Surgical patient education: Turkish nursing students experiences. (United States)

    Kaymakçi, Senay; Yavuz, Meryem; Orgun, Fatma


    Patient education has been widely used by medical schools and schools of nursing as a method for evaluating clinical performance. Training of patients provides a viable method for teaching and evaluating nurse practitioner students as they progress through their educational programs toward clinical competency. Evaluation of patient education experience provided objective and valid information regarding the students' delivery of didactic information and ability to apply knowledge in the clinical setting. The purpose of this article is to describe the preparation of materials for preoperative patient education and to evaluate patient education carried out by second-year students of the University Of Ege School Of Nursing. In this study, students, patients and lecturers evaluated patient education carried out by the nursing students. Criteria including relationships between people (listening, talking and communication ability), and behavior before education (prepare topic content, develop appropriate material for the topic, communicate which topic will be explained, etc.) and during education (attract listeners' attention to the topic, give information about the target, present the content and material of the subject well, etc.) were appraised. According to the results of evaluation, the education carried out by the students achieved the highest score from patients; the students gave the second-highest score. The lecturers gave scores that were lower than those of students and patients. At the end of this study, it has been found that patients were pleased with the education prepared according to their individual requirements and the students were pleased with giving education with the material they have prepared employing their own creativity.

  10. Health Care Providers and Dying Patients: Critical Issues in Terminal Care. (United States)

    Benoliel, Jeanne Quint


    Identifies three major areas of concern in relationship between health care providers and dying patients: (1) nature of difficulties and stresses associated with terminal care; (2) education of providers for work; and (3) influence of organizational structure and institutionalized values on services for dying patients and families. Reviews…

  11. How Infertility Patients and Providers View and Confront Religious and Spiritual Issues. (United States)

    Klitzman, Robert


    Questions arise concerning whether and how religion affects infertility treatment decisions. Thirty-seven infertility providers and patients were interviewed. Patients confront religious, spiritual, and metaphysical issues coping with treatment failures and religious opposition from clergy and others. Religion can provide meaning and support, but poses questions and objections that patients may try to avoid or negotiate-e.g., concealing treatment or changing clergy. Differences exist within and between religions. Whether and how much providers discuss these issues with patients varies. These data, the first to examine several key aspects of how infertility providers and patients confront religious/spiritual issues, have important implications for practice, research, guidelines, and education.


    Directory of Open Access Journals (Sweden)

    Ljaljević Agima


    Full Text Available Introduction: The aim of this study was to determine perceptions of service providers in the healthcare on their awareness and knowledge about HIV/AIDS, as well as the relationship of the above parameters and the existence of stigma and discrimination against people with HIV/AIDS. Method: The type of the study was a behavioral cross sectional study. The survey was conducted in 2012, on a representative sample of health workers in Montenegro. The main survey instrument was specifically designed questionnaire that consisted of six parts, out of which one was related to knowledge about HIV and AIDS. Data were analyzed by methods of inferential statistics. Results: More than four out of ten respondents have never attended educational workshops on HIV/AIDS. Research has shown that there is a highly significant statistical correlation between estimates of their own knowledge about HIV / AIDS and previous educations. Almost two-thirds of respondents, who attended some type of education in the field of HIV/AIDS, believe to have a satisfactory level of knowledge in the area. Conclusion: Health care service providers evaluate their knowledge of HIV/AIDS as insufficient.

  13. Increasing Patient / Provider Communications about Colorectal Cancer Screening In Rural Primary Care Practices (United States)

    Geller, Berta M.; Skelly, Joan M.; Dorwaldt, Anne L.; Howe, Kathleen D.; Dana, Greg S.; Flynn, Brian S.


    Background Rural populations as well as less educated people in the U.S. are less likely to receive colorectal cancer (CRC) screening than people living in urban areas and more educated people. Methods We tested a computer tablet, Patient/Provider Communication Assistant (PPCA), which collected data, educated patients, and printed personalized notes to patients and providers encouraging conversation about CRC screening. Mixed model analyses using a pre-post quasi-experimental design compared patient results during the comparison and intervention periods in 5 rural primary care practices on provider discussion about CRC screening, provider recommendation, and patient intention to be screened. Models including age, education and literacy measures as covariates were examined. Results Providers talked with patients about CRC screening in general, and colonoscopy specifically more frequently after the PPCA than with the comparison group (p values =.04 and .01, respectively). Providers recommended CRC screening more often to patients in the intervention group than to the comparison group (p=.02). Patients planned to be screened and specifically with colonoscopy more frequently following the intervention than in the comparison group (p=.003). There were no interactions between group and any of the covariates. Ninety-five percent of the patients regardless of age or education found the PPCA easy to use. Conclusion Results indicated increased provider discussion and recommendation, and patients' intentions to obtain CRC screening, and in particular colonoscopy, for patients exposed to the intervention, regardless of the patients' age or literacy levels. The PPCA is a promising intervention method that is acceptable to rural patients. PMID:18725831

  14. Resources for Educating, Training, and Mentoring All Physicians Providing Palliative Care. (United States)

    Downar, James


    This article presents a rapid review of the published literature and available resources for educating Canadian physicians to provide palliative and end-of-life care. Several key messages emerge from the review. First, there are many palliative care educational resources already available for Canadian physicians. Second, the many palliative care education resources are often not used in physician training. Third, we know that some palliative care educational interventions are inexpensive and scalable, while others are costly and time-consuming; we know very little about which palliative care educational interventions impact physician behavior and patient care. Fourth, two palliative care competency areas in particular can be readily taught: symptom management and communication skill (e.g., breaking bad news and advance care planning). Fifth, palliative care educational interventions are undermined by the "hidden curriculum" in medical education; interventions must be accompanied by continuing education and faculty development to create lasting change in physician behavior. Sixth, undergraduate and postgraduate medical training is shifting from a time-based training paradigm to competency-based training and evaluation. Seventh, virtually every physician in Canada should be able to provide basic palliative care; physicians in specialized areas of practice should receive palliative care education that is tailored to their area, rather than generic educational interventions. For each key message, one or more implications are provided, which can serve as recommendations for a framework to improve palliative care as a whole in Canada.

  15. Healthcare provider and patient perspectives on diagnostic imaging investigations. (United States)

    Makanjee, Chandra R; Bergh, Anne-Marie; Hoffmann, Willem A


    Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. AIM AND SETTING: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider-patient centred when a referral for a diagnostic imaging investigation is included.

  16. An educational strategy for using physician assistant students to provide health promotion education to community adolescents. (United States)

    Ruff, Cathy C


    The "Competencies for the Physician Assistant Profession" identify core competencies that physician assistants (PAs) are expected to acquire and maintain throughout their career (see 203.5%20for%20Publication.pdf). Two categories of competencies relate to patient care and interpersonal and communication skills and articulate the need for PAs to be effective communicators and patient educators. The value of a health education curriculum for the adolescent population has been recognized since the early 1900s. PA student-designed health promotion presentations aimed at the adolescent population are an innovative educational strategy involving students in community education. PA student-designed presentations based upon previously identified topics were presented in the community. Students presented topics including Smoking Cessation, The Effects of Drugs and Alcohol, Self-Esteem, and others to adolescents. Community audiences were varied and included alternative high schools and teens within the Department of Youth Corrections facilities. PA students created 17 portable presentations for community adolescents. Two hundred sixty-eight students gave presentations to more than 700 adolescents ranging from 11-22 years of age between the years 2005-2010. Eighty-two percent (646/791) of adolescent participants either strongly agreed or agreed that they learned at least one new piece of information from the presentations. Sixty percent (12/20) of community leaders requested that the PA students return to give additional health promotion presentations. Analysis of comments by PA students revealed that 98% of students found the experience beneficial. Students identified the experience as helping them better understand how to design presentations to meet the needs of their audience, feel more comfortable with adolescents, and gain confidence in communicating. Seventy-five percent stated they would continue to be

  17. Educating future leaders in patient safety (United States)

    Leotsakos, Agnès; Ardolino, Antonella; Cheung, Ronny; Zheng, Hao; Barraclough, Bruce; Walton, Merrilyn


    Education of health care professionals has given little attention to patient safety, resulting in limited understanding of the nature of risk in health care and the importance of strengthening systems. The World Health Organization developed the Patient Safety Curriculum Guide: Multiprofessional Edition to accelerate the incorporation of patient safety teaching into higher educational curricula. The World Health Organization Curriculum Guide uses a health system-focused, team-dependent approach, which impacts all health care professionals and students learning in an integrated way about how to operate within a culture of safety. The guide is pertinent in the context of global educational reforms and growing recognition of the need to introduce patient safety into health care professionals’ curricula. The guide helps to advance patient safety education worldwide in five ways. First, it addresses the variety of opportunities and contexts in which health care educators teach, and provides practical recommendations to learning. Second, it recommends shared learning by students of different professions, thus enhancing student capacity to work together effectively in multidisciplinary teams. Third, it provides guidance on a range of teaching methods and pedagogical activities to ensure that students understand that patient safety is a practical science teaching them to act in evidence-based ways to reduce patient risk. Fourth, it encourages supportive teaching and learning, emphasizing the need to establishing teaching environments in which students feel comfortable to learn and practice patient safety. Finally, it helps educators incorporate patient safety topics across all areas of clinical practice. PMID:25285012

  18. Role of accrediting bodies in providing education leadership in medical education

    Directory of Open Access Journals (Sweden)

    Sam Leinster


    Role of accreditation authorities: If accreditation authorities are to provide leadership in medical education they must undertake regular review of their standards. This should be informed by all stakeholders and include experts in medical education. The format of the standards must provide clear direction to medical schools. Accreditation should take place regularly and should result in the production of a publicly accessible report.

  19. Meeting the continuing education needs of rural mental health providers. (United States)

    Adler, Geri; Pritchett, Lonique R; Kauth, Michael R


    Historically, mental health clinicians at Department of Veterans Affairs (VA) community-based outpatient clinics (CBOCs) have not had the same access to continuing education (CE) as providers at VA medical centers. Mental health clinicians at CBOCs desire an opportunity for VA-sponsored CE, especially on topics and issues pertinent to rural mental healthcare. Since November 2011, VA CBOC mental health providers in 11 states have been offered a monthly live Web conferencing CE program. This article describes the program's development, implementation, and evaluation. Eleven CE programs have been offered to 397 unique participants. Participants have provided positive feedback about the topics and their impact on job performance. Most negative feedback has been related to technical and logistical problems with the Web conferencing platform. Although providers asked for reportable CE units for licensure, many did not complete the post-test, which is required to receive credit for completing the course. The Web conferencing format has been well received by participants. Despite technical issues, results show that the participants were satisfied with the content of the trainings and could apply the materials to their job. Although CE units were available, not all participants applied for credit. Efforts to improve technical support and the rate of post-test completion are discussed. Rural mental health providers often have limited access to training opportunities. The VA CBOC Mental Health Rounds, using an interactive Web conferencing platform, has been a successful modality for delivering CE to rural clinicians in the United States.

  20. A need for otolaryngology education among primary care providers (United States)

    Hu, Amanda; Sardesai, Maya G.; Meyer, Tanya K.


    Objective Otolaryngic disorders are very common in primary care, comprising 20–50% of presenting complaints to a primary care provider. There is limited otolaryngology training in undergraduate and postgraduate medical education for primary care. Continuing medical education may be the next opportunity to train our primary care providers (PCPs). The objective of this study was to assess the otolaryngology knowledge of a group of PCPs attending an otolaryngology update course. Methods PCPs enrolled in an otolaryngology update course completed a web-based anonymous survey on demographics and a pre-course knowledge test. This test was composed of 12 multiple choice questions with five options each. At the end of the course, they were asked to evaluate the usefulness of the course for their clinical practice. Results Thirty seven (74%) PCPs completed the survey. Mean knowledge test score out of a maximum score of 12 was 4.0±1.7 (33.3±14.0%). Sorted by area of specialty, the mean scores out of a maximum score of 12 were: family medicine 4.6±2.1 (38.3±17.3%), pediatric medicine 4.2±0.8 (35.0±7.0%), other (e.g., dentistry, emergency medicine) 4.2±2.0 (34.6±17.0%), and adult medicine 3.9±2.1 (32.3±17.5%). Ninety one percent of respondents would attend the course again. Conclusion There is a low level of otolaryngology knowledge among PCPs attending an otolaryngology update course. There is a need for otolaryngology education among PCPs. PMID:22754276

  1. Providing Pediatric Palliative Care Education Using Problem-Based Learning. (United States)

    Moody, Karen; McHugh, Marlene; Baker, Rebecca; Cohen, Hillel; Pinto, Priya; Deutsch, Stephanie; Santizo, Ruth O; Schechter, Miriam; Fausto, James; Joo, Pablo


    The Institute of Medicine and the American Academy of Pediatrics has called for improvement in education and training of pediatricians in pediatric palliative care (PPC). Given the shortage of PPC physicians and the immediate need for PPC medical education, this study reports the outcomes of a problem-based learning (PBL) module facilitated by academic general and subspecialty pediatric faculty (non-PPC specialists) to third year medical students. Objectives/Setting: To test the effectiveness of a PPC-PBL module on third year medical students' and pediatric faculty's declarative knowledge, attitudes toward, perceived exposure, and self-assessed competency in PPC objectives. A PBL module was developed using three PPC learning objectives as a framework: define core concepts in palliative care; list the components of a total pain assessment; and describe key principles in establishing therapeutic relationships with patients. A PPC physician and nurse practitioner guided pediatric faculty on facilitating the PPC-PBL. In Part 1, students identified domains of palliative care for a child with refractory leukemia and self-assigned questions to research and present at the follow-up session. In Part 2, students were expected to develop a care plan demonstrating the three PPC objectives. Measures included a knowledge exam and a survey instrument to assess secondary outcomes. Students' declarative knowledge, perceived exposure, and self-assessed competency in all three PPC learning objectives improved significantly after the PPC-PBL, p = 0.002, p 80%). Students and faculty rated palliative care education as "important or very important" at baseline and follow-up. This study suggests that key concepts in PPC can be taught to medical students utilizing a PBL format and pediatric faculty resulting in improved knowledge and self-assessed competency in PPC.

  2. Prediction of pharmacist intention to provide medication disposal education using the theory of planned behaviour. (United States)

    Tai, Bik-Wai Bilvick; Hata, Micah; Wu, Stephanie; Frausto, Sonya; Law, Anandi V


    Lack of familiarity with proper medication disposal options among patients can lead to personal and environmental safety concerns, besides signalling non-adherence. Given that community pharmacists are in a position to educate patients, this study assessed community pharmacists' knowledge on medication disposal and examined the utility of the theory of planned behaviour (TPB) in predicting their intention to provide medication disposal education to their patients. A cross-sectional, self-administered survey was distributed to community pharmacists in California. Descriptive statistics were reported for all survey items. Cronbach's alpha and Pearson correlation were used to determine the reliability for the four TPB constructs (attitude, subjective norm, perceived behavioural control and intention). Multiple linear regressions were performed to predict intent using the other three TPB constructs. Pharmacists (n = 142) demonstrated a positive intention to provide education (mean = 5.91 ± 1.22; range: 2 to 8), but most (67.9%) provided this information once a month or less. Attitude (β = 0.266, P = 0.001), subjective norm (β = 0.333, P subjective norm, perceived behaviour control and intention in providing such education. However, their knowledge in this area may be lacking and they are not consistently providing this information to their patients. © 2016 John Wiley & Sons, Ltd.

  3. The Effects of a Genetic Counseling Educational Program on Hereditary Breast Cancer for Korean Healthcare Providers (United States)

    Lee, Jihyoun; Cho, Hyung Jung; Yoo, Han-Wook; Park, Sue K.; Yang, Jae Jeong; Kim, Sung-Won; Kang, Eunyoung; Ahn, Sei-Hyun; Lee, Soo-Jung; Suh, Young Jin; Kim, Sung Yong; Kim, Eun-Kyu; Moon, Nan Mo


    Purpose Systematic educational programs and genetic counseling certification courses for hereditary breast/ovarian cancer (HBOC) have not yet been introduced in Korea. We provided and evaluated the effects of genetic counseling education on Korean healthcare providers' knowledge, awareness, and counseling skills for patients at high risk of HBOC. Methods A 3-day educational program was conducted for healthcare providers who were interested in genetic counseling for patients at high risk of HBOC. Participants who completed a knowledge test and satisfaction questionnaire were included in the present sample. Pre-post comparisons were conducted to determine the effects of the intervention. Results Significant differences between preprogram and postprogram knowledge scores were observed (p=0.002). Awareness (pcounseling significantly increased after the training. Doctors and participants with fewer years of work experience performed well on the knowledge test. Previous educational experience was correlated with increased confidence in knowledge and counseling skills. Conclusion Genetic counseling education regarding HBOC improved knowledge and awareness of HBOC and enhanced confidence in the counseling process. The effects varied according to occupation and participants' previous education. The implementation of systematic educational programs that consider participant characteristics may improve the effects of such interventions. PMID:24155764

  4. How Accurately Can Emergency Department Providers Estimate Patient Satisfaction?

    Directory of Open Access Journals (Sweden)

    Lalena M. Yarris


    Full Text Available Introduction: Patient satisfaction is an important measure of emergency department (ED quality of care. Little is known about providers’ ability to estimate patient satisfaction. We aimed to measure providers’ ability to assess patient satisfaction and hypothesized that providers could accurately estimate overall patient satisfaction.Methods: We surveyed ED patients regarding satisfaction with their care. Treating providers completed analogous surveys, estimating patients’ responses. Sexual assault victims and non-English-speaking or severely ill patients were excluded. Satisfaction responses were categorized as ‘‘satisfied’’ or ‘‘not satisfied.’’ Patient satisfaction scores were considered the ‘‘gold standard,’’ and providers’ perceptions of the patient satisfaction were considered tests. Measures of diagnosticaccuracy, such as positive predictive value (PPV and sensitivity, were used to assess how accurately the provider could estimate his or her patient’s satisfaction.Results: Here, 242/457 eligible patients (53% completed the survey; 227 providers (94% completed a corresponding survey. Subject-reported overall satisfaction was 96.6%, compared with a provider estimated rate of 94.4%. The sensitivity and PPV of the provider’s estimate of the patient’s satisfaction were 95.2 (95% confidence interval [CI] 91.4, 97.7 and 97.5 (95% CI 94.4, 99.2, respectively, for overall patient satisfaction. The PPV was similar for clarity of communication. The PPV was 78.9 for perceived length of ED stay (99% CI 70.8, 85.6 and 82.6 for quality of pain control (95% CI 68.6, 92.2. Accuracy of attending and resident estimates of patient satisfaction did not differ significantly. The agreement between patient-reported and provider-estimated patient satisfaction was not associated with age, gender, patient disposition, or ED divert status.Conclusion: Providers are able to assess overall patient satisfaction and clarity of

  5. Satisfaction with information provided to Danish cancer patients

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit


    To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction.......To validate five items (CPWQ-inf) regarding satisfaction with information provided to cancer patients from health care staff, assess the prevalence of dissatisfaction with this information, and identify factors predicting dissatisfaction....

  6. Patient provider communication about the health effects of obesity

    NARCIS (Netherlands)

    Durant, Nefertiti H.; Bartman, Barbara; Person, Sharina D.; Collins, Felicia; Austin, S. Bryn

    Objective: We assessed the influence of race/ethnicity and provider Communication oil overweight and obese patients' perceptions of the damage weight causes to their health. Methods: The-study included 1071 overweight and obese patients who completed the 2002 Community Health Center (CHC) User

  7. Control and Communication in Provider-Patient Relationships. (United States)

    Northouse, Peter G.

    Noting that loss of control is a major concern confronting patients experiencing an illness, this paper critically analyzes the research literature on control and clarifies the implications of this research for provider-patient communication. The paper first defines control, noting that the most frequently cited definition is the "locus of…


    Directory of Open Access Journals (Sweden)

    Vladimir D. Secerin


    Full Text Available The thesis of importance of informative constituent Comes into question as non-material assets in a postindustrial economy. Importance of limitations is shown in realization of technological processes to want of authenticity, objectivity and timeliness of actualization of knowledge of specialists. As recommendations on providing of accordance of actuality of on-line tutorial to the level of technological development on a production at the limitations determined by the system requirements of educational standard “From a teacher to a student”, the chart of forming of the creative thinking of student is offered as nooswear technologies are in organization of feed-back “From a student to a teacher “. 

  9. Critical thinking at the bedside: providing safe passage to patients. (United States)

    Robert, Ruth R; Petersen, Sandra


    The critical thinking ability of health care professionals can affect patient safety directly (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2005). The National League for Nursing (NLN, 2006) expects nursing graduates to be able to demonstrate critical thinking. Nursing programs are required to measure critical thinking as an outcome criterion for accreditation. This process of program accreditation is considered an indicator that a professional program offers a quality product. Based on NLN expectations, health care disciplines should diligently seek opportunities to enhance critical thinking by promoting qualitative and quantitative research that focuses on curriculum evaluation, enhancing educators' and faculty knowledge, and improving patient care outcomes.

  10. Interactions between patients and dental care providers: does gender matter? (United States)

    Inglehart, Marita R


    Research findings concerning the role of gender in patient-physician interactions can inform considerations about the role of gender in patient-dental care provider interactions. Medical research showed that gender differences in verbal and nonverbal communication in medical settings exist and that they affect the outcomes of these interactions. The process of communication is shaped by gender identities, gender stereotypes, and attitudes. Future research needs to consider the cultural complexity and diversity in which gender issues are embedded and the degree to which ongoing value change will shape gender roles and in turn interactions between dental patients and their providers. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study. (United States)

    Brown, Seth A; Hayden, Theresa C; Randell, Kimberly A; Rappaport, Lara; Stevenson, Michelle D; Kim, In K


    Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data. Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements. Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care. Brown SA , Hayden TC , Randell KA , Rappaport L , Stevenson MD , Kim IK . Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20-26.

  12. Evaluation of patients ' satisfaction with quality of care provided at ...

    African Journals Online (AJOL)

    Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided ...

  13. Patient satisfaction with health care services provided at HIV clinics ...

    African Journals Online (AJOL)

    Background: Since the establishment of free HIV/AIDS care and treatment services in Tanzania a lot of research has been done to assess how health care providers discharge their duties in these clinics. Little research however has been done regarding satisfaction of HIV patients with free health care services provided.

  14. Awareness of Chronic Kidney Disease among Patients and Providers (United States)

    Plantinga, Laura C.; Tuot, Delphine S.; Powe, Neil R.


    Earlier recognition of chronic kidney disease (CKD) could slow progression, prevent complications, and reduce cardiovascular-related outcomes. However, current estimates of CKD awareness indicate that both patient- and provider-level awareness remain unacceptably low. Many of the factors that are possibly associated with CKD awareness, which could help guide implementation of awareness efforts, have yet to be fully examined. Also, little is known regarding whether increased patient or provider awareness improves clinical outcomes or whether there are possible negative consequences of awareness for CKD patients. Further research is necessary to continue to design and refine awareness campaigns aimed at both patients and providers, but there is an immediate need for dissemination of basic CKD information, given both the high prevalence of CKD and its risk factors and the low estimated awareness of CKD. PMID:20439091

  15. Expression of patients' and providers' identities during the medical interview. (United States)

    Scholl, Juliann C; Wilson, Jacquee B; Hughes, Patrick C


    We apply the Communication Theory of Identity to investigate how patients display their ethnic identities during intercultural patient-provider interactions. Ethnic identity displays play a large part in reflecting patients' and providers' assumptions about the other, as well as their communicative needs. We collected paper-and-pencil responses from a convenience sample of providers and their patients, and conducted a constant comparative analysis of their open-ended reports of a recent intercultural medical interview. The results revealed how both parties viewed their roles in intercultural medical encounters and how they looked for accommodative behaviors from the other party. We draw implications for new applications and future developments of the Communication Theory of Identity and Communication Accommodation Theory.

  16. Assessment of willingness to provide diabetes education and counseling in a dental school clinic. (United States)

    Fischer, Dena J; Koerber, Anne


    Diabetes mellitus is a major public health concern for the U.S. population because of its high prevalence and long-term health implications. The purpose of this study was to apply the Theory of Planned Behavior (TPB) to assess dental faculty member and student willingness to provide diabetes education and counseling to patients in a dental school. A survey was administered to dental students (n=101 respondents) and faculty members (n=39 respondents), and summary scores for seven diabetic educational activities and TPB constructs were calculated and analyzed. Participants were most willing to refer a patient to a physician for treatment and provide basic information about diabetes and oral health, and they were least willing to provide basic information about diabetic medications. Importance, self-efficacy, and barriers constructs predicted willingness to perform diabetic educational or counseling activities. Our findings suggest that, when developing innovative approaches to expand diabetic education and counseling in our dental education environment, programs should demonstrate how diabetic counseling can improve patients' health and should include diabetic management skills-building in the curriculum.

  17. The Obligation to Provide Free Basic Education in South Africa

    African Journals Online (AJOL)


    main delivery system for the basic education of children outside the family is primary schooling." According to Sloth-Nielsen, primary education could be defined as the formal basic education given to children ...... 124 Governing Body of the Juma Musjid Primary School & Others v Essay N.O. and Others 2011 (7). BCLR 651 ...

  18. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki


    Full Text Available This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic health records and mobile health applications. Such technologies can be harnessed to improve patient safety; however, if not used properly they can negatively impact on patient safety. In this issue we focus on advances in training that can improve patient safety and the optimal use of new technologies in healthcare. For example, use of clinical simulations and online computer based training can be employed both to facilitate learning about new clinical discoveries as well as to integrate technology into day to day healthcare practices. In this issue we are publishing papers that describe advances in healthcare provider and patient training to improve patient safety as it relates to the use of educational technologies, health information technology and on-line health resources. In addition, in the special issue we describe new approaches to training and patient safety including, online communities, clinical simulations, on-the-job training, computer based training and health information systems that educate about and support safer patient care in real-time (i.e. when health professionals are providing care to patients. These educational and technological initiatives can be aimed at health professionals (i.e. students and those who are currently working in the field. The outcomes of this work are significant as they lead to safer care for patients and their family members. The issue has both theoretical and applied papers that describe advances in patient

  19. Determinants of patient loyalty to healthcare providers: An integrative review. (United States)

    Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei


    Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty.

  20. Healthcare provider and patient perspectives on diagnostic imaging investigations

    Directory of Open Access Journals (Sweden)

    Chandra R. Makanjee


    Full Text Available Background: Much has been written about the patient-centred approach in doctor–patient consultations. Little is known about interactions and communication processes regarding healthcare providers’ and patients’ perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation.Aim and setting: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex.Methods: A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars.Results: Two main themes guided our analysis: (1 provider perspectives; and (2 patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof.Conclusion: Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider–patient centred when a referral for a diagnostic imaging investigation is included.

  1. Primary care patient and provider preferences for diabetes care managers

    Directory of Open Access Journals (Sweden)

    Ramona S DeJesus


    Full Text Available Ramona S DeJesus1, Kristin S Vickers2, Robert J Stroebel1, Stephen S Cha31Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Department of Psychiatry and Psychology, Mayo Clinic, MN, USA; 3Department of Biostatistics, Mayo Clinic, Rochester, MN, USAPurpose: The collaborative care model, using care managers, has been shown to be effective in achieving sustained treatment outcomes in chronic disease management. Little effort has been made to find out patient preferences for chronic disease care, hence, we conducted a study aimed at identifying these.Methods: A 20-item questionnaire, asking for patients’ and providers’ preferences and perceptions, was mailed out to 1000 randomly selected patients in Olmsted County, Minnesota, identified through a diabetes registry to have type 2 diabetes mellitus, a prototypical prevalent chronic disease. Surveys were also sent to 42 primary care providers.Results: There were 254 (25.4% patient responders and 28 (66% provider responders. The majority of patients (>70% and providers (89% expressed willingness to have various aspects of diabetes care managed by a care manager. Although 75% of providers would be comfortable expanding the care manager role to other chronic diseases, only 39.5% of patient responders would be willing to see a care manager for other chronic problems. Longer length of time from initial diagnosis of diabetes was associated with decreased patient likelihood to work with a care manager.Conclusion: Despite study limitations, such as the lack of validated measures to assess perceptions related to care management, our results suggest that patients and providers are willing to collaborate with a care manager and that both groups have similar role expectations of a care manager.Keywords: care manager, collaborative care, patient preference, diabetes care

  2. Public Health Approaches and Barriers to Educating Providers about Hereditary Breast and Ovarian Cancer Syndrome

    Directory of Open Access Journals (Sweden)

    Angela M. Trepanier


    Full Text Available The Michigan Department of Health and Human Services implemented and evaluated two initiatives designed to enhance provider knowledge of patients appropriate for breast and/or ovarian cancer genetic risk assessment and hereditary breast and ovarian cancer (HBOC syndrome testing. The first initiative targeted select providers who had diagnosed patients meeting HBOC risk criteria. Specifically, the initiative used 2008–2009 state cancer registry data to identify all providers who had diagnosed breast cancers in women ≤50 years of age, male breast cancers, and ovarian cancers in four health systems with newly established cancer genetics clinics. Using a method coined bidirectional reporting (BDR, reports highlighting how many of these cases each provider had seen were generated and mailed. Reports on 475 cancers (9.5% of the 5005 cases statewide meeting criteria were sent to 69 providers with information about how and why to refer such patients for genetic counseling. Providers who received a report were contacted to assess whether the reports increased awareness or resulted in action (genetic counseling/referral. Based on the few responses received, despite multiple attempts to contact, and attrition rate, it is not possible to ascertain the impact of this initiative on providers. However the project resulted in the MDHHS identifying which providers see the largest proportion of at-risk patients, creating an opportunity to target those providers with HBOC education efforts. The second initiative involved creating and broadly disseminating an online, interactive case-based educational module to increase awareness and referral decisions for HBOC using high- and low-risk patient scenarios. A total of 1835 unique users accessed the module in a one year. Collectively the users viewed topic pages 2724 times and the interactive case studies 1369 times. Point of care tools (fact sheets were viewed 1624 times and downloaded 764 times. Satisfaction

  3. Selecting a provider: what factors influence patients' decision making? (United States)

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda


    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

  4. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. (United States)

    Ngo-Metzger, Quyen; Sorkin, Dara H; Phillips, Russell S; Greenfield, Sheldon; Massagli, Michael P; Clarridge, Brian; Kaplan, Sherrie H


    Provider-patient language discordance is related to worse quality care for limited English proficient (LEP) patients who speak Spanish. However, little is known about language barriers among LEP Asian-American patients. We examined the effects of language discordance on the degree of health education and the quality of interpersonal care that patients received, and examined its effect on patient satisfaction. We also evaluated how the presence/absence of a clinic interpreter affected these outcomes. Cross-sectional survey, response rate 74%. A total of 2,746 Chinese and Vietnamese patients receiving care at 11 health centers in 8 cities. Provider-patient language concordance, health education received, quality of interpersonal care, patient ratings of providers, and the presence/absence of a clinic interpreter. Regression analyses were used to adjust for potential confounding. Patients with language-discordant providers reported receiving less health education (beta = 0.17, p interpreter. Patients with language-discordant providers also reported worse interpersonal care (beta = 0.28, p interpreter did not mitigate these effects and in fact exacerbated disparities in patients' perceptions of their providers. Language barriers are associated with less health education, worse interpersonal care, and lower patient satisfaction. Having access to a clinic interpreter can facilitate the transmission of health education. However, in terms of patients' ratings of their providers and the quality of interpersonal care, having an interpreter present does not serve as a substitute for language concordance between patient and provider.

  5. Beliefs and attitudes about prescribing opioids among healthcare providers seeking continuing medical education. (United States)

    Hooten, W Michael; Bruce, Barbara K


    The purpose of this study was to assess the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain. The setting was a continuing medical education conference that was specifically designed to deliver content about chronic pain and prescription opioids to providers without specialty expertise in pain medicine. Conference attendees with prescribing privileges were eligible to participate, including physicians, physician assistants, and advance practice nurses. Study participants completed a questionnaire using an electronic response system. Study participants completed a validated questionnaire that was specifically developed to measure the beliefs and attitudes of healthcare providers about prescribing opioids for chronic pain. The questionnaire was completed by 128 healthcare providers. The majority (58 percent) indicated that they were "likely" to prescribe opioids for chronic pain. A significant proportion of respondents had favorable beliefs and attitudes toward improvements in pain (p opioids. However, a significant proportion had negative beliefs and attitudes about medication abuse (p opioids could significantly increase the complexity of patient care and could unfavorably impact several administrative aspects of clinical practice. The beliefs and attitudes identified in this study highlight important educational gaps that exist among healthcare providers about prescribing opioids. Knowledge of these educational gaps could build the capacity of medical educators to develop targeted educational materials that could improve the opioid prescribing practices of healthcare providers.

  6. Teamwork: building healthier workplaces and providing safer patient care. (United States)

    Clark, Paul R


    A changing healthcare landscape requires nurses to care for more patients with higher acuity during their shift than ever before. These more austere working conditions are leading to increased burnout. In addition, patient safety is not of the quality or level that is required. To build healthier workplaces where safe care is provided, formal teamwork training is recommended. Formal teamwork training programs, such as that provided by the MedTeams group, TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), or participatory action research programs such as the Healthy Workplace Intervention, have decreased errors in the workplace, increased nurse satisfaction and retention rates, and decreased staff turnover. This article includes necessary determinants of teamwork, brief overviews of team-building programs, and examples of research programs that demonstrate how teamwork brings about healthier workplaces that are safer for patients. Teamwork programs can bring about these positive results when implemented and supported by the hospital system.

  7. Comparing perceptions of cancer fatalism among African American patients and their providers. (United States)

    Powe, Barbara D; Daniels, Elvan C; Finnie, Ramona


    To describe perceptions of cancer fatalism and identify demographic correlates; to explore whether providers believe their patients are fatalistic about cancer and compare these views to the patients' views. Both patients (n= 52) and providers (n= 35) were recruited at federally funded, community primary care centers. Data were collected using the Powe Fatalism Inventory, the Perceived Patient Fatalism Inventory, and a demographic data questionnaire. Data were analyzed using descriptive statistics, Pearson correlations, and t-test. The majority of patients were African American women. The majority of providers were physicians and nurses. Patients indicated low perceptions of cancer fatalism, but providers believed patients were highly fatalistic. As the patients' educational level increased, perceptions of cancer fatalism decreased. The providers' belief that patients are fatalistic about cancer may influence patient-provider communication. They may be less likely to recommend screening, and patients may be less likely to initiate a discussion about cancer. Strategies are needed that target providers and their patients to address actual and/or perceived perceptions and their influence on cancer screening.

  8. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers. (United States)

    Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C


    Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

  9. Compassionate care: enhancing physician-patient communication and education in dermatology: Part II: Patient education. (United States)

    Hong, Judith; Nguyen, Tien V; Prose, Neil S


    Patient education is a fundamental part of caring for patients. A practice gap exists, where patients want more information, while health care providers are limited by time constraints or difficulty helping patients understand or remember. To provide patient-centered care, it is important to assess the needs and goals, health beliefs, and health literacy of each patient. This allows health care providers to individualize education for patients. The use of techniques, such as gaining attention, providing clear and memorable explanations, and assessing understanding through "teach-back," can improve patient education. Verbal education during the office visit is considered the criterion standard. However, handouts, visual aids, audiovisual media, and Internet websites are examples of teaching aids that can be used as an adjunct to verbal instruction. Part II of this 2-part series on patient-physician interaction reviews the importance and need for patient education along with specific guidelines and techniques that can be used. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Caring for Patients with Service Dogs: Information for Healthcare Providers (United States)

    Krawczyk, Michelle


    People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.

  11. Providing dental treatment for patients with cardiovascular disease. (United States)

    Waters, B G


    patients who are potentially hypertensive should be referred for medical evaluation. A preventive approach to the treatment of these patients will serve to prevent untoward outcomes and provide safe and simple delivery of dental care for cardiovascular patients.

  12. Factors affecting North Carolina dental hygienists' confidence in providing obesity education and counseling. (United States)

    Kading, Cherri L; Wilder, Rebecca S; Vann, William F; Curran, Alice E


    Obesity is a major public health issue in the United States. Dental hygienists influence their patients' oral health by providing dietary and behavioral recommendations that encourage good oral health practices. However, it is not known if they are ready to provide behavioral counseling strategies for weight loss. This study investigates whether dental hygienists in North Carolina are confident to counsel patients who are at-risk for obesity. A questionnaire was used to survey 246 dental hygienists attending a continuing education (CE) course. It investigated self-reported confidence in providing obesity counseling, educational preparation, outcome expectations and self-efficacy. The primary outcome was confidence in providing weight loss counseling. Mantel Haenszel statistics were used to compare group of interest. Of the dental hygienists surveyed, 43% perceived an increase of overweight patients in their practices. Nearly all (95%) felt that dental hygienists have a role in helping patients improve nutrition. Over half (65%) expressed confidence in discussing obesity-related health risks. On average, the confidence in getting patients to follow weight loss advice was significantly different (p=0.02) for those with a 2 year degree and those with a 4 year degree. The findings indicate that many North Carolina dental hygienists are willing to discuss obesity with patients.

  13. Virtual patients in geriatric education. (United States)

    Tan, Zaldy S; Mulhausen, Paul L; Smith, Stephen R; Ruiz, Jorge G


    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction.

  14. Providing An Appropriate Education Programme For Children With ...

    African Journals Online (AJOL)

    ... special school, integrated school, special unit in regular schools and the new emphasis on inclusive education. The paper then emphasized the danger inherent in wrong education programme for the children with mental retardation. International Journal of Emotional psychology and sport ethics (IJEPSE) Vol. 7 2005: pp.

  15. Virtual Patients in Geriatric Education (United States)

    Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.


    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…

  16. Assessment of Surgery Resident Competency Provided by Patients. (United States)

    Zhu, Yaxin; Yan, Tingmei; Qu, Bo


    The objective of this study was to assess the competency of surgery residents from the patient perspective in the current healthcare environment in China. The authors performed an assessment of 508 surgery residents in Liaoning province. Seven patients were as a group to complete the self-administered questionnaires on the survey for each individual corresponding resident. A 5-point rating scale with an unable-to-evaluate category was used to assess surgery resident competency by patients. Reliability and validity were assessed by Cronbach alpha (α) and exploratory factor analysis, respectively. Statistical analysis was performed using SPSS 13.0. The surveys on 421 residents were valid, and the valid response rate was 82.8%. A total of 2947 questionnaires from patients were analyzed in this study. The Cronbach α coefficient was 0.92. The 4 factors emerging in the exploratory factor analysis reached a cumulative contribution rate of 66.98%. The items of "promotes health maintenance (talks about preventive care)" (206/7.0%), "tells me about any side effects of the medicine" (177/6.0%), "spends enough time with me" (189/6.4%), and "answers my questions thoroughly" (168/5.7%) were scored <4 by higher percentage of patients. The instrument provided an acceptable means for patients to evaluate the competency of Chinese surgery residents. Surgery residents should improve their competencies on preventive care, patient safety, and communication skills.

  17. Patients' and providers' perceptions of the impact of health literacy on communication in pulmonary rehabilitation. (United States)

    Sadeghi, Shiva; Brooks, Dina; Goldstein, Roger S


    Chronic obstructive pulmonary disease (COPD) is the most prevalent form of chronic respiratory diseases worldwide. Pulmonary rehabilitation, including self-management education, highlights the importance of good patient-provider communication in establishing optimal care. There is a growing awareness of the potential impact of health literacy (HL) on the patients' access to and understanding of medical information. This study was designed to explore the patients' and health care professionals' (HCPs) perceptions of the role of HL in health communication. Semi-structured interviews and focus groups were conducted with 12 patients and 20 HCPs at a Pulmonary Rehabilitation Center in Metropolitan Toronto. Although the term health literacy was not familiar to many patients, the contribution of knowledge to patient well-being was consistently identified by patients and HCPs. Barriers to communication included provider time constraints and the use of medical jargon. For providers they also included patient characteristics, language, culture and awareness of health resources. Approaches that might improve communication incorporated family support, peer support, better print and visual teaching material and a trusting empathic patient-provider relationship. The findings provide an increased understanding of patients' and providers' perceptions of HL as a barrier to effective communication of medical information to patients with COPD as well as approaches that might improve this communication.

  18. Patients' perceptions of patient care providers with tattoos and/or body piercings. (United States)

    Westerfield, Heather V; Stafford, Amy B; Speroni, Karen Gabel; Daniel, Marlon G


    This study evaluated patients' perceptions of patient care providers with visible tattoos and/or body piercings. As tattooing and body piercing are increasingly popular, research that informs nursing administrators regarding policies on patient care providers having visible tattoos and body piercings is warranted. A total of 150 hospitalized adult patients compared pictures of male and female patient care providers in uniform with and without tattoos and/or nonearlobe body piercings. Patient care providers with visible tattoos and/or body piercings were not perceived by patients in this study as more caring, confident, reliable, attentive, cooperative, professional, efficient, or approachable than nontattooed or nonpierced providers. Tattooed female providers were perceived as less professional than male providers with similar tattoos. Female providers with piercings were perceived as less confident, professional, efficient, and approachable than nonpierced female providers. Nursing administrators should develop and/or evaluate policies regarding patient care providers with visible tattoos and/or body piercings.

  19. Feedback in Clinical Education, Part I: Characteristics of Feedback Provided by Approved Clinical Instructors (United States)

    Nottingham, Sara; Henning, Jolene


    Context Providing students with feedback is an important component of athletic training clinical education; however, little information is known about the feedback that Approved Clinical Instructors (ACIs; now known as preceptors) currently provide to athletic training students (ATSs). Objective To characterize the feedback provided by ACIs to ATSs during clinical education experiences. Design Qualitative study. Setting One National Collegiate Athletic Association Division I athletic training facility and 1 outpatient rehabilitation clinic that were clinical sites for 1 entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants A total of 4 ACIs with various experience levels and 4 second-year ATSs. Data Collection and Analysis Extensive field observations were audio recorded, transcribed, and integrated with field notes for analysis. The constant comparative approach of open, axial, and selective coding was used to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results The ACIs gave 88 feedback statements in 45 hours and 10 minutes of observation. Characteristics of feedback categories included purpose, timing, specificity, content, form, and privacy. Conclusions Feedback that ACIs provided included several components that made each feedback exchange unique. The ACIs in our study provided feedback that is supported by the literature, suggesting that ACIs are using current recommendations for providing feedback. Feedback needs to be investigated across multiple athletic training education programs to gain more understanding of certain areas of feedback, including frequency, privacy, and form. PMID:24143902

  20. Evaluation of a Sickle Cell Disease Educational Website for Emergency Providers. (United States)

    Kayle, Mariam; Brennan-Cook, Jill; Carter, Brigit M; Derouin, Anne L; Silva, Susan G; Tanabe, Paula


    Sickle cell disease (SCD) is a complex multisystem debilitating disease. Despite its complexity, health care providers who are not SCD experts receive little formal education on SCD. An open-access, educational website, "Emergency Department Sickle Cell Disease: Crisis Management and Beyond," was created to provide education about SCD to emergency department (ED) providers who are not SCD experts but who provide care for patients with SCD. Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. The evaluation consisted of (1) individual module pre- and post-knowledge assessment, (2) content validity assessment of educational modules, (3) overall website content assessment, and (4) overall website assessment (Health on the Net core principles). A convenient sample of ED providers, accelerated bachelor of science in nursing students, SCD experts, and website experts completed the anonymous surveys. Descriptive statistics and paired t tests were used to compare mean difference in post- minus pre-knowledge test scores. Knowledge scores statistically improved for nursing students (p value less than 0.0001). Emergency department providers showed a mean improvement of 3.2 points on the eight-item knowledge assessment. Both SCD experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives. Participants agreed that the website was clear, easy to navigate, and visually appealing. Website experts stated that the website met much of the Health on the Net criteria. The website is a useful resource for providers and nursing students, especially those who serve or plan to serve in EDs.

  1. Effectiveness of Provider Education Followed by Computerized Provider Order Entry Alerts in Reducing Inappropriate Red Blood Cell Transfusion

    Directory of Open Access Journals (Sweden)

    Vijay M. Patel


    Full Text Available To reduce the rate of inappropriate red blood cell transfusion, a provider education program, followed by alerts in the computerized provider order entry system (CPOE, was established to encourage AABB transfusion guidelines. Metrics were established for nonemergent inpatient transfusions. Service lines with high order volume were targeted with formal education regarding AABB 2012 transfusion guidelines. Transfusion orders were reviewed in real time with email communications sent to ordering providers falling outside of AABB recommendations. After 12 months of provider education, alerts were activated in CPOE. With provider education alone, the incidence of pretransfusion hemoglobin levels greater than 8 g/dL decreased from 16.64% to 6.36%, posttransfusion hemoglobin levels greater than 10 g/dL from 14.03% to 3.78%, and number of nonemergent two-unit red blood cell orders from 45.26% to 22.66%. Red blood cell utilization decreased by 13%. No additional significant reduction in nonemergent two-unit orders was observed with CPOE alerts. Provider education, an effective and low-cost method, should be considered as a first-line method for reducing inappropriate red blood cell transfusion rates in stable adult inpatients. Alerts in the computerized order entry system did not significantly lower the percentage of two-unit red blood cells orders but may help to maintain educational efforts.

  2. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight. (United States)

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L


    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Boundary Negotiating Artifacts in Personal Informatics: Patient-Provider Collaboration with Patient-Generated Data. (United States)

    Chung, Chia-Fang; Dew, Kristin; Cole, Allison; Zia, Jasmine; Fogarty, James; Kientz, Julie A; Munson, Sean A


    Patient-generated data is increasingly common in chronic disease care management. Smartphone applications and wearable sensors help patients more easily collect health information. However, current commercial tools often do not effectively support patients and providers in collaboration surrounding these data. This paper examines patient expectations and current collaboration practices around patient-generated data. We survey 211 patients, interview 18 patients, and re-analyze a dataset of 21 provider interviews. We find that collaboration occurs in every stage of self-tracking and that patients and providers create boundary negotiating artifacts to support the collaboration. Building upon current practices with patient-generated data, we use these theories of patient and provider collaboration to analyze misunderstandings and privacy concerns as well as identify opportunities to better support these collaborations. We reflect on the social nature of patient-provider collaboration to suggest future development of the stage-based model of personal informatics and the theory of boundary negotiating artifacts.

  4. Interprofessionalism: Educating to Meet Patient Needs (United States)

    Kirch, Darrell G.; Ast, Cori


    Interprofessional teams in health care are showing promise in achieving the triple aim--providing better care for the individual patient, reducing costs, and improving population health. To complement current changes in health care delivery in the United States, there is a growing consensus among health professions educators that students should…

  5. Providing culturally congruent care for Saudi patients and their families. (United States)

    Mutair, Abbas Saleh Al; Plummer, Virginia; O'Brien, Anthony Paul; Clerehan, Rosemary


    This article aims to increase an awareness of caring for Saudi families by non-Saudi nurses to improve their understanding of culturally competent care from a Saudi perspective. Healthcare providers have a duty of a care to deliver holistic and culturally specific health care to their patients. As a consequence of 'duty of care' obligations, healthcare providers must facilitate culturally congruent care for patients of diverse cultural backgrounds. For the Saudi family considerable cultural clashes may arise when Saudi patients are hospitalized and receive care from healthcare professionals who do not understand Islamic principles and Saudi cultural beliefs and values. The healthcare workforce in Saudi Arabia is a unique multicultural workforce that is mix of Saudi and significant other nationalities. Saudi nurses for example represent only 36.3% of the workforce in the different health sectors. Whilst the different ethnic and cultural background expatriate nurses represent 63.7% (Ministry of Health, 2010). This article also could increase the awareness of healthcare professionals caring for Arab and Muslims patients in another context in the world.

  6. "A Lot of Things Passed Me by": Rural Stroke Survivors' and Caregivers' Experience of Receiving Education From Health Care Providers. (United States)

    Danzl, Megan M; Harrison, Anne; Hunter, Elizabeth G; Kuperstein, Janice; Sylvia, Violet; Maddy, Katherine; Campbell, Sarah


    The purpose of this study is to examine rural Appalachian Kentucky stroke survivors' and caregivers' experiences of receiving education from health care providers with the long-term goal of optimizing educational interactions and interventions for an underserved population. An interprofessional research team, representing nursing, occupational therapy, physical therapy, and speech language pathology, conducted a qualitative descriptive study involving semistructured interviews with 13 stroke survivors and 12 caregivers. Qualitative content analysis included predetermined and emerging coding. This article presents an in-depth analysis of a subset of data from the coding scheme of a larger study that examined the overall experience of stroke for participants. Findings are presented within a developing model of patient and caregiver education constructs including providers and receivers of education and the content, timing, and delivery of information. Understanding the experience of receiving education for survivors and caregivers will help practitioners provide the right education, to the right people, at the right time, and in the right way to better support underserved groups. Improving patient and caregiver education is paramount to supporting health behavior change to optimize life poststroke and prevent future strokes. Our results suggest the need for improved access to educational providers, proactive identification of informational needs by providers, greater inclusion of caregivers in education, enhanced communication with information provision, and education from multiple providers using multiple delivery methods at multiple time points. © 2015 National Rural Health Association.

  7. Effects of an Education Intervention about HPV Self-Testing for Healthcare Providers and Staff. (United States)

    Presser, Brynne E; Katz, Mira L; Shoben, Abigail B; Moore, Deborah; Ruffin, Mack T; Paskett, Electra D; Reiter, Paul L


    Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet efforts to educate healthcare providers and staff about HPV self-testing are lacking. We report the findings of a brief education intervention about HPV self-testing for healthcare providers and staff. We conducted education sessions during 2015 with healthcare providers and staff (n = 33) from five federally qualified health centers located in Appalachian Ohio. Participants attended a one-time session and completed pre- and post-intervention surveys. Analyses for paired data assessed changes in knowledge and beliefs about HPV, HPV-related disease, and HPV self-testing. The intervention increased participants' knowledge and affected many of the beliefs examined. Participants answered an average of 4.67 of six knowledge items correctly on pre-intervention surveys and 5.82 items correctly on post-intervention surveys (p < 0.001). The proportion of participants who answered all six knowledge items correctly increased substantially (pre-intervention =9% vs. post-intervention =82%, p < 0.001). Compared to pre-intervention surveys, participants more strongly believed on post-intervention surveys that it is important to examine HPV self-testing as a potential cervical cancer screening strategy, that their female patients would be willing to use an HPV self-test at home by themselves, and that they have the knowledge to talk with their patients about HPV self-testing (all p < 0.05). A brief education intervention can be a viable approach for increasing knowledge and affecting beliefs about HPV self-testing among healthcare providers and staff. Findings will be valuable for planning and developing future HPV self-test interventions that include an education component for healthcare providers and staff.

  8. Continuing Education for Lay Ministry: Providers, Beliefs, Issues, and Programs. (United States)

    English, Leona M.


    Responses from 23 of 35 leaders of lay minister education programs indicated liberal attitudes on some issues (social justice, women's ordination); 74% were hopeful about the church's future; 17% felt at risk because of their views; 32% experienced little or no congregational support; and 82% felt that the church needed to improve its acceptance…

  9. Patient choice of provider type in the emergency department: perceptions and factors relating to accommodation of requests for care providers. (United States)

    Padela, Aasim I; Schneider, Sandra M; He, Hua; Ali, Zarina; Richardson, Thomas M


    Patient satisfaction is related to the perception of care. Some patients prefer, and are more satisfied with, providers of the same gender, race or religious faith. This study examined emergency medical provider attitudes towards, as well as patient and provider characteristics that are associated with, accommodating such requests. A survey administered to a convenience sample of participants at the 2007 American College of Emergency Physicians Scientific Assembly. The nine-question survey ascertained Likert-type responses to the likelihood of accommodating patient requests for specific provider types. Statistical analyses used Wilcoxon rank-sum, Wilcoxon signed-rank and Cochran's Q tests. The 176 respondents were predominantly white (83%) and male (74%), with a mean age of 42 y. Nearly a third of providers felt that patients perceive better care from providers of shared demographics with racial matching perceived as more important than gender or religion (p=0.02). Female providers supported patient requests for same gender providers more so than males (prequesting like providers, female patients had higher accommodation scores than male patients (prequests for providers of specific demographics within the emergency department may be related to provider characteristics. When patients ask for same gender providers, female providers are more likely to accommodate such a request than male providers. Female, non-white and Muslim patients may be more likely to have their requests honoured for matched providers.

  10. Patient-provider conversations about sterilization: A qualitative analysis. (United States)

    Kimport, Katrina; Dehlendorf, Christine; Borrero, Sonya


    Although female sterilization is the second most commonly used contraceptive method in the US, research suggests that providers may serve as barriers to desired sterilization. We conducted a modified grounded theory analysis of audio-recorded contraceptive counseling visits with 52 women who specified on a previsit survey that they wanted no future children and a supplemental analysis of visits with 14 women who wanted or were unsure about future children in which sterilization was mentioned. Sterilization was discussed in only 19 of the 52 visits, primarily with patients who were older women with children. Although some framed sterilization positively, many clinicians discouraged patients from pursuing sterilization, encouraging them instead to use long-acting reversible methods and framing the permanence of sterilization as undesirable. In the 33 remaining sessions, sterilization was not mentioned, and clinicians largely failed to solicit patients' future reproductive intentions. We found no clear patterns regarding discussion of sterilization in the 14 supplemental cases. Clinicians did not discuss sterilization with all patients for whom it might have been appropriate and thus missed opportunities to discuss sterilization as part of the full range of appropriate methods. When they did discuss sterilization, they only infrequently presented the method in positive ways and more commonly encouraged patients to choose a long-acting reversible method instead. Clinicians may want to reflect on their counseling practices around sterilization to ensure that counseling is centered on patient preferences, rather than driven by their own assumptions about the desirability of reversibility. Clinicians often fail to discuss sterilization as a contraceptive option with potentially appropriate candidates and, when they do, often discourage its selection. Clinicians should consider assessing reproductive intentions to ensure that potentially relevant methods are included in

  11. Patient education in The Netherlands

    NARCIS (Netherlands)

    Bensing, J.; Visser, Adriaan; Saan, Hans


    This article presents the development of patient education (PE) in The Netherlands from a historical perspective. A description is given of the first pioneering years from the 70s till the late 80s, in which early topics like the organization of PE, the orchestration of PE between different

  12. Change in Provider Beliefs Regarding Cervical Cancer Screening Intervals After an Educational Intervention. (United States)

    Benard, Vicki B; Greek, April; Roland, Katherine B; Hawkins, Nikki A; Lin, Lavinia; Saraiya, Mona


    Current cervical cancer screening guidelines include the option of lengthening the screening interval to 5 years for average-risk women aged 30-65 years when screened with Pap and human papillomavirus (HPV) test (co-test). Because many providers are reluctant to extend screening intervals, we launched an educational intervention to promote recommended screening practices. The study objective was to assess changes in provider attitudes and beliefs to extending screening intervals among low-income women. The study was conducted in 15 clinics in Federally Qualified Health Centers in Illinois. Providers in the intervention arm received a multicomponent educational intervention. Fifty-six providers (n = 29 intervention and n = 27 control) completed baseline and 12-month follow-up surveys assessing beliefs and intentions about extending screening intervals. The 12-month assessment showed providers in the intervention arm were significantly more likely than those in the control arm to recommend a 3-year screening interval (guideline recommendation at time of study) with a normal co-test result. Providers who received the intervention were significantly more likely to agree that routine co-testing is the best way to screen for cervical cancer, that extending the screening interval would be good, easy, and beneficial, and to disagree that the increased screening interval would cause patients to lose contact with the medical system. Educating providers on the natural history of HPV infection and cervical cancer and the benefits of extended intervals increased their willingness to follow guidelines. This study provides evidence that an educational intervention delivered with HPV testing materials may be effective in encouraging appropriate cervical screening intervals.

  13. Prescription Opioid Analgesics: Promoting Patient Safety with Better Patient Education. (United States)

    Costello, Margaret


    Patients expect and deserve adequate postoperative pain relief. Opioid analgesics are widely used and effective in controlling postoperative pain, but their use poses risks that many patients don't understand and that all too often result in adverse outcomes. Inappropriate and often dangerous use of prescription medication has increased sharply in the past two decades in the United States. Patients and caregivers must have an adequate understanding of safe use, storage, and disposal of opioids to prevent adverse drug events in patients and others. Nurses play a key role in providing this patient education. This article provides a case study that highlights the risks and important aspects of opioid medication use in the postoperative patient.

  14. Creating a patient education tool. (United States)

    Stonecypher, Karen


    Developing a patient education tool based on low literacy levels, behavioral theories, role modeling, and The Joint Commission's standards was the primary objective of this project. The initial goal was merely to develop a population-appropriate patient education tool. This led to a process whereby significant knowledge was gained by all to enrich overall professional development. An interdisciplinary team developed a low-literacy, self-management book for patients who had suffered a stroke. Team experts were responsible for the development of specific subject matter. Editing addressed the message, readability, typeface and font size, and charts and illustrations. Collaboration with the National Stroke Association guided the didactic pedagogical content presented. A well-known cartoonist who was a U.S. military veteran was willing to work with the team to develop the illustrations. Copyright 2009, SLACK Incorporated.

  15. Empowering Nurses in Providing Palliative Care to Cancer Patients: Action Research Study. (United States)

    Taleghani, Fariba; Shahriari, Mohsen; Alimohammadi, Nasrollah


    Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation). Participants (33 samples) included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.

  16. Empowering nurses in providing palliative care to cancer patients: Action research study

    Directory of Open Access Journals (Sweden)

    Fariba Taleghani


    Full Text Available Background: Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. Materials and Methods: This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation. Participants (33 samples included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Results: Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. Conclusions: To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.

  17. Nursing students' practice in providing oral hygiene for patients. (United States)

    McAuliffe, Ann

    To explore and identify precedent factors that may influence nursing students' oral hygiene practice in hospitalised patients, by using an adaptation of the Precede Model. A quantitative approach with a descriptive design was adopted in this pilot study. A questionnaire was designed and implemented as a self-report method of data collection. A convenience sample of 37 second-year diploma nursing students in an Irish teaching hospital participated in the study. The clinical area and the practices within it are influential factors in the provision of oral hygiene. Students are exposed to and influenced by outdated and non-research-based practices. Role modelling is an effective means of motivating and reinforcing student practices. However, qualified nurses' practices need to be critically reviewed before assuming that they can act as role models in assisting students to implement research-based oral hygiene. Formal education, current practices, socialisation and role modelling may influence students' behaviour in relation to oral hygiene. The results should be tentatively reviewed by clinical staff as an indication of current practices.

  18. Health literacy in the "oral exchange": an important element of patient-provider communication. (United States)

    Nouri, Sarah S; Rudd, Rima E


    Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange. A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included. The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand. This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field. Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Ovarian Cancer Knowledge in Women and Providers Following Education with Inside Knowledge Campaign Materials. (United States)

    Puckett, Mary C; Townsend, Julie S; Gelb, Cynthia A; Hager, Polly; Conlon, Amy; Stewart, Sherri L


    Because no effective methods for preventing or screening for ovarian cancer exist, symptom recognition is integral to its early detection. The Centers for Disease Control and Prevention's Inside Knowledge: Get the Facts about Gynecologic Cancer campaign was developed to raise awareness and educate women and providers about risk factors, symptoms, recommended screening, and prevention strategies for the five main gynecologic cancers, including ovarian cancer. Inside Knowledge campaign materials were utilized by CDC's National Comprehensive Cancer Control Program grantees to educate women and providers about gynecologic cancer from 2014 to 2015. Grantees recruited participants and held educational sessions using Inside Knowledge materials. Questionnaires were given before and after the sessions to assess changes in awareness, confidence, and behavioral intentions around gynecologic cancer information and analyzed in 2016. This analysis focused on an assessment of changes related to ovarian cancer information. Participants' knowledge increased after educational sessions. Among women, there were increases in correctly identifying that the Papanicolaou (Pap) test does not screen for ovarian cancer (89.2%) and that genetic testing is available (77.9%). There was a lower increase in knowledge that HPV is not a cause of ovarian cancer (56.4%). Providers and women reported significant increases in their confidence in their ability to talk to each other about gynecologic cancer post-session. Ovarian cancer awareness, confidence, and related behaviors increased in participants exposed to Inside Knowledge materials. Using these materials to increase knowledge could lead to more empowered patients, better provider-patient communications, and improved care for gynecologic cancers, including ovarian cancer.

  20. Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior. (United States)

    Clare, Camille A; Afzal, Omara; Knapp, Kenneth; Viola, Deborah


    To determine whether a patient's level of assertiveness and other factors influences her comfort level in asking her provider to wash his or her hands. In this pilot study, we developed a survey to gather cross-sectional information on a variety of factors that might explain patient willingness to ask her health-care provider to wash his or her hands. Three primary predictor variables are analyzed: (1) patient assertiveness; (2) patient familiarity with her healthcare provider; and (3) whether the patient has observed hand-washing behavior. Fifty patients participated from the Obstetrics and Gynecology Department of Metropolitan Hospital Center. Less assertive patients are much less likely than assertive patients to ask physicians to wash hands (25% versus 68%; Fisher's exact test P = 0.0427). Among the 3 assertiveness questions included in the survey, the ability to ask physicians questions during visits is most strongly indicative of willingness to ask about hand washing. Familiarity with the names of regular health-care providers has a statistically significant impact on willingness to ask about hand washing. Evidence suggests that observing hand washing behavior affects willingness to ask, but differences are not statistically significant. Results by socioeconomic status such as age, education, income, and race/ethnicity are inconclusive. A patient's level of assertiveness alone is not sufficient to determine her willingness to inquire about the hand-washing behavior of her provider. A high percentage of patients did not see their provider engaging in adequate hand washing behavior. If patients feel comfortable with their provider to inquire about their care and request hand-washing behavior, health outcomes are affected by reducing the rates of health care-associated infections.

  1. Attitudes and perceptions of patients, caregivers, and health care providers toward background music in patient care areas: an exploratory study. (United States)

    Perez-Cruz, Pedro; Nguyen, Linh; Rhondali, Wadih; Hui, David; Palmer, J Lynn; Sevy, Ingrid; Richardson, Michael; Bruera, Eduardo


    Background music can be used to distract from ordinary sounds and improve wellbeing in patient care areas. Little is known about individuals' attitudes and beliefs about music versus ordinary sound in this setting. To assess the preferences of patients, caregivers and healthcare providers regarding background music or ordinary sound in outpatient and inpatient care areas, and to explore their attitudes and perceptions towards music in general. All participants were exposed to background music in outpatient or inpatient clinical settings. 99 consecutive patients, 101 caregivers and 65 out of 70 eligible healthcare providers (93%) completed a survey about music attitudes and preferences. The primary outcome was a preference for background music over ordinary sound in patient care areas. Preference for background music was high and similar across groups (70 patients (71%), 71 caregivers (71%) and 46 providers (71%), p=0.58). The three groups had very low disapproval for background music in patient care areas (10%, 9% and 12%, respectively; p=0.91). Black ethnicity independently predicted lower preference for background music (OR: 0.47, 95%CI: 0.23, 0.98). Patients, caregivers and providers reported recent use of music for themselves for the purpose of enjoyment (69%, 80% and 86% respectively p=0.02). Age, gender, religion and education level significantly predicted preferences for specific music styles. Background music in patient care areas was preferred to ordinary sound by patients, caregivers and providers. Demographics of the population are strong determinants of music style preferences.

  2. Classroom Animals Provide More than Just Science Education (United States)

    Herbert, Sandra; Lynch, Julianne


    Keeping classroom animals is a common practice in many classrooms. Their value for learning is often seen narrowly as the potential to involve children in learning biological science. They also provide opportunities for increased empathy, as well as socio-emotional development. Realization of their potential for enhancing primary children's…

  3. Education of Rural Community Pharmacists To Provide Nutrition Information. (United States)

    Boggs, Sharon A. C.; And Others


    A survey of 130 rural community pharmacists in Washington State found 70% in towns with five or fewer pharmacies; almost all provided nutrition information to their communities though only 20% had taken a nutrition course during pharmacy training. Most common questions concerned supplements and weight loss. Respondents relied on pharmacy journals,…

  4. Patient, provider, and clinic characteristics associated with public STD clinic patient satisfaction


    Mehta, S.; Zenilman, J; Erbelding, E


    Objectives: There is a lack of information describing levels of patient satisfaction among patients seeking sexually transmitted diseases (STD) care in a public clinic setting. We sought to identify patient, provider, and clinic characteristics associated with patient satisfaction within public STD clinics.

  5. Pharmacist-provided diabetes management and education via a telemonitoring program. (United States)

    Shane-McWhorter, Laura; McAdam-Marx, Carrie; Lenert, Leslie; Petersen, Marta; Woolsey, Sarah; Coursey, Jeffrey M; Whittaker, Thomas C; Hyer, Christian; LaMarche, Deb; Carroll, Patricia; Chuy, Libbey


    To assess clinical outcomes (glycosylated hemoglobin [A1C], blood pressure, and lipids) and other measurements (disease state knowledge, adherence, and self-efficacy) associated with the use of approved telemonitoring devices to expand and improve chronic disease management of patients with diabetes, with or without hypertension. Four community health centers (CHCs) in Utah. Federally qualified safety net clinics that provide medical care to underserved patients. Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring). Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values. Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group. Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group. Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.

  6. Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns. (United States)

    Douglas, Susan R; Vides de Andrade, Ana Regina; Boyd, Stephanie; Leslie, Melanie; Webb, Lynn; Davis, Lauren; Fraine, Melissa; Frazer, Nicole L; Hargraves, Ryan; Bickman, Leonard


    To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology. Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate). All Soldiers were eligible to participate and were blinded to provider training status. Immediately after screening encounters, providers reported on their identification of mental health concerns and Soldiers reported on provider communication behaviors resulting in 1,400 matched pairs. Electronic health records were also available for 26,005 Soldiers. The workshop was found to increase (1) providers' patient-centered communication behaviors as evaluated by Soldiers; (2) provider identification of Soldier mental health concerns; and (3), related health outcomes including provision of education and referral to a confidential counseling resource. Results are promising, but with small effect sizes and study limitations, further research is warranted. A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Classroom Animals Provide More Than Just Science Education (United States)

    Herbert, Sandra; Lynch, Julianne


    Keeping classroom animals is a common practice in many classrooms. Their value for learning is often seen narrowly as the potential to involve children in learning biological science. They also provide opportunities for increased empathy, as well as socio-emotional development. Realization of their potential for enhancing primary children's learning can be affected by many factors. This paper focuses on teachers' perceptions of classroom animals, drawing on accounts and reflections provided by 19 participants located in an Australian primary school where each classroom kept an animal. This study aims to progress the conversation about classroom animals, the learning opportunities that they afford, and the issues they present. Phenomenographic analysis of data resulted in five categories of teachers' perceptions of the affordances and constraints of keeping classroom animals.

  8. Clinical management apps: creating partnerships between providers and patients. (United States)

    Silow-Carroll, Sharon; Smith, Barbara


    The market for health applications, or apps, on mobile devices is growing rap­idly, with over 40,000 currently in use. One type of app technology--clinical manage­ment apps--enable patients and providers to work together to manage chronic conditions, particularly diabetes and asthma. These apps are mostly used by health plans and large health care organizations with an interest in improving outcomes and controlling costs. Challenges to broader adoption of apps include the lack of objective research to evalu­ate outcomes, uncertainty about how to pay for and encourage the use of cost-effective apps, and the absence of a regulatory framework that standardizes development to ensure performance. If this infrastructure is developed, apps may serve as a catalyst to stimulate the transformation of health care generally and target low-income populations to expand access to care and help reduce health disparities.

  9. Influence of patient education on profiles of physician practices. (United States)

    Fiscella, K; Franks, P


    Few data are available about the effect of patient socioeconomic status on profiles of physician practices. To determine the ways in which adjustment for patients' level of education (as a measure of socioeconomic status) changes profiles of physician practices. Cross-sectional survey of patients in physician practices. Managed care organization in western New York State. A random sample of 100 primary care physicians and 50 consecutive patients seen by each physician. Ranks of physicians for patient physical and mental health (Short Form 12-Item Health Survey) and satisfaction (Patient Satisfaction Questionnaire), adjusted for patient age, sex, morbidity, and education. Physicians whose patients had a lower mean level of education had significantly better ranks for patient physical and mental health status after adjustment for patients' level of education level than they did before adjustment (P education, each 1-year decrease in mean educational level was associated with a rank that improved by 8.1 (95% CI, 6.6 to 9.6) for patient physical health status and by 4.9 (CI, 3.9 to 5.9) for patient mental health status. Adjustment for education had similar effects for practices with more educated patients and those with less educated patients. Profiles of physician practices that base ratings of physician performance on patients' physical and mental health status are substantially affected by patients' level of education. However, these results do not suggest that physicians who care for less educated patients provide worse care. Physician profiling should account for differences in patients' level of education.

  10. Smartphone medication adherence apps: potential benefits to patients and providers. (United States)

    Dayer, Lindsey; Heldenbrand, Seth; Anderson, Paul; Gubbins, Paul O; Martin, Bradley C


    To provide an overview of medication adherence, discuss the potential for smartphone medication adherence applications (adherence apps) to improve medication nonadherence, evaluate features of adherence apps across operating systems (OSs), and identify future opportunities and barriers facing adherence apps. Medication nonadherence is a common, complex, and costly problem that contributes to poor treatment outcomes and consumes health care resources. Nonadherence is difficult to measure precisely, and interventions to mitigate it have been largely unsuccessful. Using smartphone adherence apps represents a novel approach to improving adherence. This readily available technology offers many features that can be designed to help patients and health care providers improve medication-taking behavior. Currently available apps were identified from the three main smartphone OSs (Apple, Android, and Blackberry). In addition, desirable features for adherence apps were identified and ranked by perceived importance to user desirability using a three-point rating system: 1, modest; 2, moderate; or 3, high. The 10 highest-rated apps were installed and subjected to user testing to assess app attributes using a standard medication regimen. RESULTS 160 adherence apps were identified and ranked. These apps were most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of their basic medication reminder features coupled with their enhanced levels of functionality. Despite being untested, medication apps represent a possible strategy that pharmacists can recommend to nonadherent patients and incorporate into their practice.

  11. Will electronic personal health records benefit providers and patients in rural America? (United States)

    Hargreaves, John S


    The objective of this study was to educate stakeholders (e.g., providers, patients, insurers, government) in the healthcare industry about electronic personal health records (PHRs) and their potential application in rural America. Extensive research was performed on PHRs through standard literature search, product demonstrations, educational webinars, and fact finding via news releases. Various stakeholders are eager to transform the healthcare industry into the digital age like other industries (i.e., banking, retail). Despite low adoption of PHRs in 2008 (2.7% of U.S. adults), patients are interested in secure messaging and eVisits with their physicians, online appointment scheduling and reminders, and online access to their laboratory and radiology results. Federal agencies (e.g., Health and Human Services, Department of Defense, Veterans Affairs [VA]), popular information technology (IT) vendors (e.g., Google, Microsoft), and large insurers (e.g., Aetna) have energized the industry through pilot programs and new product announcements. It remains to be seen if barriers to adoption, including privacy concerns, lack of interoperability standards and funding, and provider resistance, can be overcome to enable PHRs to become a critical tool in the creation of a more efficient and less costly U.S. healthcare industry. Electronic PHRs hold great promise to enhance access and improve the quality of care provided to patients in rural America. Government, vendors, and insurers should create incentives for providers and patients to implement PHRs. Likewise, patients need to become more aware of PHRs and their ability to improve health outcomes.

  12. E-mail in patient-provider communication: a systematic review. (United States)

    Ye, Jiali; Rust, George; Fry-Johnson, Yvonne; Strothers, Harry


    To review systematically the role of e-mails in patient-provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care. A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008. A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed. The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool. It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  13. An approach to consistent patient education. (United States)

    Ortoleva, Catherine


    Patient education is instrumental to postoperative recovery. To that end, the nurse must be able to decipher the discharge instructions and the patient and caregivers must be able to understand them. Ambulatory surgery patients are in the clinical setting for shorter periods; therefore, nurses need to provide these patients with effective educational tools that will assist them in achieving optimal surgical outcomes. In an effort to improve our perioperative and discharge orders, which were being handwritten, I created standardized forms that require little handwriting and allow surgeons to complete their orders by checkmarking the items. Use of these forms has improved turnover time, provided nurses and patients with orders that are easier to read and understand, and produced fewer incidences in which information is left off orders or misunderstood. Following up with patients to ensure their comprehension and active participation in their postsurgical care allows the nurses to assess the success of surgical care and patient satisfaction. Copyright © 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  14. Health care provider education as a tool to enhance antibiotic stewardship practices. (United States)

    Ohl, Christopher A; Luther, Vera P


    Antibiotic stewardship education for health care providers provides a foundation of knowledge and an environment that facilitates and supports optimal antibiotic prescribing. There is a need to extend this education to medical students and health care trainees. Education using passive techniques is modestly effective for increasing prescriber knowledge, whereas education using active techniques is more effective for changing prescribing behavior. Such education has been shown to enhance other antibiotic stewardship interventions. In this review, the need and suggested audience for antibiotic stewardship education are highlighted, and effective education techniques are recommended for increasing knowledge of antibiotics and improving their use. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

    Directory of Open Access Journals (Sweden)

    Wiener L


    Full Text Available Lori Wiener,1,*,# Meaghann Shaw Weaver,2,3,*,# Cynthia J Bell,4,# Ursula M Sansom-Daly,5–7 1Pediatric Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA; 2Department of Oncology, Children’s National Health System, Washington, DC, USA; 3Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN, USA; 4College of Nursing, Wayne State University and Hospice of Michigan Institute, Detroit, MI, USA; 5Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia; 6Discipline of Paediatrics, School of Women’s and Children’s Health, UNSW Medicine, The University of New South Wales, Kensington, NSW, Australia; 7Sydney Youth Cancer Service, Sydney Children’s/Prince of Wales Hospitals, Randwick, NSW, Australia *These authors have contributed equally to this work #On behalf of the Pediatric Palliative Care Special Interest Group at Children’s National Health System Abstract: Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs. The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential

  16. Providing oral care in haematological oncology patients: nurses' knowledge and skills. (United States)

    Potting, Carin M J; Mank, Arno; Blijlevens, Nicole M A; Donnelly, J Peter; van Achterberg, Theo


    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care improve when education in oral care is provided to nurses in charge of patients who are at risk of oral mucositis. This intervention study consists of a baseline test on the knowledge and skills of nurses of the haematology wards of two different hospitals. Oral care education sessions were given in one hospital and follow-up tests were performed in both hospitals. Nursing records were examined and observations of nurses performing oral care were made at baseline as well as at follow-up. The results show significant differences in the scores for knowledge and skills before and after the education, whereas there was no difference in scores at the two points in time for the comparison hospital, where no education had taken place. The records test showed no differences at baseline or follow-up for the two groups. Observations showed that nurses who followed the education session implemented the oral care protocol considerably better than those who did not attended. Education in oral care has a positive influence on the knowledge and skills of nurses who care for patient at risk of oral mucositis, but not on the quality of oral care documentation.

  17. Corruption in a Comprehensive School: Sociological Diagnosis and Educational Providence

    Directory of Open Access Journals (Sweden)

    Valdas Pruskus


    Full Text Available The article is about the phenomenon of corruption in a comprehensive school. It analyses the expression forms of corruption and their peculiarities and disputes the main reasons stimulating educators to take part in corrupt interchanges thus tolerate it. On the ground of empirical research in Vilnius secondary schools it discloses attitudes of teachers, schoolchildren and parents towards corruption. The research was carried out in Vilnius Salomėja Nėris gymnasium, Vilnius Mikalojus Daukša secondary school, Mindaugas secondary school, Užupys gymnasium, Antakalnis gymnasium, Naujamiestis secondary school and Stanevičius secondary school. Overall 500 respondents were questioned: 300 pupils of ninth – twelfth forms, 100 teachers and 100 parents of schoolchildren. Difficult financial circumstances were pointed out as the main reason stimulating teachers to take part in corrupt interchanges. This answer was chosen by 42 per cent of respondents. Most of them think that raising wages would reduce corruption crimes. The research data show it is an important problem in schools though 70 per cent of respondents state it is not the biggest problem in their school. Only 15 per cent of questioned schoolchildren, 4 per cent of parents and 14 percent of teachers safely state that corruption is the main problem in their school. About 20 per cent of respondents (21.4 per cent of schoolchildren, 19 per cent of parents and 21 per cent of teachers acknowledge of making a payoff or receiving an offer to take it. Respondents state that 30 per cent of their friends and relatives made a payoff to school staff. 26.7 percent of schoolchildren and 27 per cent of parents’ acquaintances made a payoff to school staff. Only the answers of teachers did not change – 21 per cent of their colleagues were offered a payoff. These results do not let affirm that corruption is very widely spread in schools and therefore could be named as the biggest problem here. Though

  18. Developing patient education in community pharmacy

    NARCIS (Netherlands)

    Blom, A.T.G.


    This thesis deals with the development of patient education in the community pharmacy. The research questions concentrate on the determinants of technicians’ patient education behavior and the effects of a one-year lasting intervention program on the patient education activities in the pharmacy.

  19. Patient education in Europe: united differences

    NARCIS (Netherlands)

    Visser, Adriaan; Deccache, A.; Bensing, J.


    This issue of Patient Education and Counseling presents the state of the art of patient education in several European countries. It is based on papers presented at a meeting in Paris on the evolution and development of patient education in western, central and eastern Europe (May 1999). Also

  20. Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives. (United States)

    Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W


    Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Internet and electronic resources for inflammatory bowel disease: a primer for providers and patients. (United States)

    Fortinsky, Kyle J; Fournier, Marc R; Benchimol, Eric I


    Patients with inflammatory bowel disease (IBD) are increasingly turning to the Internet to research their condition and engage in discourse on their experiences. This has resulted in new dynamics in the relationship between providers and their patients, with misinformation and advertising potentially presenting barriers to the cooperative patient-provider partnership. This article addresses important issues of online IBD-related health information and social media activity, such as quality, reliability, objectivity, and privacy. We reviewed the medical literature on the quality of online information provided to IBD patients, and summarized the most commonly accessed Websites related to IBD. We also assessed the activity on popular social media sites (such as Facebook, Twitter, and YouTube), and evaluated currently available applications for use by IBD patients and providers on mobile phones and tablets. Through our review of the literature and currently available resources, we developed a list of recommended online resources to strengthen patient participation in their care by providing reliable, comprehensive educational material. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

  2. Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies. (United States)

    Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma


    To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

  3. Community Health Centers: Providers, Patients, and Content of Care (United States)

    ... tobacco use and exposure, weight reduction, and other education. 6 Nonmedication treatment includes complementary and alternative medicine, durable medical equipment, home health care, hospice care, physical therapy, radiation therapy, speech and occupational ...

  4. Providing dental care to pregnant patients: a survey of Oregon general dentists. (United States)

    Huebner, Colleen E; Milgrom, Peter; Conrad, Douglas; Lee, Rosanna Shuk Yin


    A growing number of studies and reports indicate preventive, routine and emergency dental procedures can be provided safely to pregnant patients to alleviate dental problems and promote oral health of mothers and children. In 2006 and 2007, the authors conducted a survey of 1,604 general dentists in Oregon. The survey asked dentists about their attitudes, beliefs and practices regarding dental care for pregnant patients. The authors compared the responses with 2006 guidelines from a New York State Department of Health expert panel. The response rate was 55.2 percent. Most respondents (91.7 percent) agreed that dental treatment should be part of prenatal care. Two-thirds of respondents (67.7 percent) were interested in receiving continuing dental education (CDE) regarding the care of pregnant patients. Comparisons of self-reported knowledge and practice with the aforementioned guidelines revealed several points of difference; the greatest regarded obtaining full-mouth radiographs, providing nitrous oxide, administering long-acting anesthetic injections and use of over-the-counter pain medications. Dentists need pregnancy-specific education to provide up-to-date preventive and curative care to pregnant patients. The results of the study identified specific skills and misinformation that could be addressed through CDE. Comprehensive dental care provided during pregnancy is needed to ensure the oral health of all women at risk of experiencing pregnancy-specific problems, as well as the prevention of early childhood caries.

  5. Education and employability of young cardiac patients. (United States)

    Robida, A


    Between 1966-1980, 136 young cardiac patients were categorized as disabled in accordance with the National Act of Rehabilitation. To study their fate a questionnaire was circulated to them: 96 patients responded, all were 15 years of age or more at the time of the study; 31.2% attended middle or higher school education and 63.3% were employed; 45.9% were skilled and 54.1% unskilled workers; 2.2% were unemployed, which was very close to the general youth unemployment rate. Work was provided for unemployed patients in their homes but they needed additional financial support. The benefits for the young disabled cardiac patients include health insurance, vocational training, payment of boarding school fees and financial support. Nevertheless the focus of the team dealing with these patients should be their preparation for employment.

  6. Compassion training in healthcare: what are patients' perspectives on training healthcare providers? (United States)

    Sinclair, Shane; Torres, Mia-Bernadine; Raffin-Bouchal, Shelley; Hack, Thomas F; McClement, Susan; Hagen, Neil A; Chochinov, Harvey M


    The purpose of this qualitative study was to investigate advanced cancer patients' perspectives on the importance, feasibility, teaching methods, and issues associated with training healthcare providers in compassionate care. This study utilized grounded theory, a qualitative research method, to develop an empirical understanding of compassion education rooted in direct patient reports. Audio-recorded semi-structured interviews were conducted to obtain an in-depth understanding of compassion training from the perspectives of hospitalized advanced cancer patients (n = 53). Data were analyzed in accordance with grounded theory to determine the key elements of the underlying theory. Three overarching categories and associated themes emerged from the data: compassion aptitude, cultivating compassion, and training methods. Participants spoke of compassion as an innate quality embedded in the character of learners prior to their healthcare training, which could be nurtured through experiential learning and reflective practices. Patients felt that the innate qualities that learners possessed at baseline were further fashioned by personal and practice experiences, and vocational motivators. Participants also provided recommendations for compassion training, including developing an interpersonal relationship with patients, seeing the patient as a person, and developing a human connection. Teaching methods that patients suggested in compassion training included patient-centered communication, self-reflection exercises, and compassionate role modeling. This study provides insight on compassion training for both current and future healthcare providers, from the perspectives of the end recipients of healthcare provider training - patients. Developing a theoretical base for patient centred, evidence-informed, compassion training is a crucial initial step toward the further development of this core healthcare competency.

  7. Education and informed consent about increased risk donor kidneys: a national survey of non-physician transplant providers. (United States)

    Gordon, E J; Mullee, J; Beauvais, N; Warren, E; Theodoropoulos, N; McNatt, G; Rassiwala, J; Ison, M G


    Transplant providers must understand the definition of increased risk donor (IRD) organs to effectively educate transplant candidates and obtain informed consent. This study surveyed non-physician providers from 20 transplant centers about their educational and informed consent practices of IRD kidneys. An anonymous, web-based survey about the content and timing of education and informed consent for potential recipients of IRD kidneys, providers' knowledge of IRD kidneys, and provider and center characteristics was completed by most (67%; 90 of 135) of those invited to participate; 87 responses were included in analysis. Most (80%) reported understanding the concept of IRD kidneys. However, few reported sufficient knowledge of the Organ Procurement and Transplantation Network definition of IRDs, risk factors, screening tests, window periods, and infection transmission rates. Most (56%) felt uncomfortable with obtaining specific informed consent for IRD kidneys. Most respondents received informal education about IRD kidneys (78%), and recognized the need for (98%) and were interested in receiving (99%) further education on this topic. Non-physician transplant providers need and are interested in better education about IRD kidneys to effectively educate patients and obtain patients' informed consent. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients. (United States)

    Patterson, Brendan M; Eskildsen, Scott M; Clement, R Carter; Lin, Feng-Chang; Olcott, Christopher W; Del Gaizo, Daniel J; Tennant, Joshua N


    Clinic wait time is considered an important predictor of patient satisfaction. The goal of this study was to determine whether patient satisfaction among orthopedic patients is associated with clinic wait time and time with the provider. The authors prospectively enrolled 182 patients at their outpatient orthopedic clinic. Clinic wait time was defined as the time between patient check-in and being seen by the surgeon. Time spent with the provider was defined as the total time the patient spent in the examination room with the surgeon. The Consumer Assessment of Healthcare Providers and Systems survey was used to measure patient satisfaction. Factors associated with increased patient satisfaction included patient age and increased time with the surgeon (P=.024 and P=.037, respectively), but not clinic wait time (P=.625). Perceived wait time was subject to a high level of error, and most patients did not accurately report whether they had been waiting longer than 15 minutes to see a provider until they had waited at least 60 minutes (P=.007). If the results of the current study are generalizable, time with the surgeon is associated with patient satisfaction in orthopedic clinics, but wait time is not. Further, the study findings showed that patients in this setting did not have an accurate perception of actual wait time, with many patients underestimating the time they waited to see a provider. Thus, a potential strategy for improving patient satisfaction is to spend more time with each patient, even at the expense of increased wait time. [Orthopedics. 2017; 40(1):43-48.]. Copyright 2016, SLACK Incorporated.

  9. The periodic health examination provided to asymptomatic older women: an assessment using standardized patients. (United States)

    Carney, P A; Dietrich, A J; Freeman, D H; Mott, L A


    To describe physical examination and cancer prevention services provided by primary care physicians in response to the request for a "checkup" by an asymptomatic 55-year-old woman seeking to establish ongoing care; to assess the effects of two interventions (education and office organization) intended to improve these services; and to assess the feasibility of using "standardized" patients to evaluate physician responses to such a request. Northern New England. Fifty-nine primary care physicians who were accepting new patients and were participating in a study of early detection and prevention of cancer. Cross sectional; observations of patient visits. Actresses trained to portray a specific patient role ("standardized" or "simulated" patients) visited each physician once. Physicians were blinded to the simulated patients' true identities. Actresses reported the components of the general physical examination and the cancer-related "checkup." Most interactions were audiotaped. Fourteen physical examination components were measured, ranging from assessment of vibratory sense (5%) to measurement of blood pressure (98%). Provision of 10 services recommended by the National Cancer Institute to standardized patients included 16% being advised to reduce dietary fat; 53% to do monthly breast self-examination; 74% to quit smoking; and 89% to obtain a mammogram. Physicians spent from 5 to 60 minutes with the patients. Two physicians did not charge, whereas others charged from $24 to $108. Study group assignment was not associated with statistical differences in provider performance. Two standardized patients (3%) were detected by physicians. Audiotapes were used to verify the actresses' ability to replicate their scenario (consistently repeat their performance) and to verify physician performance. Physician responses to an identical patient request varied widely in terms of time spent with the patient, the services provided, and the cost of the visit. Using standardized

  10. Improving outcomes of transported newborns in Panama: impact of a nationwide neonatal provider education program. (United States)

    Spector, J M; Villanueva, H Solano; Brito, M E; Sosa, P Gallardo


    To determine whether national distribution of a neonatal provider education program (the S.T.A.B.L.E. Program) positively impacts the health of ill newborns that require transport in Panama. The investigation used a prospective, pre- and postintervention study design with a double pretest. The 10 birthing centers in Panama that routinely transport the greatest number of newborns received the education program intervention. Primary outcomes were body temperature and serum glucose level on arrival at the referral facility. Length of stay and mortality were evaluated as secondary outcomes. Variation in outcome indicators was compared for 7 months before and after the intervention. Data from all live newborns transported from outlying birthing center study sites during the study dates were included in the investigation. A total of 136 and 146 newborns were transported during the observation and postintervention periods, respectively. Significantly more patients in the postintervention group had temperatures within the normal range (56% in postintervention group vs 34% in observation group; P<0.01). No statistical difference was observed in serum glucose levels, length of stay or mortality. Distribution of a neonatal provider educational program was associated with improved thermal management of transported newborns in Panama. Further study will help to confirm this association and determine the extent to which these findings are generalizable to other resource-constrained settings.

  11. Challenging obesity: Patient, provider, and expert perspectives on the roles of available and emerging nonsurgical therapies. (United States)

    Apovian, Caroline M; Garvey, W Timothy; Ryan, Donna H


    Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient's disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare

  12. The patient-provider discordance in patients' needs assessment: a qualitative study in breast cancer patients receiving oral chemotherapy. (United States)

    Wei, Chunlan; Nengliang, Yao; Yan, Wang; Qiong, Fang; Yuan, Changrong


    To explore the differing perspectives of patients and providers and their assessment of supportive care needs in breast cancer patients receiving oral chemotherapy. The patient-provider concordance in patients' needs assessment is critical to the effective management of cancer. Self-administered oral chemotherapy greatly shifts responsibilities for side-effect monitoring, symptom management and dose adjustments from the provider to the patient. Home-based care plans will be central to the effective management of these patients. A descriptive qualitative design was used. A purposive sample of nine breast cancer patients, four oncologists and four oncology nurses were recruited in Shanghai, China. Semi-structured and in-depth interviews were conducted to collect data. A qualitative content analysis aimed at finding manifest and latent meanings of data was applied to analyse the information. Four themes of needs emerged from the interviews with patients and providers: information/knowledge, communication, social support and symptom management, but patients and providers only agreed on the assessment of symptom and side-effects management needs. Patients want more positive encouraging information from providers, but providers think patients need more information of efficacy and safety. Patients appreciate support from other peer patients with similar experiences, but providers think the support from families and friends are readily available to them. Patients discussed their spiritual needs, while oncologists see the need to improve patient adherence to medication. Breast cancer patients differed from their providers in assessment of healthcare needs. Further investigation of the relationships between patient-provider discordance and patient outcomes may guide interventions to improve care for cancer patients receiving oral chemotherapy. Oncology nurses should develop a holistic home-based care plan by exploring and integrating the discordance of needs assessment of

  13. Should doctors provide futile medical treatment if patients or their ...

    African Journals Online (AJOL)

    not be discounted', implying that it is justified to prescribe a placebo if it improves a patient's quality of life. Such treatment plays a palliative care role, which differs from futile treatment.[4]. Palliative care aims at alleviating the patient's pain or suffering – not curing their condition – and becomes futile if it can no longer.

  14. The Quality of Care Provided to Patients with Chronic Non ...

    African Journals Online (AJOL)

    BACKGROUND: Chronic Non-Communicable Diseases are among the major causes of morbidity and mortality worldwide. However, access to and quality of health care for patients is very low in developing countries including Ethiopia. Hospitals and Health Centers are the main sources of health care for such patients in ...

  15. Patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    Background: In Tanzania, patient satisfaction with dental services has received only minor attention. Objective: To assess patients' satisfaction with public dental health services in Dar es Salaam. Design: A cross-sectional study. Setting: Five public dental clinics randomly selected from a list of all the nine public dental ...

  16. Blood Products Provided to Patients Receiving Futile Critical Care. (United States)

    Neville, Thanh H; Ziman, Alyssa; Wenger, Neil S


    The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment. Of 1136 critically ill patients, physicians assessed 123 patients (11%) as receiving futile treatment. Fifty-nine (48%) of the 123 patients received blood products after they were assessed to be receiving futile treatment: 242 units of packed red blood cells (PRBCs) (7.6% of all PRBC units transfused into critical care patients during the 3-month study period); 161 (9.9%) units of plasma, 137 (12.1%) units of platelets, and 21 (10.5%) units of cryoprecipitate. Explicit guidelines on the use of blood products should be developed to ensure that the use of this precious resource achieves meaningful goals. © 2017 Society of Hospital Medicine.

  17. Barriers to diabetes management: patient and provider factors. (United States)

    Nam, Soohyun; Chesla, Catherine; Stotts, Nancy A; Kroon, Lisa; Janson, Susan L


    Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients and clinicians. A search of PubMed, CINAHL, ERIC, and PsycINFO identified 1454 articles in English published between 1990 and 2009, addressing type 2 diabetes, patient's barriers, clinician's barriers, and self-management. Patients' adherence, attitude, beliefs, and knowledge about diabetes may affect diabetes self-management. Culture and language capabilities influence the patient's health beliefs, attitudes, health literacy, thereby affecting diabetes self-management. Other influential factors include the patient's financial resources, co-morbidities, and social support. Clinician's attitude, beliefs and knowledge about diabetes also influence diabetes management. Clinicians may further influence the patient's perception through effective communication skills and by having a well-integrated health care system. Identifying barriers to diabetes management is necessary to improve the quality of diabetes care, including the improvement of metabolic control, and diabetes self-management. Further research that considers these barriers is necessary for developing interventions for individuals with type 2 diabetes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Postdischarge community pharmacist-provided home services for patients after hospitalization for heart failure. (United States)

    Kalista, Tom; Lemay, Virginia; Cohen, Lisa


    To establish a community pharmacist-provided home health service to improve medication adherence and reduce 30-day heart failure-related hospital readmissions. Visiting Nurse Services of Newport and Bristol Counties located in Portsmouth, RI, from December 2013 to April 2014. Each patient received one in-home visit provided by a Postgraduate Year 1 community pharmacy resident within 1 week of admission to visiting nurse services followed by two follow-up telephone calls, 1 week and 4 weeks after the visit. The in-home visit consisted of a baseline assessment of medication adherence using the Morisky 8-Item Medication Adherence Questionnaire as well as pharmacist-provided education regarding chronic heart failure management. The follow-up telephone calls were used to reassess patient adherence and to monitor for hospital readmission within 30 days of the initial in-home visit. Community pharmacist-provided in-home medication reconciliation and medication teaching has not been described in the literature previously. In addition, pharmacists are often not included on home health care teams placing patients undergoing transitions in care at risk for potential medication-related errors. Improvement in medication adherence and reduction in 30-day heart failure-related hospital readmission rates. Ten patients were enrolled from December 2013 through April 2014. Following intervention, all patients saw improvements in adherence questionnaire scores during follow-up. Hospital readmission rates for patients seen by the pharmacist were lower compared with agencywide figures over a similar time period. A community pharmacist-provided in-home medication teaching service for patients following recent hospital discharge helps facilitate successful transitions of care from an inpatient to outpatient setting, improves medication adherence and has produced lower observed 30-day heart failure-related hospital readmission rates. Expansion of this or a similar service within the

  19. Provider Perception of Pharmacy Services in the Patient-Centered Medical Home. (United States)

    Albanese, Nicole P; Pignato, Alyssa M; Monte, Scott V


    Despite the positive data on clinical outcomes, cost savings, and provider experience, no study has surveyed providers to evaluate what pharmacy services they find to be worthwhile. To determine what clinical, cost/access, and educational pharmacy services providers in a patient-centered medical home (PCMH) consider worthwhile and the perceived barriers to successful pharmacist incorporation. A cross-sectional online survey was distributed to primary care physicians, nurse practitioners, and physician assistants in a PCMH physician group. The survey response rate was 78%. Top-tier clinical services were identified as medication counseling, reconciliation, adherence assessment, polypharmacy assessment, and drug information. Formulary review was the only top-tier cost- or access-related service. Top-tier educational services included new black-boxed warnings, drug market withdrawals, and new drug reviews. Ninety-one percent of providers were comfortable referring to a pharmacist for diabetes medication selection and dose titration, but no other disease state eclipsed 75%. More than twice as many providers found the pharmacy service to be very or extremely valuable when the pharmacist is physically located in the office versus virtual interactions (70% vs 34%). Top-tier clinical, cost/access, and educational services considered worthwhile by providers in a PCMH have been identified. In addition to these services, when developing or evaluating a pharmacy service, special attention should be paid to provider preference for physical location in the office and perceived barriers to the pharmacist availability, concern over complex disease management competency and patient confusion as to the role of the pharmacist.

  20. Patientś experiences of patient education on psychiatric inpatient wards; a systematic review. (United States)

    Kristiansen, S T; Videbech, P; Kragh, M; Thisted, C N; Bjerrum, M B


    To synthesize the evidence on how patients with serious mental disorders perceived patient education on psychiatric wards and to learn more about the patient perceived benefits and limitations related to patient education and how well patient education meets the perceived needs of inpatients. Quantitative and qualitative data were categorized and synthesized. A systematic literature search was conducted. Articles were validated using validated critical appraisal tools. Data were analyzed using inductive content analysis. Five articles met the inclusion criteria. The results concerned the specific population with bipolar disorder or schizophrenia. Two explanatory syntheses were aggregated: (I) Benefits and perceived barriers to receiving education and (II) Educational needs of mental health patients. Patients reported mechanical information dissemination and lack of individual and corporative discussions. Patients preferred patient education from different educational sources with respect to individual needs. Patient education were most useful when it could be tailored to an individuaĺs specific needs and match patient preference for how to receive it. The findings did not provide evidence to support any educational methods of preference. The findings may contribute to the development of educational interventions that are perceived more helpful for in-patients suffering from serious mental disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 34 CFR 668.5 - Written arrangements to provide educational programs. (United States)


    ... the requirements of § 668.8. (b) Written arrangements for study-abroad. Under a study abroad program...) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS General... consortium provides all or part of the educational program of students enrolled in the former institution...

  2. Providing a Supportive Alternative Education Environment for At-Risk Students (United States)

    McGee, John J.; Lin, Fan-Yu


    Many factors cause student disengagement from school that subsequently result in high dropout rates. Alternative education (AE) programs provide a different pathway for at-risk youths who do not meet the goals, standards, and requirements of traditional educational settings. However, educational agencies have vastly different interpretations…

  3. Patients' and providers' perceptions of the preventability of hospital readmission

    DEFF Research Database (Denmark)

    van Galen, Louise S; Brabrand, Mikkel; Cooksley, Tim


    OBJECTIVES: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority...

  4. Challenging Obesity: Patient, Provider, and Expert Perspectives on the Roles of Available and Emerging Nonsurgical Therapies (United States)

    Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.


    Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management

  5. Investigating Effective Components of Higher Education Marketing and Providing a Marketing Model for Iranian Private Higher Education Institutions (United States)

    Kasmaee, Roya Babaee; Nadi, Mohammad Ali; Shahtalebi, Badri


    Purpose: The purpose of this paper is to study and identify the effective components of higher education marketing and providing a marketing model for Iranian higher education private sector institutions. Design/methodology/approach: This study is a qualitative research. For identifying the effective components of higher education marketing and…

  6. Attitudes and Perceptions of Patients, Caregivers, and Health Care Providers toward Background Music in Patient Care Areas: An Exploratory Study (United States)

    Perez-Cruz, Pedro; Nguyen, Linh; Rhondali, Wadih; Hui, David; Palmer, J. Lynn; Sevy, Ingrid; Richardson, Michael


    Abstract Background Background music can be used to distract from ordinary sounds and improve wellbeing in patient care areas. Little is known about individuals' attitudes and beliefs about music versus ordinary sound in this setting. Objectives To assess the preferences of patients, caregivers and healthcare providers regarding background music or ordinary sound in outpatient and inpatient care areas, and to explore their attitudes and perceptions towards music in general. Methods All participants were exposed to background music in outpatient or inpatient clinical settings. 99 consecutive patients, 101 caregivers and 65 out of 70 eligible healthcare providers (93%) completed a survey about music attitudes and preferences. The primary outcome was a preference for background music over ordinary sound in patient care areas. Results Preference for background music was high and similar across groups (70 patients (71%), 71 caregivers (71%) and 46 providers (71%), p=0.58). The three groups had very low disapproval for background music in patient care areas (10%, 9% and 12%, respectively; p=0.91). Black ethnicity independently predicted lower preference for background music (OR: 0.47, 95%CI: 0.23, 0.98). Patients, caregivers and providers reported recent use of music for themselves for the purpose of enjoyment (69%, 80% and 86% respectively p=0.02). Age, gender, religion and education level significantly predicted preferences for specific music styles. Conclusion Background music in patient care areas was preferred to ordinary sound by patients, caregivers and providers. Demographics of the population are strong determinants of music style preferences. PMID:22957677

  7. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Beune, Erik J. A. J.; Baim-Lance, Abigail M.; Bruessing, Raynold C.; Essink-Bot, Marie-Louise


    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study

  8. Providing palliative care to patients with cancer: Addressing the needs in Kenya

    Directory of Open Access Journals (Sweden)

    Pam Malloy


    Full Text Available Cancer is the third highest cause of death in Kenya, preceded by infectious and cardiovascular diseases, and in most cases, diagnosed in later stages. Nurses are the primary caregivers, assessing and managing these patients in the clinic, in inpatient settings, and in rural and remote communities. While cancer rates remain high, the burden to the patient, the caregiver, and society as a whole continues to rise. Kenya's poverty complicates cancer even further. Many Kenyans are unaware of cancer's signs and symptoms, and limited diagnostic and treatment centers are available. Despite these barriers, there is still hope and help for those in Kenya, who suffer from cancer. The World Health Organization has stated that palliative care is a basic human right and nurses providing this care in Kenya are making efforts to support cancer patients' ongoing needs, in order to promote compassionate palliative care and prevent suffering. The purpose of this paper is to address the palliative care needs of patients with cancer in Kenya by providing education to nurses and influencing health-care policy and education at micro and macro levels. A case study weaved throughout will highlight these issues.

  9. Toward Optimal Decision Making among Vulnerable Patients Referred for Cardiac Surgery: A Qualitative Analysis of Patient and Provider Perspectives. (United States)

    Gainer, Ryan A; Curran, Janet; Buth, Karen J; David, Jennie G; Légaré, Jean-Francois; Hirsch, Gregory M


    Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population. Focus groups were held with both providers and former patients. Three focus groups were convened for Coronary Artery Bypass Graft (CABG), Valve, or CABG +Valve patients ≥ 70 y old (2-y post-op, ≤ 8-wk post-op, complicated post-op course) (n = 15). Three focus groups were convened for Intermediate Medical Care Unit (IMCU) nurses, Intensive Care Unit (ICU) nurses, surgeons, anesthesiologists and cardiac intensivists (n = 20). We used a semi-structured interview format to ask questions surrounding the informed consent process. Transcribed audio data was analyzed to develop consistent and comprehensive themes. We identified 5 main themes that influence the decision making process: educational barriers, educational facilitators, patient autonomy and perceived autonomy, patient and family expectations of care, and decision making advocates. All themes were influenced by time constraints experienced in the current consent process. Patient groups expressed a desire to receive information earlier in their care to allow time to identify personal values and preferences in developing plans for treatment. Both groups strongly supported a formal approach for shared decision making with a decisional coach to provide information and facilitate communication with the care team. Identifying the barriers and facilitators to patient and caretaker engagement in decision making is a key step in the development of a structured, patient-centered SDM approach. Intervention

  10. Providing dental care for the patient with autism. (United States)

    Waldman, H Barry; Perlman, Steven P; Wong, Allen


    The increasing number of children and adults with autism spectrum disorders highlights the need to provide a full range of services, including dental care. A review of the autism spectrum, the magnitude of the problem, and approaches to providing services by dental practitioners are presented.

  11. Implementing and Using a Patient Portal: A qualitative exploration of patient and provider perspectives on engaging patients. (United States)

    Ryan, Bridget L; Brown, Judith Belle; Terry, Amanda; Cejic, Sonny; Stewart, Moira; Thind, Amardeep


    The use of portals might be expected to rise; however, adoption has been slow. Development of portals has occurred with limited patient involvement. This paper fills a need for literature concerning perspectives regarding the value of portals, how best to organize and provide portals, and critically how to seek patient involvement in implementation.ObjectiveThe objective was to explore the feelings, ideas, and expectations of patients and primary care providers concerning the implementation and use of patient portals. The study employed a descriptive qualitative design interviewing seven patients and four providers from an interdisciplinary primary health care clinic in Ontario, Canada. Patients were older with at least one chronic condition. Interviews were analysed independently by three coders who then met to synthesize the findings. There was limited experience of portals and substantial convergence between patients and providers regarding concerns and potential benefits with an overall positive view. Four themes emerged: 1) the Context in which patient portal use takes place; 2) the Necessary conditions for use of a patient portal; 3) the Implementation of a patient portal; and 4) the Use of a patient portal for care. Findings highlight that it is not sufficient to engage patients in the use of a portal; it is critical that patients be engaged in the early stages of implementation. With many health and fitness electronic tools available (e.g. Fitbit©), this study remind us that tools are not enough. Patient engagement requires patient-centred partnerships between patients and health care providers.

  12. Experiences of Parish Nurses in Providing Diabetes Education and Preconception Counseling to Women With Diabetes. (United States)

    Devido, Jessica A; Doswell, Willa M; Braxter, Betty J; Spatz, Diane L; Dorman, Janice S; Terry, Martha Ann; Charron-Prochownik, Denise

    To explore the role and experiences of the parish nurse in providing diabetes education and preconception counseling to women with diabetes. Mixed-methods concurrent embedded design. Focus groups of community-based parish nurses accessed from a regional database (Pennsylvania, Florida, Ohio, New York, Arizona, and Minnesota). Forty-eight parish nurses recruited from the Parish Nurse and Health Ministry Program database in Western Pennsylvania. The primary method was focus groups using face-to-face, teleconference, and videoconferencing formats. A secondary method used a quantitative descriptive design with three self-report measures (demographic, preconception counseling self-efficacy, and preconception counseling knowledge). Qualitative content analysis techniques were conducted and combined with descriptive analysis. Forty-eight parish nurses participated in 1 of 11 focus groups. Eight qualitative themes emerged: Awareness, Experience, Formal Training, Usefulness, Willingness, Confidence, "Wise Women," and Preconception Counseling Tool for Patients. Participants provided recommendations for training and resources to increase their knowledge and skills. Parish nurses' knowledge scores were low (mean = 66%, range = 40%-100%) with only moderate levels of self-efficacy (mean = 99, range = 27-164). Self-efficacy had a significantly positive association with knowledge (r = .29, p = .05). Quantitative results were consistent with participants' qualitative statements. Parish nurses were unaware of preconception counseling and lacked knowledge and teaching self-efficacy as it related to preconception counseling and diabetes education. Understanding parish nurses' experiences with women with diabetes and identifying their needs to provide education and preconception counseling will help tailor training interventions that could affect maternal and fetal outcomes. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published

  13. Providing truly patient-centred care: Harnessing the pragmatic ...

    African Journals Online (AJOL)

    Healthcare professionals in South Africa have to improvise when treating patients who do not speak their language – generally by using ad-hoc interpreters, who may be nurses, refugees, family members, or even children. A number of studies (Cambridge 1999, Meyer et al. 2003, Penn 2007) have found that using ad-hoc ...

  14. Patient Satisfaction with Care Provided at the Antiretroviral Clinic of ...

    African Journals Online (AJOL)

    In Nigeria, there is a dearth of information on patient satisfaction with HIV/AIDS care. ... Questionnaire Long Form was used to assess seven dimensions of care: general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with doctor, and access/availability/convenience.

  15. Evaluation of Care Provided to Terminally Ill Patients. (United States)

    Loomis, Margaret T.; Williams, T. Franklin


    Studied the quality of terminal care in 40 patients in an acute care facility and a chronic care facility. Minimial difficulty was observed in making the transition from active to comfort care. An evaluation method and a model of terminal care emphasizing improved communication and emotional support are proposed. (Author/JAC)

  16. Patient safety competency and educational needs of nursing educators in South Korea. (United States)

    Jang, Haena; Lee, Nam-Ju


    Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators' competencies and educational needs for patient safety in hospitals and nursing schools. A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors). Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul. Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of "medication" and "infection prevention" as being higher and "human factors" and "complexity of systems" as being lower. Nursing educators desired different types of education for patient safety. It is necessary to enhance nursing educators' patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless.

  17. Patient education for adults with rheumatoid arthritis

    NARCIS (Netherlands)

    Riemsma, R.P.; Kirwan, J.R.; Taal, Erik; Rasker, Hans J.


    Patient education shows short-term benefits for adults with rheumatoid arthritis. The purpose was to examine the effectiveness of patient education interventions on health status (pain, functional disability, psychological well-being and disease activity) in patients with rheumatoid arthritis (RA).

  18. Supplemental Educational Services: An Action Science Research Study of Achieving State Standards for Provider Effectiveness (United States)

    McClintock, Cynthia Collette


    Supplemental educational services are designed to contribute tremendous support to local school districts and communities through state-approved provider programs. The state, however, prior to approving supplemental educational services provider programs, must utilize all available resources to assist in the process of screening and approving…

  19. Provider and Patient Directed Financial Incentives to Improve Care and Outcomes for Patients with Diabetes (United States)

    Lorincz, Ilona S.; Lawson, Brittany C. T.


    Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

  20. ER/LA opioid REMS and accredited education: Survey results provide insight into clinical roles, educational needs, and learner preferences. (United States)

    Kear, Cynthia; McKeithen, Tom; Robertson, Sheila


    The Collaborative for REMS (Risk Evaluation and Mitigation Strategy) Education (CO*RE) includes 13 organizations that provide REMS Program Companies (RPC) grant-supported accredited education on extended-release and long-acting (ER/LA) opioid therapy. This report summarizes results of a survey designed to investigate the impact of participant criteria and to better understand the roles and preferences of continuing medical education/continuing education (CME/CE) participants. In April 2015, the authors made an online survey available to an estimated 10,000 clinicians who had completed a CO*RE CME/CE activity since 2013. The purpose of the survey was to (1) examine possible reasons learners may underreport prescribing status, (2) investigate ways in which learners engage in nonprescribing roles relevant to reducing adverse patient outcomes, and (3) determine the acceptability of a potential test-based learning tool that allows participants with mastery to test out in lieu of participating in 2- to 3-hour education. Findings revealed that there was little confusion or reluctance by learners to answer questions about Drug Enforcement Administration (DEA) licensing and whether they prescribed opioids in the past year. REMS "prescriber" education covers opioid management responsibilities that are distributed among team members who play critical nonprescribing roles in reducing serious adverse outcomes from both ER/LA and immediate-release (IR) opioids. Seventy-three percent of study participants would favor a test-based learning tool should future circumstances warrant it. The authors concluded the likelihood of underreporting is small, but there is an opportunity to clarify license and prescribing questions; opioid management responsibilities are distributed among nonprescribing team members who play roles in reducing adverse outcomes from both ER/LA and IR opioids, who would therefore benefit from REMS education; and clinicians favor a test-based learning tool, should

  1. Patients' experiences of diabetes education teams integrated into primary care. (United States)

    Grohmann, Barbara; Espin, Sherry; Gucciardi, Enza


    To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care. Qualitative study using semistructured, one-on-one interviews. Three diabetes education programs operating in 11 primary care sites in one region of Ontario. Twenty-three patients with diabetes. Purposeful sampling was used to recruit participants from each site for interviews. Educator teams invited patients with whom they had met at least once to participate in semistructured interviews. Data were analyzed using thematic analysis with NVivo 11 software. The diabetes education teams integrated into primary care exhibited many of the principles of person-centred care, as evidenced by the 2 overarching themes. The first is personalized care, with the subthemes care environment, shared decision making, and patient preference for one-on-one care. Participants described feeling included in partnerships with their health care providers, as they collaborated with physicians and diabetes educators to develop knowledge and set goals in the convenience and comfort of their usual primary care settings. Many participants also expressed a preference for one-on-one sessions. The second theme is patient-provider relationship, with the subthemes respect, supportive interaction, and facilitating patient engagement. Supportive environments created by the educators built trusting relationships, where patients expressed enhanced motivation to improve their self-care. Diabetes educators integrated into primary care can serve to enrich the experience of patients, provide key education to improve patient understanding, and support primary care physicians in providing timely and comprehensive clinical care. Diabetes patients appear to benefit from convenient access to interprofessional teams of educators in primary care to support diabetes self-management. Copyright© the College of Family Physicians of Canada.

  2. Patient-Centered Cancer Care Programs in Italy: Benchmarking Global Patient Education Initiatives. (United States)

    Truccolo, Ivana; Cipolat Mis, Chiara; Cervo, Silvia; Dal Maso, Luigino; Bongiovanni, Marilena; Bearz, Alessandra; Sartor, Ivana; Baldo, Paolo; Ferrarin, Emanuela; Fratino, Lucia; Mascarin, Maurizio; Roncadin, Mario; Annunziata, Maria Antonietta; Muzzatti, Barbara; De Paoli, Paolo


    In Italy, educational programs for cancer patients are currently provided by the national government, scientific societies, and patient advocate organizations. Several gaps limit their effectiveness, including the lack of coordinated efforts, poor involvement of patient feedback in the planning of programs, as well as a lack of resources on innovative cancer-related topics. This process is parallel to a strong shift in the attitude of patients towards health in general and taking charge of their own health conditions in particular. The National Cancer Institute in the USA and the Organization of European Cancer Institutes encourage comprehensive cancer centers in providing educational programs conceived to overcome these gaps. The goal of this paper is to identify and describe the key elements necessary to develop a global patient education program and provide recommendations for strategies with practical examples for implementation in the daily activities of cancer institutes. A multidisciplinary committee was established for patient education, including patient representatives as equal partners, to define, implement, verify, and evaluate the fundamental steps for establishing a comprehensive education program. Six essential topics were identified for the program: appropriate communication of cancer epidemiology, clinical trial information, new therapeutic technologies, support in the use of medicines, psycho-oncological interventions, age-personalized approaches, and training programs for healthcare providers. Integration of these topics along with patient feedback is the key to a successful model for educational programs. An integrated educational program can transform a comprehensive cancer center to an institution that provides research and care for and with patients.

  3. Email Between Patient and Provider: Assessing the Attitudes and Perspectives of 624 Primary Health Care Patients. (United States)

    Seth, Puneet; Abu-Abed, Mohamed Ismail; Kapoor, Vikram; Nicholson, Kathryn; Agarwal, Gina


    Email between patients and their health care providers can serve as a continuous and collaborative forum to improve access to care, enhance convenience of communication, reduce administrative costs and missed appointments, and improve satisfaction with the patient-provider relationship. The main objective of this study was to investigate the attitudes of patients aged 16 years and older toward receiving email communication for health-related purposes from an academic inner-city family health team in Southern Ontario. In addition to exploring the proportion of patients with a functioning email address and interest in email communication with their health care provider, we also examined patient-level predictors of interest in email communication. A cross-sectional study was conducted using a self-administered, 1-page survey of attitudes toward electronic communication for health purposes. Participants were recruited from attending patients at the McMaster Family Practice in Hamilton, Ontario, Canada. These patients were aged 16 years and older and were approached consecutively to complete the self-administered survey (N=624). Descriptive analyses were conducted using the Pearson chi-square test to examine correlations between variables. A logistic regression analysis was conducted to determine statistically significant predictors of interest in email communication (yes or no). The majority of respondents (73.2%, 457/624) reported that they would be willing to have their health care provider (from the McMaster Family Practice) contact them via email to communicate health-related information. Those respondents who checked their personal email more frequently were less likely to want to engage in this electronic communication. Among respondents who check their email less frequently (fewer than every 3 days), 46% (37/81) preferred to communicate with the McMaster Family Practice via email. Online applications, including email, are emerging as a viable avenue for patient

  4. Interventions for providers to promote a patient-centred approach in clinical consultations. (United States)

    Dwamena, Francesca; Holmes-Rovner, Margaret; Gaulden, Carolyn M; Jorgenson, Sarah; Sadigh, Gelareh; Sikorskii, Alla; Lewin, Simon; Smith, Robert C; Coffey, John; Olomu, Adesuwa


    philosophy of care that encourages: (a) shared control of the consultation, decisions about interventions or management of the health problems with the patient, and/or (b) a focus in the consultation on the patient as a whole person who has individual preferences situated within social contexts (in contrast to a focus in the consultation on a body part or disease). Within our definition, shared treatment decision-making was a sufficient indicator of PCC. The participants were healthcare providers, including those in training. We classified interventions by whether they focused only on training providers or on training providers and patients, with and without condition-specific educational materials. We grouped outcome data from the studies to evaluate both direct effects on patient encounters (consultation process variables) and effects on patient outcomes (satisfaction, healthcare behaviour change, health status). We pooled results of RCTs using standardized mean difference (SMD) and relative risks (RR) applying a fixed-effect model. Forty-three randomized trials met the inclusion criteria, of which 29 are new in this update. In most of the studies, training interventions were directed at primary care physicians (general practitioners, internists, paediatricians or family doctors) or nurses practising in community or hospital outpatient settings. Some studies trained specialists. Patients were predominantly adults with general medical problems, though two studies included children with asthma. Descriptive and pooled analyses showed generally positive effects on consultation processes on a range of measures relating to clarifying patients' concerns and beliefs; communicating about treatment options; levels of empathy; and patients' perception of providers' attentiveness to them and their concerns as well as their diseases. A new finding for this update is that short-term training (less than 10 hours) is as successful as longer training.The analyses showed mixed results on

  5. Training Informal Educators Provides Leverage for Space Science Education and Public Outreach (United States)

    Allen, J. S.; Tobola, K. W.; Betrue, R.


    How do we reach the public with the exciting story of Solar System Exploration? How do we encourage girls to think about careers in science, math, engineering and technology? Why should NASA scientists make an effort to reach the public and informal education settings to tell the Solar System Exploration story? These are questions that the Solar System Exploration Forum, a part of the NASA Office of Space Science Education (SSE) and Public Outreach network, has tackled over the past few years. The SSE Forum is a group of education teams and scientists who work to share the excitement of solar system exploration with colleagues, formal educators, and informal educators like museums and youth groups. One major area of the SSE Forum outreach supports the training of Girl Scouts of the USA (GS) leaders and trainers in a suite of activities that reflect NASA missions and science research. Youth groups like Girl Scouts structure their activities as informal education.

  6. Regulating Abortion: Impact on Patients and Providers in Texas (United States)

    Colman, Silvie; Joyce, Ted


    The State of Texas began enforcement of the Woman's Right to Know (WRTK) Act on January 1, 2004. The law requires that all abortions at or after 16 weeks' gestation be performed in an ambulatory surgical center (ASC). In the month the law went into effect, not one of Texas's 54 nonhospital abortion providers met the requirements of a surgical…

  7. Do health care providers discuss HIV with older female patients ...

    African Journals Online (AJOL)

    The aim of this study was to determine whether older women could recall receiving HIV-related information from health care providers. ... difference (p = 0.003; odds ratio [OR]: 0.26; 95% CI: 0.09–0.69) between their age stratification of 50 to 59 years and 60 to 80 years with respect to receiving information regarding HIV.

  8. Patients' and providers' perspectives on bibliotherapy in primary care. (United States)

    McKenna, Grainne; Hevey, David; Martin, Elaine


    Bibliotherapy is a form of self-administered treatment in which structured materials provide a means to alleviate distress. Although the treatment has evidence of effectiveness, evaluations of bibliotherapy have typically focused on outcomes, and the perspectives of both the client and the service provider have been understudied. In the present study, eleven users of a bibliotherapy scheme were interviewed regarding their experiences of bibliotherapy. In addition, five referring practitioners to the scheme were also interviewed. Thematic analyses revealed three super-ordinate themes in the transcripts: participants' personal experiences of the bibliotherapy scheme factors that facilitate change and the influence of the professionals involved. The implications of these findings for bibliotherapy schemes are considered. Copyright © 2010 John Wiley & Sons, Ltd.

  9. Dental student perceptions of predoctoral implant education and plans for providing implant treatment. (United States)

    Yuan, Judy Chia-Chun; Kaste, Linda M; Lee, Damian J; Harlow, Rand F; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino


    This study aims to identify dental students' perceptions of pre-patient care laboratory exercises (PCLEs) and clinical experiences that influence their future plans for providing implant care. One of two questionnaires was administered to dental student classes at one dental school (D2: Survey 1; D3 and D4: Survey 2). Future plans as graduates to provide implant diagnosis and treatment planning (DxTP), restoration of single-tooth implants (STIs), and implant-retained overdentures (IODs) were cross-sectionally assessed along with potential influences such as PCLE, clinical experiences, gender, and class. The majority of students planned to provide implant services after graduation (DxTP 68.9 percent; STI 61.2 percent; IOD 62.1 percent). Bivariately, males reflected more preparedness from PCLEs than females (p=.002) and the D2 students more than D3 and D4 students (pimplant therapy. However, this varied by gender and class. These findings indicate that PCLEs are important for their influence on students' future plans to provide implant therapy. However, further studies are needed to validate actual PCLEs and clinical implant practices (both longitudinally and for other schools) and to determine educational interventions to optimize the provision of implant care.

  10. Impact of video technology on efficiency of pharmacist-provided anticoagulation counseling and patient comprehension. (United States)

    Moore, Sarah J; Blair, Elizabeth A; Steeb, David R; Reed, Brent N; Hull, J Heyward; Rodgers, Jo Ellen


    Discharge anticoagulation counseling is important for ensuring patient comprehension and optimizing clinical outcomes. As pharmacy resources become increasingly limited, the impact of informational videos on the counseling process becomes more relevant. To evaluate differences in pharmacist time spent counseling and patient comprehension (measured by the Oral Anticoagulation Knowledge [OAK] test) between informational videos and traditional face-to-face (oral) counseling. This prospective, open, parallel-group study at an academic medical center randomized 40 individuals-17 warfarin-naïve ("New Start") and 23 with prior warfarin use ("Restart")-to receive warfarin discharge education by video or face-to-face counseling. "Teach-back" questions were used in both groups. Although overall pharmacist time was reduced in the video counseling group (P counseling method (P = 0.012) suggests the difference between counseling methods was smaller in New Start participants. Following adjustment, mean total time was reduced 8.71 (95% CI = 5.15-12.26) minutes (adjusted P counseling. Postcounseling OAK test scores did not differ. Age, gender, socioeconomic status, and years of education were not predictive of total time or OAK test score. Use of informational videos coupled with teach-back questions significantly reduced pharmacist time spent on anticoagulation counseling without compromising short-term patient comprehension, primarily in patients with prior warfarin use. Study results demonstrate that video technology provides an efficient method of anticoagulation counseling while achieving similar comprehension. © The Author(s) 2015.

  11. Patient education as empowerment and self-rebiasing. (United States)

    Jotterand, Fabrice; Amodio, Antonio; Elger, Bernice S


    The fiduciary nature of the patient-physician relationship requires clinicians to act in the best interest of their patients. Patients are vulnerable due to their health status and lack of medical knowledge, which makes them dependent on the clinicians' expertise. Competent patients, however, may reject the recommendations of their physician, either refusing beneficial medical interventions or procedures based on their personal views that do not match the perceived medical indication. In some instances, the patients' refusal may jeopardize their health or life but also compromise the clinician's moral responsibility to promote the patient's best interests. In other words, health professionals have to deal with patients whose behavior and healthcare decisions seem counterproductive for their health, or even deteriorate it, because of lack of knowledge, bad habits or bias without being the patients' free voluntary choice. The moral dilemma centers on issues surrounding the limits of the patient's autonomy (rights) and the clinician's role to promote the well-being of the patient (duties). In this paper we argue that (1) the use of manipulative strategies, albeit considered beneficent, defeats the purpose of patient education and therefore should be rejected; and (2) the appropriate strategy is to empower patients through patient education which enhances their autonomy and encourages them to become full healthcare partners as opposed to objects of clinical intervention or entities whose values or attitudes need to be shaped and changed through education. First, we provide a working definition of the concept of patient education and a brief historical overview of its origin. Second, we examine the nature of the patient-physician relationship in order to delineate its boundaries, essential for understanding the role of education in the clinical context. Third, we argue that patient education should promote self-rebiasing, enhance autonomy, and empower patients to

  12. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers. (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E


    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as

  13. Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers

    Directory of Open Access Journals (Sweden)

    Rannou François


    Full Text Available Abstract Background The expectations of patients for managing pain induced by exercise and mobilization (PIEM have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs. Methods We performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women and 14 care providers (6 women: 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists. Results Patients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity. Conclusion PIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.

  14. Aiding Education in Conflict: The Role of International Education Providers Operating in Afghanistan and Pakistan (United States)

    Harmer, Adele; Stoddard, Abby; DiDomenico, Victoria


    Amid rising violence against civilian aid operations in insecure environments, attacks on the education sector pose a unique set of challenges for international aid actors. In recent years incidents of violence targeting the education sector in Afghanistan and the conflict-affected areas of Pakistan have increased. This article synthesizes recent…

  15. Internet use and e-mail communications between patients and providers: a survey of rheumatology outpatients. (United States)

    Siva, Chokkalingam; Smarr, Karen L; Hanson, Kathleen Donovan; Parikh, Meghal; Lawlor, Kenneth; Ge, Bin


    As health care costs rise in the United States and elsewhere, adopting health information technology is being advocated to reduce costs and improve efficiency. Physician e-mail communication is a frequently proposed tool in this strategy. We examined the interest of rheumatology outpatients in using E-mail for communication with their rheumatologist. We sought to identify their privacy and cost concerns on this issue, and examine the patients' demographics, internet usage, and preferences. An anonymous survey was given to 150 consecutive patients. Patients responded to questions on demographics, rheumatic diseases, comorbidities, computer/internet access, E-mail use, privacy concerns, payment issues, and preferences regarding communication with their rheumatologist. Statistical analyses on the relationships between demographics and patient preferences on communications with their rheumatologist were conducted. There were 145 respondents; the mean age was 52.3 years, mean education level was 13.6 years. The sample tended to be women (74%), retired/disabled (46%) or employed full time (35%). Most had internet access (74.5%). Differences were found based on gender, age, education, and income levels. Younger adults were more likely to desire E-mail communication with their rheumatologists, especially if paid by insurance. More men than women had concerns about privacy; persons with higher income levels were more willing to self-pay for E-mail. As a significant number of patients with rheumatic diseases express interest in E-mail communication with their providers, rheumatologists need to be cognizant of patients' preferences. To deliver patient-centered care, rheumatology practices might consider incorporating E-mail communication into their practices.

  16. Healthcare providers' beliefs and attitudes about electronic cigarettes and preventive counseling for adolescent patients. (United States)

    Pepper, Jessica K; McRee, Annie-Laurie; Gilkey, Melissa B


    Electronic cigarettes (e-cigarettes) are battery-powered nicotine delivery systems that may serve as a "gateway" to tobacco use by adolescents. Use of e-cigarettes by U.S. adolescents rose from 3% in 2011 to 7% in 2012. We sought to describe healthcare providers' awareness of e-cigarettes and to assess their comfort with and attitudes toward discussing e-cigarettes with adolescent patients and their parents. A statewide sample (n = 561) of Minnesota healthcare providers (46% family medicine physicians, 20% pediatricians, and 34% nurse practitioners) who treat adolescents completed an online survey in April 2013. Nearly all providers (92%) were aware of e-cigarettes, and 11% reported having treated an adolescent patient who had used them. The most frequently cited sources of information about e-cigarettes were patients, news stories, and advertisements, rather than professional sources. Providers expressed considerable concern that e-cigarettes could be a gateway to tobacco use but had moderately low levels of knowledge about and comfort discussing e-cigarettes with adolescent patients and their parents. Compared with pediatricians and nurse practitioners, family medicine physicians reported knowing more about e-cigarettes and being more comfortable discussing them with patients (both p adolescents may need to incorporate screening and counseling about e-cigarettes into routine preventive services, particularly if the prevalence of use continues to increase in this population. Education about e-cigarettes could help providers deliver comprehensive preventive services to adolescents at risk of tobacco use. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Differences in referral and use of complementary and alternative medicine between pediatric providers and patients. (United States)

    Jenkins, Brooke N; Vincent, Nicole; Fortier, Michelle A


    The goal of this study was to compare pediatric complementary and alternative medicine (CAM) use and pediatric health care provider CAM referral as well as identify predictors of use and referral. Surveys were administered to 283 parents/caregivers of pediatric patients and 200 pediatric health care providers (HCP). This study took place at the Children's Hospital of Orange County (CHOC Children's) in Orange, CA. Caregivers and HCP were provided a list of 32 CAM interventions and asked to indicate which treatments their child had ever used or which they would consider using for their child and which treatments they had ever referred or which they would consider referring, respectively. The main outcome variables were the number and type of CAM therapies endorsed by participants. Providers referred the majority of CAM therapies significantly more often than patients used each therapy and more often than caregivers would consider each therapy for their child. In addition, children from families with higher incomes, whose parents were older and had more education, who were White, and whose primary language spoken at home was English were more likely to use CAM therapies, all p'spediatric patients needs to be explored. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 'That would have been beneficial': LGBTQ education for home-care service providers. (United States)

    Daley, Andrea; MacDonnell, Judith A


    This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer (LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to good-quality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse home-care service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, 'provider education' and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives. © 2014 John Wiley & Sons Ltd.

  19. Impact of Physician Asthma Care Education on Patient Outcomes (United States)

    Cabana, Michael D.; Slish, Kathryn K.; Evans, David; Mellins, Robert B.; Brown, Randall W.; Lin, Xihong; Kaciroti, Niko; Clark, Noreen M.


    Objective: We evaluated the effectiveness of a continuing medical education program, Physician Asthma Care Education, in improving pediatricians' asthma therapeutic and communication skills and patients' health care utilization for asthma. Methods: We conducted a randomized trial in 10 regions in the United States. Primary care providers were…

  20. Using interactive theatre to help fertility providers better understand sexual and gender minority patients. (United States)

    Tarasoff, Lesley A; Epstein, Rachel; Green, Datejie C; Anderson, Scott; Ross, Lori E


    To determine the effectiveness of interactive theatre as a knowledge translation and exchange (KTE) method to educate assisted human reproduction (AHR) service providers about lesbian, gay, bisexual, trans and queer (LGBTQ) patients. We transformed data from the 'Creating Our Families' study, a qualitative, community-based study of LGBTQ peoples' experiences accessing AHR services, into a script for an interactive theatre workshop for AHR service providers. Based on forum theatre principles, our workshop included five scenes illustrating LGBTQ people interacting with service providers, followed by audience interventions to these scenes. Before and after the workshop, service providers completed surveys to assess their knowledge and comfort concerning LGBTQ patients, as well as the modality of the interactive theatre workshop as a KTE strategy. Wilcoxon signed-rank tests were used to determine changes in preworkshop and postworkshop knowledge and comfort scores. Thirty AHR service providers attended the workshop. Twenty-three service providers (76.7%) fully completed the preworkshop and postworkshop evaluation forms. Service providers' knowledge scores significantly improved after the workshop, while their comfort scores minimally decreased. Most agreed that the interactive workshop was an effective KTE method. In comparison with traditional forms of KTE, interactive theatre may be particularly effective in engaging service providers and addressing their attitudes towards marginalised patient populations. Although the evaluation results of our interactive workshop were mostly positive, the long-term impact of the workshop is unknown. Long-term evaluations are needed to determine the effectiveness of arts-based KTE efforts. Other considerations for developing effective arts-based KTE strategies include adequate funding, institutional support, attention to power dynamics and thoughtful collaboration with forum theatre experts. Published by the BMJ Publishing Group

  1. Patient safety competency and educational needs of nursing educators in South Korea (United States)


    Background Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators’ competencies and educational needs for patient safety in hospitals and nursing schools. Method A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors). Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul. Results Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of “medication” and “infection prevention” as being higher and “human factors” and “complexity of systems” as being lower. Nursing educators desired different types of education for patient safety. Conclusion It is necessary to enhance nursing educators’ patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless. PMID:28873099

  2. Cancer education and training in primary health care--a national audit of training providers. (United States)

    McAvoy, Brian Ramsay; Fletcher, Jane M; Elwood, Mark


    Primary care professionals play a critical role in cancer care but relatively little is known about their education and training. This article presents the results of a national audit of education and training providers in relation to primary care and cancer. A semistructured telephone questionnaire. The response rate was very high (96%) with 210 organisations participating. Forty-two percent provided cancer education and training. Evidence of good adult education practice was demonstrated, and 95% of organisations ran accredited programs. Although pharmaceutical industry support was not favoured, the majority (78%) described this as their main source of funding. There is optimism and strong commitment among primary care cancer education and training providers. Their content seems appropriate and their approach is consistent with good adult learning principles and multidisciplinary care, but this could be enhanced with increased funding and improved collaboration and communication between organisations.

  3. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa


    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  4. New look for Ortho OCs aids patients, providers. (United States)


    This article presents an update on the Dialpak oral contraceptive dispenser from Ortho-McNeil Pharmaceutical in Raritan, New Jersey. This innovation is ready for instant use with any day start and a one-day dial to help minimize the possibility of mistakes. Its clearly numbered pills and days of the week help women keep track throughout the month. Pills are enclosed in a sleek, refillable, reusable, and recyclable dispenser case that resembles a makeup compact. When opened, the case displays the pills, which are packaged to fit around a dial ring. Refill packs can be inserted into the case each month. The discreet design of the Dialpack allows it to blend in with other personal items, so women would feel more at ease keeping it during the day. While packaging can aid in successful pill taking, the providers continue to play a crucial role in encouraging compliance. The report suggests that counseling should be focused on the transience of most side effects and there is a need to identify a backup should there be problems with the pills.

  5. Patient, provider, and clinic characteristics associated with public STD clinic patient satisfaction (United States)

    Mehta, S; Zenilman, J; Erbelding, E


    Objectives: There is a lack of information describing levels of patient satisfaction among patients seeking sexually transmitted diseases (STD) care in a public clinic setting. We sought to identify patient, provider, and clinic characteristics associated with patient satisfaction within public STD clinics. Methods: A cross sectional survey with random sampling was conducted among patients attending two public STD clinics. Satisfaction was assessed using questions from validated national surveys. Outcomes for multivariate logistic regression analysis were ratings of overall health care and clinician. Results: 499/605 (82%) patients were enrolled. Patients were mean age 29 years, 51% male, 94% black. Lower rating of clinician technical skills (OR = 15.6 clinic A, OR = 7.9 clinic B) and clinic environment (OR = 3.9 clinic A, OR = 9.6 clinic B) were associated with lower healthcare rating, as was lower rating of television/video in waiting room (OR = 10.2, clinic A) and dysuria (OR = 4.2, clinic B). Higher clinician rating (OR = 0.58, clinic A) and receiving written materials (OR = 0.44, clinic B) were protective of lower healthcare rating. Risks for lower clinician rating at clinic A were greater pain, problems getting care, lower rating of clinician technical skill, and overall health care, while receiving written materials was protective. At clinic B, lower rating of clinician technical skill and clinic environment were risks for lower clinician rating. Conclusions: Patient satisfaction was associated with modifiable provider and clinic characteristics. Results from our study indicate a need to examine whether health outcomes of STD management vary by patient satisfaction. PMID:15800094

  6. Predictors of Quality and Commitment in Family Child Care: Provider Education, Personal Resources, and Support. (United States)

    Weaver, Ruth Harding


    Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…

  7. What Educational Opportunities Should Professionals in Aging Provide?: A Pilot Community Assessment (United States)

    Van Dussen, Daniel J.; Leson, Suzanne M.


    With the aging workforce and the increase of older adults, educational needs of the workforce in aging services are broadening. The pilot study used a survey to examine the types of educational opportunities and needs of professionals providing services to older adults in eastern Ohio and western Pennsylvania. Respondents (25.9%) reported learning…

  8. The Curriculum Design in Universities from the Perspective of Providers in Accounting Education (United States)

    Cheng, Kai-Wen


    Under the influence of globalization and the ongoing expansion of technology, many scholars believe that there is an obvious discrepancy of expectation between the providers of accounting education (i.e. teachers and students) and the demanders of that education (i.e. accounting firms and business enterprises) (Albrecht & Sack, 2000; Li, 1999; Ma,…

  9. Functional Foods Programs Serve as a Vehicle to Provide Nutrition Education to Groups (United States)

    Cirignano, Sherri M.


    An increase in consumer interest in functional foods provides an opportunity for FCS educators to use this topic in Extension programming to promote current nutrition recommendations. The Functional Foods for Life Educational Programs (FFL) are a curriculum of six evidence-based mini-seminars that highlight specific functional foods that have the…

  10. Can "Ubuntu" Provide a Model for Citizenship Education in African Democracies? (United States)

    Enslin, Penny; Horsthemke, Kai


    Some proponents of Africanism argue that African traditional education and the principles of "ubuntu" should provide the framework for citizenship education. While conceding that understandable concerns lie behind defences of "ubuntu" as underpinning African democracy, we argue that the Africanist perspective faces various problems and makes…

  11. 'Can the patient speak?': postcolonialism and patient involvement in undergraduate and postgraduate medical education. (United States)

    Sharma, Malika


    Patients are increasingly being engaged in providing feedback and consultation to health care institutions, and in the training of health care professionals. Such involvement has the potential to disrupt traditional doctor-patient power dynamics in significant ways that have not been theorised in the medical literature. Critical theories can help us understand how power flows when patients are engaged in the training of medical students. This paper applies postcolonial theory to the involvement of patients in the development and delivery of medical education. First, I review and summarise the literature around patient involvement in medical education. Subsequently, I highlight how postcolonial frameworks have been applied to medical education more broadly, extrapolating from the literature to apply a postcolonial lens to the area of patient engagement in medical education. Concepts from postcolonial theory can help medical educators think differently about how patients can be engaged in the medical education project in ways that are meaningful and non-tokenistic. Specifically, the positioning of the patient as 'subaltern' can provide channels of resistance against traditional power asymmetries. This has curricular and methodological implications for medical education research in the area of patient engagement. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  12. Brief Training on Patient Anger Increases Oncology Providers' Self-Efficacy in Communicating With Angry Patients. (United States)

    Gerhart, James I; Sanchez Varela, Veronica; Burns, John W


    Anger is a common reaction to pain and life-limiting and life-threatening illness, is linked to higher levels of pain, and may disrupt communication with medical providers. Anger is understudied compared with other emotions in mental health and health care contexts, and many providers have limited formal training in addressing anger. The objective of this study was to assess if a brief provider training program is a feasible method for increasing providers' self-efficacy in responding to patient anger. Providers working in stem cell transplant and oncology units attending a brief training session on responding to patient anger. The program was informed by cognitive behavioral models of anger and included didactics, discussion, and experiential training on communication and stress management. Provider-rated self-efficacy was significantly higher for nine of 10 skill outcomes (P didactics, and experiential exercises can support provider awareness of anger, shape adaptive communication, and foster stress management skills. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  13. Nurses’ attitudes and behaviors on patient medication education

    Directory of Open Access Journals (Sweden)

    Bowen JF


    Full Text Available Background: Medication education is vital for positive patient outcomes. However, there is limited information about optimal medication education by nurses during hospitalization and care transitions. Objective: Examine nurses’ attitudes and behaviors regarding the provision of patient medication education. The secondary objectives were to determine if nurses’ medication education attitudes explain their behaviors, describe nurses’ confidence in patient medication knowledge and abilities, and identify challenges to and improvements for medication education. Methods: A cross sectional survey was administered to nurses servicing internal medicine, cardiology, or medical-surgical patients. Results: Twenty-four nurses completed the survey. Greater than 90% of nurses believed it is important to provide information on new medications and medical conditions, utilize resources, assess patient understanding and adherence, and use open ended question. Only 58% believed it is important to provide information on refill medications. Greater than 80% of nurses consistently provided information on new medications, assessed patient understanding, and utilized resources, but one-third or less used open-ended questions or provided information on refill medications. Most nurses spend 5-9 minutes per patient on medication education and their attitudes matched the following medication education behaviors: assessing adherence (0.57; p<0.01, providing information on new medications (0.52; p<0.05, using open-ended questions (0.51; p<0.01, and providing information on refill medications (0.39; p<0.05. Nurses had higher confidence that patients can understand and follow medication instructions, and identify names and purpose of their medications. Nurses had lower confidence that patients know what to expect from their medication or how to manage potential side effects. Communication, including language barriers and difficulty determining the patient

  14. Educating patients about anaesthesia: effect of various modes on patients' knowledge, anxiety and satisfaction. (United States)

    Lee, Anna; Gin, Tony


    This review summarizes the current research on the effects of preoperative education about anaesthesia on patient knowledge, anxiety, and satisfaction. Misconceptions about the process and the risks of general and regional anaesthesia are common. Information leaflets should be formally assessed to ensure that patient knowledge is increased. Patients should be surveyed to see what information they want, rather than just providing what healthcare professionals think is appropriate. The amount of information requested by patients can vary considerably. Providing detailed drug information leaflets for anaesthetic drugs was not thought necessary by many patients, but was not associated with increased preoperative state anxiety. Information sessions to small groups of patients by multidisciplinary healthcare professionals were useful for patients undergoing total hip arthroplasty, with a small reduction in preoperative state anxiety, but patient satisfaction levels remained unchanged. Patient satisfaction should be measured by a valid and reliable questionnaire. When this was done, the introduction of pamphlets did not improve patient satisfaction. The evidence for better patient outcomes after patient education interventions is not convincing. Preoperative patient education should recognize that different patients have various misconceptions, expectations and needs. Multiple modes may be required to increase knowledge for informed consent and decrease patient anxiety. Patient satisfaction is generally high irrespective of the mode of patient education.

  15. Does patient choice of healthcare providers lead to better patient experiences in the Netherlands? A cross-sectional questionnaire study .

    NARCIS (Netherlands)

    Victoor, A.; Reitsma-van Rooijen, M.; Jong, J. de; Delnoij, D.; Friele, R.; Rademakers, J.


    Background: Various European healthcare systems encourage patients to make an active choice of healthcare provider, both as a worthwhile effort for patients and an instrument to encourage competition between providers. In previous research, patient groups were distinguished


    Directory of Open Access Journals (Sweden)

    Nurhan UNUSAN


    Full Text Available Distance learning applications in nutrition education have evolved together with communication technology. Distance delivery is transforming the culture of professional health education by expanding access to learners, introducing novel teaching and learning methods, as well as shifting the paradigm of how instructors and students interact. The aim of the paper is to prepare a participant centred, active learning model. The model proposed in this article is based on the literature review. This model resembles active delivery models that have been highly successful in increasing learning and problem solving abilities in other courses. The model focuses on constructs that distance delivery courses should address during design and assessment. For a model to be succeeded the required prerequisites should involve the establishment of a centre for educational technology, to take a model in forming the infrastructure for web based distance delivery, to update the technology required, and to train supporting staff to help in the design of web material/documentation.

  17. Enhancing patient-provider communication for long-term post-stroke spasticity management. (United States)

    Sunnerhagen, K S; Francisco, G E


    Stroke is a major public health concern, with estimated 16 million people worldwide experiencing first-time strokes each year, a number that is expected to rise. Two-thirds of those experiencing a stroke are younger than 70 years of age. Stroke is a leading cause of disability in adults as a result of major sequelae that include spasticity, cognitive impairment, paresis, and depression. Disabling spasticity, defined as spasticity severe enough to require intervention, occurs in 4% of stroke survivors within 1 year of first-time stroke. The aim of this report is to focus instead on a discussion of patient-provider communication, and its role in post-stroke spasticity (PSS) rehabilitation within the context of patient-centered health care. A discussion based on a review of the literature, mainly since 2000. Problems within communication are identified and suggestion to enhance communication are proposed thus improving patient-centered goal setting/goal achievement for the effective management of spasticity rehabilitation. These are as follows: (i) involving family members, (ii) educating patients and family members on stroke and rehabilitation, and (iii) establishing a common definition for long-term goals. Increased communication among physicians, patients, and payers may bridge some of the gaps and increase the effectiveness of PSS rehabilitation and management. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Combining Classwide Curriculum-Based Measurement and Peer Tutoring to Help General Educators Provide Adaptive Education. (United States)

    Phillips, Norris B.; And Others


    This paper describes and evaluates the efficacy of a combination of curriculum-based measurement and peer tutoring incorporated into 40 elementary education mathematics classes, to differentiate instruction and improve student achievement. The evaluation indicated that students with low achievement, average achievement, and learning disabilities…

  19. Impact of asthma education received from health care providers on parental illness representation in childhood asthma. (United States)

    Peterson-Sweeney, Kathleen; McMullen, Ann; Yoos, H Lorrie; Kitzmann, Harriet; Halterman, Jill S; Arcoleo, Kimberly Sidora; Anson, Elizabeth


    The burden of asthma has increased dramatically despite increased understanding of asthma and new medication regimens. Data reported here are part of a larger study investigating factors that influence parental asthma illness representation and the impact of this representation on treatment outcomes, including the parent/health care provider relationship. We investigated the influence of asthma related education provided by health care providers on these outcomes. After interviewing 228 parents of children with asthma, we found that asthma education received from the child's health care providers positively influenced parental belief systems, especially attitudes towards anti-inflammatory medications and facts about asthma. Parents who reported receiving more education also reported stronger partnerships with their child's health care provider. (c) 2007 Wiley Periodicals, Inc.

  20. Roles for Information professionals in patient education: Librarians' perspective

    Directory of Open Access Journals (Sweden)

    Susan L. MacDonald


    Full Text Available Through an examination of librarians’ contributions to the PEPTalk research project, this article highlights roles for information professionals at various stages in the design and clinical implementation of an information system that delivers patient education. The Personal Education Plan (PEPTalk was a collaborative, multi-disciplinary research project (2005-2006 based at the University Health Network’s Princess Margaret Hospital that designed an information system to provide web-based health information resources to both patients and clinicians under a shared umbrella of patient education. This article provides an overview of the PEPTalk project methods and outcomes, and documents the contributions of librarians throughout the design and clinical implementation stages of the project. Librarians brought expertise about information seeking behaviours of both patients and clinicians to the project; liaised across institutional and professional boundaries; developed a classification system for online learning objects, and educated project team about information and health literacies. The contributions of librarians on the PEPTalk project illustrate the need for boundary spanners, information brokers, knowledge translators, and change champions in the design and implementation of patient education delivery systems. There are new roles emergent at the intersections of clinical practice and health information provision. There is a need for the traditional skills and expertise of librarians and other information professionals in tailoring health information. Yet the design and implementation of patient education systems also require the development of new skills and the application of advanced information literacy as it pertains to both clinicians and patients.

  1. Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

    Directory of Open Access Journals (Sweden)

    Vivek Arora


    Full Text Available Vivek Arora, Shannon Philp, Kathryn Nattress, Selvan Pather, Christopher Dalrymple, Kenneth Atkinson, Sofia Smirnova, Stephen Cotterell, Jonathan CarterSydney Gynecological Oncology Group, Royal Prince Alfred Hospital, University of Sydney, Sydney, AustraliaPurpose: Patient satisfaction with the provision of hospital oncology services can have a significant impact on their overall treatment experience.Aims: To assess patient satisfaction with the inpatient hospital services in the gynecological oncology setting using the IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC.Methods: A modified version of the IN-PATSAT32 questionnaire with additional 16 items was administered to 52 adult surgical inpatients admitted with the Sydney Gynecological Oncology Group. All participants were provided with an information leaflet regarding the survey and written consent obtained.Results: A high response rate (100% from patients with varied social, ethnic, and educational backgrounds confirmed the acceptability of the survey. Standard of medical care provided, frequency of doctors’ visits, exchange of information with doctors, friendliness of the staff, and state of the room ranked highly (>95% on the patient satisfaction scales. Problems were identified with ease of access to and within the hospital, quality of food, and exchange of information with other hospital staff.Conclusions: Overall the satisfaction with inpatient care was rated very highly in most areas. Deficiencies in certain elements of provision of medical care to the patients were identified and steps have been taken to improve upon these shortcomings.Keywords: patient satisfaction, EORTC, IN-PATSAT32, gynecological oncology, survey

  2. Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    in our understanding of the group consultation. Our specific focus is on interpersonal communication in group consultations, with specific focus on patient-patient communication. This paper presents findings from a research project on pregnant women’s experiences of group consultations with a midwife...... in the Danish setting. Methods: Using a sequential mixed methods design, we first performed a discourse analysis of the written materials provided to the women about the group consultations. In the second step, we interview the women about their experiences of the group consultations. Findings: The analysis...... of the written materials found the juxtaposition of biomedical and patient empowerment discourses; these findings form the backdrop to the interviews, which are currently being undertaken. Conclusions: This study not only presents empirical findings on a relatively new, but increasingly used, setting for client...

  3. Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities. (United States)

    Mays, Keith A; Maguire, Meghan


    Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

  4. Pilot study evaluating the effects of an intervention to enhance culturally appropriate hypertension education among healthcare providers in a primary care setting

    NARCIS (Netherlands)

    Beune, E.J.A.J.; Bindels, P.J.E.; Mohrs, J.; Stronks, K.; Haafkens, J.A.


    ABSTRACT: BACKGROUND: To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the

  5. Pilot study evaluating the effects of an intervention to enhance culturally appropriate hypertension education among healthcare providers in a primary care setting

    NARCIS (Netherlands)

    E.J.A.J. Beune (Erik Jaj); P.J.E. Bindels (Patrick); J. Mohrs (Jacob); K. Stronks (Karien); J.A. Haafkens (Joke)


    textabstractBackground: To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the

  6. 'Educator talk' and patient change

    DEFF Research Database (Denmark)

    Skinner, T. C.; Carey, M. E.; Cradock, S.


    of diabetes (coherence IPQ-R), personal responsibility for influencing diabetes (personal responsibility IPQ-R), seriousness of diabetes (seriousness DIRQ) and impact on daily life (impact DIRQ), before and after the education programme. Results: Where data from the event coding indicated educators were...

  7. The absent discourse of communication: understanding ethics of provider-patient relationship in six hospitals in urban India. (United States)

    Ghoshal, Rakhi; Madhiwalla, Neha; Jesani, Amar; Samant, Padmaja; Badhwar, Vijaya; Surve, Sweta


    Understanding the complexities of a provider-patient relationship is considered to be of critical importance especially in medical ethics. It is important to understand this relation from the perspectives of all stakeholders. This article derives from a qualitative study conducted across six obstetric care providing institutions in the cities of Mumbai and Navi Mumbai, India, over a period of 10 months. Thirty obstetricians were interviewed in-depth to understand what they perceived as the most important aspect in developing a good provider-patient relationship. The study found that while most providers highlighted the point of communication as the most critical part of the provider-patient relationship, they admitted that they could not engage in communication with the patients for various reasons. Obstetric consultants and residents said that they were too overburdened to spend time communicating with patients; providers working in public hospitals added that the lack of education of their patients posed a hindrance in effective communication. However, providers practicing in private institutions explained that they faced a challenge in communicating with patients because their patients came from educated families who tended to trust the provider less and were generally more critical of the provider's clinical judgement. The article shows how provider-patient communication exists as an idea among medical providers but is absent in daily clinical practice. This gives rise to a discourse shaped around an absence. The authors conclude by decoding the term 'communication' - they read the word against the context of its use in the interviews, and argue that for the providers 'communication' was not intended to be a trope towards setting up a dialogue-based, egalitarian provider-patient relationship. Providers used the word in lieu of 'counselling', 'guiding', 'talking to'. It concludes that, despite the providers' insisting on the significance of communication and

  8. Teaching in crisis. Patient and family education in critical care. (United States)

    Palazzo, M O


    Although the critical care setting is not always a positive teaching environment, it is possible to achieve the goal of optimal patient and family education. The critical care nurse must understand the unique learning needs of patients and families who are experiencing a life crisis a recognize that there are substantial obstacles to overcome to educate in this setting. In addition, it takes experience and resources to develop the teaching skills of the bedside nurse, so that those teachable moments are easily recognized and suitably used to give patients and family members valuable information in small doses. The advanced practice nurse is an essential nursing resource who can spearhead the development of teaching skills for all members of the health care team. In addition, the advanced practice nurse is a clinical expert who can assess the educational needs of patients and their families and provide more detailed and individualized health information from a different perspective. Achieving good patient and family education outcomes is possible when patient care continuity is a priority and the advanced practice nurse is an active part of the nursing team. Exploring the use of new technologies and resources to meet patient and family education needs is absolutely necessary. As hospitals continue to evolve and react to the financial demands placed on them, nursing leadership and critical care nurses will need to articulate clearly all of the essential components of patient care, including patient and family education. In keeping with the rich nursing tradition of patient and family education, critical care nurses and advanced practice nurses have the opportunity to demonstrate their unique teaching skills and continue to promote health education as a priority of patient care.

  9. patient perceptions of print information, education, and ...

    African Journals Online (AJOL)

    patient perceptions of print information, education, and communication related to HIV/AIDS treatment. ... Four patient-oriented print IEC brochures in Swahili were designed to be read at the clinic waiting areas and also carried home by patients to supplement the knowledge received from routine counseling during clinic ...

  10. Patients as educators: interprofessional learning for patient-centred care. (United States)

    Towle, Angela; Godolphin, William


    Patients with chronic conditions have unique expertise that enhances interprofessional education. Although their active involvement in education is increasing, patients have minimal roles in key educational tasks. A model that brings patients and students together for patient-centred learning, with faculty playing a supportive role, has been described in theory but not yet implemented. To identify issues involved in creating an educational intervention designed and delivered by patients and document outcomes. An advisory group of community members, students and faculty guided development of the intervention (interprofessional workshops). Community educators (CEs) were recruited through community organizations with a healthcare mandate. Workshops were planned by teams of key stakeholders, delivered by CEs, and evaluated by post-workshop student questionnaires. Workshops were delivered by CEs with epilepsy, arthritis, HIV/AIDS and two groups with mental health problems. Roles and responsibilities of planning team members that facilitated control by CEs were identified. Ten workshops attended by 142 students from 15 different disciplines were all highly rated. Workshop objectives defined by CEs and student learning both closely matched dimensions of patient-centredness. Our work demonstrates feasibility and impact of an educational intervention led by patient educators facilitated but not controlled by faculty.

  11. Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination. (United States)

    Moss, Jennifer L; Gilkey, Melissa B; Rimer, Barbara K; Brewer, Noel T


    Healthcare providers may vary their communications with different patients, which could give rise to differences in vaccination coverage. We examined demographic disparities in parental report of collaborative provider communication and implications for human papillomavirus (HPV) vaccination. Participants were 4,124 parents who completed the National Immunization Survey-Teen about daughters ages 13-17. We analyzed disparities in collaborative communication (mutual information exchange, deliberation, and decision) and whether they mediated the relationship between demographic characteristics and HPV vaccine initiation. Half of parents (53%) in the survey reported collaborative communication. Poor, less educated, Spanish-speaking, Southern, and rural parents, and parents of non-privately insured and Hispanic adolescents, were least likely to report collaborative communication (all pcommunication accounted for geographic variation in HPV vaccination, specifically, the higher rates of uptake in the Northeast versus the South (mediation z=2.31, pcommunication showed widespread disparities, being least common among underserved groups. Collaborative communication helped account for differences-and lack of differences-in HPV vaccination among some subgroups of adolescent girls. Leveraging patient-provider communication, especially for underserved demographic groups, could improve HPV vaccination coverage.

  12. eHealth patient-provider communication in the United States: interest, inequalities, and predictors. (United States)

    Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J


    Health-related Internet use and eHealth technologies, including online patient-provider communication (PPC), are continually being integrated into health care environments. This study aimed to describe sociodemographic and health- and Internet-related correlates that influence adult patients' interest in and electronic exchange of medical information with health care providers in the United States. Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey ( N  = 3677) were analyzed. Descriptive statistics and multivariable regression analyses were performed to examine associations between patient-level characteristics and online PPC behavior and interests. Most respondents were Internet users (82.8%), and 61.5% of information seekers designated the Internet as their first source for health information. Younger respondents (Internet users (odds ratio, OR = 2.87, 95% CI, 1.35-6.08), college graduates (OR = 2.92, 95% CI, 1.42-5.99), and those with frequent provider visits (OR = 1.94, 95% CI, 1.02-3.71) had a higher likelihood of online PPC via email or fax, while Hispanics and those from higher-income households were 2-3 times more likely to communicate via text messaging or phone/mobile apps. Patients' interest in and display of online PPC-related behaviors vary by age, race/ethnicity, education, income, Internet access/behaviors, and information type. These findings can inform efforts aimed at improving the use and adoption of eHealth technologies, which may contribute to a reduction in communication inequalities and health care disparities.

  13. Continuous glucose monitoring technology for personal use: an educational program that educates and supports the patient. (United States)

    Evert, Alison; Trence, Dace; Catton, Sarah; Huynh, Peter


    The purpose of this article is to describe the development and implementation of an educational program for the initiation of real-time continuous glucose monitoring (CGM) technology for personal use, not 3-day CGMS diagnostic studies. The education program was designed to meet the needs of patients managing their diabetes with either diabetes medications or insulin pump therapy in an outpatient diabetes education center using a team-based approach. Observational research, complemented by literature review, was used to develop an educational program model and teaching strategies. Diabetes educators, endocrinologists, CGM manufacturer clinical specialists, and patients with diabetes were also interviewed for their clinical observations and experience. The program follows a progressive educational model. First, patients learn in-depth about real-time CGM technology by attending a group presensor class that provides detailed information about CGM. This presensor class facilitates self-selection among patients concerning their readiness to use real-time CGM. If the patient decides to proceed with real-time CGM use, CGM initiation is scheduled, using a clinic-centered protocol for both start-up and follow-up. Successful use of real-time CGM involves more than just patient enthusiasm or interest in a new technology. Channeling patient interest into a structured educational setting that includes the benefits and limitations of real-time CGM helps to manage patient expectations.

  14. Partnering with diabetes educators to improve patient outcomes

    Directory of Open Access Journals (Sweden)

    Burke SD


    Full Text Available Sandra D Burke,1,2 Dawn Sherr,3 Ruth D Lipman3 1American Association of Diabetes Educators, Chicago, IL, USA; 2University of Illinois at Chicago College of Nursing, Urbana, IL, USA; 3Science and Practice, American Association of Diabetes Educators, Chicago, IL, USA Abstract: Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient's health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes. Keywords: diabetes

  15. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge. (United States)

    Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena


    Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P allergy over time (54% vs 80%; P allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Effect of Educational Level on Hypertensive Patients' Compliance ...

    African Journals Online (AJOL)

    Among the educated compliant patients, those with secondary education were 14 (30.4%), followed by those with tertiary education who were ten (10) (21.7%) and primary education accounting for 5 (10.8%). There were 134 non compliant patients accounting for 86 (64.2%) educated patients and 48 (35.8%) non educated.

  17. Genetic education and nongenetic health professionals: educational providers and curricula in Europe

    NARCIS (Netherlands)

    Challen, K.; Harris, H.J.; Julian-Reynier, C.; ten Kate, L.P.; Kristoffersson, U.; Nippert, I.; Schmidtke, J.; Benjamin, C.; Harris, R


    Purpose: Advances in and diffusion of genetic technology mean that nongeneticist health professionals have an increasing need to develop and maintain genetic competencies. This has been recognized by patient support groups and the European Commission. As the first phase of the GenEd (Genetic

  18. Genetic education and nongenetic health professionals: educational providers and curricula in Europe

    NARCIS (Netherlands)

    Challen, K.; Harris, H.J.; Julian-Reynier, C.; Kate, L.P. ten; Kristoffersson, U.; Nippert, I.; Schmidtke, J.; Benjamin, C.; Harris, R


    PURPOSE: Advances in and diffusion of genetic technology mean that nongeneticist health professionals have an increasing need to develop and maintain genetic competencies. This has been recognized by patient support groups and the European Commission. As the first phase of the GenEd (Genetic

  19. The Obligation to Provide Free Basic Education in South Africa: An International Law Perspective

    Directory of Open Access Journals (Sweden)

    L Arendse


    Full Text Available In South Africa many learners are denied the right to basic education because of the levying of school fees and other educational charges, in spite of the international obligation imposed on government to provide free primary education. This article examines the exact nature and extent of this obligation by exploring the concept of "free" basic education. The applicable international instruments and their interpretation as well as the significance of the right to education as a central, facilitative right are examined in order to establish the content of the right to basic education and the legal obligations that ensue. Against this background, the implications of the South African Constitutional Court's approach to the realisation of socio-economic rights and the possibility of the establishment of a core minimum obligation are analysed. It is argued that learners in South Africa may come from different socio-economic backgrounds but as learners in the same public school domain and as equal bearers of their constitutional right to basic education all of them are entitled to the same type and quality of free basic education.

  20. Patient and Provider Perceptions of Weight Gain, Physical Activity, and Nutrition Counseling during Pregnancy: A Qualitative Study. (United States)

    Whitaker, Kara M; Wilcox, Sara; Liu, Jihong; Blair, Steven N; Pate, Russell R


    This study investigated patient and provider perceptions of weight gain, physical activity, and nutrition counseling during prenatal care visits. Individual qualitative interviews were conducted with 30 pregnant women between 20 and 30 weeks gestation (15 African American, 15 White) and 11 prenatal care providers (5 attending physicians, 5 residents, 1 nurse practitioner) in 2014. The majority of patients and providers reported receiving or giving advice on weight gain (87% and 100%, respectively), physical activity (87% and 91%), and nutrition (100% and 91%) during a prenatal visit. Discussion of counseling content was largely consistent between patients and providers. However, counseling was limited and not fully consistent with current weight gain, physical activity, or dietary guidelines during pregnancy. Most patients viewed provider advice positively, but some wanted more detailed information. Providers discussed many barriers to lifestyle counseling, including lack of time, inadequate training, concern about the sensitivity of the topic, lower education or income level of the patient, cultural differences, and lack of patient interest. Providers discussed weight gain, physical activity, and nutrition during prenatal care visits and patients accurately recalled this advice. However, counseling was limited and not fully consistent with guidelines. Future studies are needed to develop and evaluate the efficacy of interventions to help providers overcome perceived barriers and more effectively counsel women on weight and healthy lifestyles during pregnancy. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  1. Group education for rheumatoid arthritis patients

    NARCIS (Netherlands)

    Taal, Erik; Rasker, Hans J.; Wiegman, O.


    This article reviews the effectiveness of group education programs in improving the knowledge, behavior, and health status of patients with rheumatoid arthritis (RA) and evaluates to what extent various programs fulfill certain criteria for educational self-management programs. Thirty-one studies

  2. Vocations: The Link between Post-Compulsory Education and the Labour Market. What the Research Says For... Tertiary Education Providers & School Educators (United States)

    Wheelahan, Leesa; Buchanan, John; Yu, Serena


    This summary brings together the relevant key findings for tertiary education providers and school educators from the research program "Vocations: The Link between Post-Compulsory Education and the Labour Market." The program was comprised of three different strands: (1) pathways from VET in Schools, (2) pathways within and between…

  3. A Systematic Review of the Effects of Continuing Education Programs on Providing Clinical Community Pharmacy Services (United States)

    Marques dos Reis, Tiago; Guidoni, Camilo Molino; Girotto, Edmarlon; Guerra, Marisabelle Lima; de Oliveira Baldoni, André; Leira Pereira, Leonardo Régis


    Objective. To summarize the effects of media methods used in continuing education (CE) programs on providing clinical community pharmacy services and the methods used to evaluate the effectiveness of these programs. Methods. A systematic review was performed using Medline, SciELO, and Scopus databases. The timeline of the search was 1990 to 2013. Searches were conducted in English, Portuguese, and Spanish. Results. Nineteen articles of 3990 were included. Fourteen studies used only one media method, and the live method (n=11) was the most frequent (alone or in combination). Only two studies found that the CE program was ineffective or partially effective; these studies used only the live method. Most studies used nonrobust, nonvalidated, and nonstandardized methods to measure effectiveness. The majority of studies focused on the effect of the CE program on modifying the knowledge and skills of the pharmacists. One study assessed the CE program’s benefits to patients or clients. Conclusion. No evidence was obtained regarding which media methods are the most effective. Robust and validated methods, as well as assessment standardization, are required to clearly determine whether a particular media method is effective. PMID:27402991

  4. A Systematic Review of the Effects of Continuing Education Programs on Providing Clinical Community Pharmacy Services. (United States)

    Obreli-Neto, Paulo Roque; Marques Dos Reis, Tiago; Guidoni, Camilo Molino; Girotto, Edmarlon; Guerra, Marisabelle Lima; de Oliveira Baldoni, André; Leira Pereira, Leonardo Régis


    Objective. To summarize the effects of media methods used in continuing education (CE) programs on providing clinical community pharmacy services and the methods used to evaluate the effectiveness of these programs. Methods. A systematic review was performed using Medline, SciELO, and Scopus databases. The timeline of the search was 1990 to 2013. Searches were conducted in English, Portuguese, and Spanish. Results. Nineteen articles of 3990 were included. Fourteen studies used only one media method, and the live method (n=11) was the most frequent (alone or in combination). Only two studies found that the CE program was ineffective or partially effective; these studies used only the live method. Most studies used nonrobust, nonvalidated, and nonstandardized methods to measure effectiveness. The majority of studies focused on the effect of the CE program on modifying the knowledge and skills of the pharmacists. One study assessed the CE program's benefits to patients or clients. Conclusion. No evidence was obtained regarding which media methods are the most effective. Robust and validated methods, as well as assessment standardization, are required to clearly determine whether a particular media method is effective.

  5. How does patient-provider communication influence adherence to asthma medications? (United States)

    Young, Henry N; Len-Rios, Maria E; Brown, Roger; Moreno, Megan M; Cox, Elizabeth


    To assess hypothesized pathways through which patient-provider communication impacts asthma medication adherence. A national sample of 452 adults with asthma reported assessments of patient-provider communication, proximal outcomes (understanding of asthma self-management, patient-provider agreement, trust in the clinician, involvement in care, motivation), and adherence to asthma medications. Structural equation modeling was used to examine hypothesized pathways. Significantly positive direct pathways were found between patient-provider communication and all proximal outcomes. Only positive indirect pathways, operating through trust and motivation, were found between patient-provider communication and medication adherence. Patient-provider communication influences many desirable proximal outcomes, but only influences adherence through trust and motivation. To promote better adherence to asthma medication regimens and, ultimately positive asthma outcomes, healthcare providers can focus on implementing communication strategies that strengthen patients' trust and increase patient motivation to use asthma medications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The impact of watching educational video clips on analogue patients' physiological arousal and information recall

    NARCIS (Netherlands)

    Bruinessen, I.R. van; Ende, I.T. van den; Visser, L.N.; Dulmen, S. van


    OBJECTIVE: Investigating the influence of watching three educational patient-provider interactions on analogue patients' emotional arousal and information recall. METHODS: In 75 analogue patients the emotional arousal was measured with physiological responses (electrodermal activity and heart rate)

  7. The impact of watching educational video clips on analogue patients' physiological arousal and information recall

    NARCIS (Netherlands)

    van Bruinessen, I. R.; van den Ende, I. T. A.; Visser, L. N. C.; van Dulmen, S.


    Investigating the influence of watching three educational patient-provider interactions on analogue patients' emotional arousal and information recall. In 75 analogue patients the emotional arousal was measured with physiological responses (electrodermal activity and heart rate) and self-reported


    Directory of Open Access Journals (Sweden)



    Full Text Available Introduction. Cardiovascular disease are the major cause of mortality in developed countries. CHF is also a chronic cardiovascular disorder. Teaching the self care plays a major role in its prevention and chronic complications. Regarding the importance of self care investigating the, effect of self care education on the knowledge of the patients on CHF is so important. Methods. In this study 42 patients with CHF were selected in the first exam held 15 days before and after a two hour training class. A training booklet was given to them. Data was collected by a questionnarie which includ 5 section as follows. The 1st section included the demographic charactristics. The 2nd section, 7 questions about anatpmy and physiology of the heart, the 3rd section included eight questions about drugs history, the 4th section included nine questions about regimen of the patients and the 5th section included 6 questions about physical activity. Results. The self care knowledge of patients increased 95 percent after education. There was no correlation between the effects of self care education and the age of all units studied. Statistical tests showed no correlation between the effects of self care education and educational level. Discussion. The knowlegde of the patients is low regarding the self care. The self care education to patients is the main duty of nurses. So, it is recommended to be considered as the first nursing intervention regarding these patients.

  9. Behaviors of providers of traditional korean medicine therapy and complementary and alternative medicine therapy for the treatment of cancer patients. (United States)

    Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young


    In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Adequate management and quality control of CAM providers is thought to involve both education and legislation.

  10. Perspectives of Never-in-Care HIV-Positive Patients and Providers in Rakai, Uganda

    Directory of Open Access Journals (Sweden)

    Gertrude Nakigozi


    Full Text Available Background. Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5% of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. Methods. We conducted 48 in-depth interviews among HIV-infected individuals aged 15–49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Results. Barriers to using HIV care included fear of stigma and HIV disclosure, women’s lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Conclusion. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.

  11. Patient stoma care: educational theory in practice. (United States)

    Williams, Jenny

    Patients undergoing stoma formation encounter many challenges including psychosocial issues, relationship concerns and fear of leakage. Leakage, inappropriate product usage and poor patient adaptation post stoma formation has cost implications for the NHS. Developing good, practical stoma care skills has been identified as improving patient outcomes, promoting the provision of quality care and improving efficiency within the NHS. However, a thorough literature search indicated that there is little research available on patient stoma care education. This is considered surprising by Metcalf (1999), O'Connor (2005) and the author of this article. This article considers and adapts generic educational theory to make it pertinent to patient stoma care education in order to bridge the gap between theory and practice.

  12. Hospital-based patient education programs and the role of the hospital librarian. (United States)

    Harris, C L


    This paper examines current advances in hospital-based patient education, and delineates the role of the hospital librarian in these programs. Recently, programs of planned patient education have been recognized by health care personnel and the public as being an integral part of health care delivery. Various key elements, including legislative action, the advent of audiovisual technology, and rising health care costs have contributed to the development of patient education programs in hospitals. As responsible members of the hospital organization, hospital librarians should contribute their expertise to patient education programs. They are uniquely trained with skills in providing information on other health education programs; in assembling, cataloging, and managing collections of patient education materials; and in providing documentation of their use. In order to demonstrate the full range of their skills and to contribute to patient care, education, and research, hospital librarians should actively participate in programs of planned patient education.

  13. Race/Ethnicity and Health Care Communication: Does Patient-Provider Concordance Matter? (United States)

    Sweeney, Casey F; Zinner, Darren; Rust, George; Fryer, George E


    Although many minority patients would prefer a provider of their own race/ethnicity, the influence of this relationship on patient-provider communication remains unknown. This analysis examined the effect of patient-provider race/ethnicity concordance on patient-reported provider communication quality using data from the Medical Expenditure Panel Survey years 2002-2012. Ordinary least squares regressions were executed on communication rating, measured by the Consumer Assessment of Health Providers and Systems. Only 13.8% of black, non-Hispanic patients reported their usual source of care provider matched their race/ethnicity, compared with 94.4% of white, non-Hispanic patients and 43.8% of Hispanic patients. Differences in communication ratings were driven by patient race, rather than provider race. Although black, non-Hispanic patients rate their communication significantly higher than their counterparts overall, there was no significant influence of patient-provider racial concordance on ratings of communication when controlling for other sociodemographic variables. Minorities may seek the services of minority providers, but they are not more satisfied with patient-provider communication experience than when in race-discordant provider arrangements.

  14. Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds. (United States)

    Carolan, Mary


    To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators. Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study. The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51). Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful. Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout. There is a need

  15. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support. (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L


    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  16. Behaviors of Providers of Traditional Korean Medicine Therapy and Complementary and Alternative Medicine Therapy for the Treatment of Cancer Patients

    Directory of Open Access Journals (Sweden)

    Jun-Sang Yu


    Full Text Available Objectives: In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Methods: Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. Results: The questionnaires (182 were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%. The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4% experienced side effects, and 6 patients (12.5% experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider’s qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Conclusion: Adequate management and quality control of CAM providers is thought to involve both

  17. A Comparison of the Effect of Virtual and Lecture-Based Patient Safety Education on Patient Safety Culture among Nurses

    Directory of Open Access Journals (Sweden)

    Neda Pakzad


    Full Text Available Background and Objectives: Patient safety is crucial for promotion of healthcare quality and is monitored as an important parameter by all healthcare provider organizations worldwide. Nurses play a major role in maintaining and promoting patient safety due to the nature of their work. The purpose of this study was to compare the effect of patient safety education program on patient safety culture among nurses working in Ilam education-treatment centers. Methods: In this experimental study, 40 nurses were selected from Ilam educational-treatment centers and randomly allocated to two groups of virtual patient safety education and lecture-based education. Hospital Survey on Patient Safety Culture questionnaire was completed by nurses of the two groups before and after patient safety education program. Statistical analysis was performed using Kolmogorov-Smirnov, independent t-, and paired t-tests. The significance level was considered less that 0.05. Results: Patient safety culture was significantly improved in both virtual and lecture groups after educational intervention (p<0.01. In the virtual education group, the mean score of patient safety culture was higher than lecture group, and this difference was significant (p<0.01. Conclusion: The findings of this study indicated that educational programs could be used by administrators of health service providers to improve patient safety culture among nurses. Also, providing patient safety educations as virtual or lecture both will be helpful.  

  18. Medical student appraisal: applications for bedside patient education. (United States)

    Markman, T M; Sampognaro, P J; Mitchell, S L; Weeks, S R; Khalifian, S; Dattilo, J R


    Medical students are often afforded the privilege of counselling patients. In the past resources were limited to pen and paper or anatomic models. The evolution of mobile applications allows for limitless access to resources that facilitate bedside patient education. To evaluate the utility of six applications in patient education and promote awareness of implementing mobile resources in clinical care. Six medical students rotating on various clerkships evaluated a total of six mobile applications. Strengths, limitations, and suggested uses in clinical care were identified. Applications included Meditoons™, VisiblePatient™, DrawMD™, CardioTeach™, Visual Anatomy™, and 360° Patient Education Suite™. Data was generated from narrative responses supplied by each student during their evaluation period. Bedside teaching was enhanced by professional illustrations and animations depicting anatomy and pathophysiology. Impromptu teaching was facilitated, as resources were conveniently available on a student's smartphone or tablet. The ability to annotate and modify images and subsequently email to patients was an extraordinary improvement in provider-patient communication. Universal limitations included small smartphone screens and the novelty of new technology. Mobile applications have the potential to greatly enhance patient education and simultaneously build rapport. Endless opportunities exist for their integration in clinical practice, particularly for new diagnoses, consent for procedures, and at time of discharge. Providers should be encouraged to try new applications and utilize them with patients.

  19. Patient/Family Education for Newly Diagnosed Pediatric Oncology Patients. (United States)

    Landier, Wendy; Ahern, JoAnn; Barakat, Lamia P; Bhatia, Smita; Bingen, Kristin M; Bondurant, Patricia G; Cohn, Susan L; Dobrozsi, Sarah K; Haugen, Maureen; Herring, Ruth Anne; Hooke, Mary C; Martin, Melissa; Murphy, Kathryn; Newman, Amy R; Rodgers, Cheryl C; Ruccione, Kathleen S; Sullivan, Jeneane; Weiss, Marianne; Withycombe, Janice; Yasui, Lise; Hockenberry, Marilyn

    There is a paucity of data to support evidence-based practices in the provision of patient/family education in the context of a new childhood cancer diagnosis. Since the majority of children with cancer are treated on pediatric oncology clinical trials, lack of effective patient/family education has the potential to negatively affect both patient and clinical trial outcomes. The Children's Oncology Group Nursing Discipline convened an interprofessional expert panel from within and beyond pediatric oncology to review available and emerging evidence and develop expert consensus recommendations regarding harmonization of patient/family education practices for newly diagnosed pediatric oncology patients across institutions. Five broad principles, with associated recommendations, were identified by the panel, including recognition that (1) in pediatric oncology, patient/family education is family-centered; (2) a diagnosis of childhood cancer is overwhelming and the family needs time to process the diagnosis and develop a plan for managing ongoing life demands before they can successfully learn to care for the child; (3) patient/family education should be an interprofessional endeavor with 3 key areas of focus: (a) diagnosis/treatment, (b) psychosocial coping, and (c) care of the child; (4) patient/family education should occur across the continuum of care; and (5) a supportive environment is necessary to optimize learning. Dissemination and implementation of these recommendations will set the stage for future studies that aim to develop evidence to inform best practices, and ultimately to establish the standard of care for effective patient/family education in pediatric oncology.

  20. A new approach for patient education: beyond constructivism. (United States)

    Giordan, A; Jacquemet, S; Golay, A


    Over the last ten years, research developed in science education, especially at the University of Geneva, has demonstrated that education must be centered on interactions between the learner's conceptions and a systemic educational environment. Transposed to a medical knowledge, this new model, originally conceived by the authors and called the 'allosteric learning model', offers new ways of considering patient education. After criticizing the 'grand theories' of learning, mainly the latest ones called constructivist models, the authors suggest a new set of micromodels designed to explain thoroughly the functioning of the patient's thought process (questions, frame of references, semantic network,...) and his understanding of medical information on his own disease. For health care providers, these models also offer a series of new pedagogical approaches both efficient and original to regulate the act of education based on confrontation, mobilisation, integration, etc.

  1. Development of a Web-based educational intervention to improve cross-cultural communication among hospice providers. (United States)

    Doorenbos, Ardith Z; Lindhorst, Taryn; Schim, Stephanie Myers; Van Schaik, Eileen; Demiris, George; Wechkin, Hope A; Curtis, J Randall


    In this article, the authors describe the theoretical foundation, development, and content of a Web-based educational intervention to improve cross-cultural communication about end-of-life concerns and report on the preliminary evaluation of this intervention using a qualitative study design. The data were collected with non-structured questions in a convenience sample of 21 hospice providers. Participants reported that they found the training appropriate and useful. Participants also reported finding the online delivery convenient and the interactive format valuable. Improving the quality of cross-cultural patient-provider communication can contribute to reducing disparities at end-of-life.

  2. Approaches to health-care provider education and professional development in perinatal depression: a systematic review. (United States)

    Legere, Laura E; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn


    Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression. A systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis. Two thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes. This systematic review reveals a

  3. What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators. (United States)

    Wells, Kristen J; Valverde, Patricia; Ustjanauskas, Amy E; Calhoun, Elizabeth A; Risendal, Betsy C


    A nationwide cross-sectional study was conducted to assess patient navigator, patient population, and work setting characteristics associated with performance of various patient navigation (PN) tasks. Using respondent-driven sampling, 819 navigators completed a survey assessing frequency of providing 83 PN services, along with information about themselves, populations they serve, and setting in which they worked. Analyses of variance and Pearson correlations were conducted to determine differences and associations in frequency of PN services provided by various patient, navigator, and work setting characteristics. Nurse navigators and navigators with lower education provide basic navigation; social workers typically made arrangements and referrals; and individuals with higher education, social workers, and nurses provide treatment support and clinical trials/peer support. Treatment support and clinical trials/peer support are provided to individuals with private insurance. Basic navigation, arrangements and referrals, and care coordination are provided to individuals with Medicaid or no insurance. Providing basic navigation is a core competency for patient navigators. There may be two different specialties of PN, one which seeks to reduce health disparities and a second which focuses on treatment and emotional support. The selection and training of patient navigators should reflect the specialization required for a position. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Patients' perceptions of the interpersonal sensitivity of their healthcare providers: the potential role of patient-provider racial/ethnic concordance. (United States)

    Phillips, Karon L; Chiriboga, David A; Jang, Yuri


    Preliminary studies have revealed an association between cultural competence and an improvement in the quality of healthcare services, increased patient satisfaction, and increased effectiveness of services. This study examined factors that helped to explain patients' perceptions of their providers' interpersonal sensitivity - one component of cultural competence. The respondents were 2075 racially/ethnically diverse adults, aged 50 years and older, who responded to a national telephone survey. Results indicate that one of the main factors predicting interpersonal sensitivity is self-rated physical health: those who reported better health were more likely to see their provider as exhibiting higher levels of sensitivity. This was true for Hispanic/Latino patients. The results also suggest that having a provider of the same race/ethnicity was a significant factor only for Hispanic/Latino patients. Despite findings from previous research, racial/ethnic concordance may not be universally effective in improving interpersonal sensitivity in healthcare settings for all racial/ethnic groups.

  5. Methodological Approaches and Principles of Foreign Language Teachers’ Training to Provide Schoolchildren with Ethnic Education

    Directory of Open Access Journals (Sweden)

    Botakoz A. Zhekibaeva


    Full Text Available The article presents description of the main methodological approaches and principles of foreign language teachers’ training to provide schoolchildren with ethic education, including: person-centered, ethno-cultural, didactic, ethno-pedagogical, system, pragmatic approaches and principles of cultural conformity, dialectical unity of universal and national-ethnic, dialogue and cultural interaction. This analysis of methodological approaches and principles allowed us to define the content of foreign language teachers’ training to provide schoolchildren with ethic education, including combination of ethnic education knowledge, skills, its essence and features and to identify the forms, methods and means of teaching, enabling to train the foreign language teachers this branch of activity in the shortest time

  6. Intelligent Patient Education: Saving Time and Increasing Nurses Efficiency

    Directory of Open Access Journals (Sweden)

    Rafat Rezapour-Nasrabad


    Full Text Available Background: Patient education completes value chain process in presenting therapy and care services to patients. Thus, it is necessary to use the latest technologies in patients’ education. The present study aims to design an educational software to provide the verified scientific, educational and care data of the patients.Methods: The software is performed in three stages:1-      Formation of databases including the nursing care based on the latest educational and care standards2-      Design an intelligent software to present care education based on nursing process3-      For pilot study, the relevant software is installed on some systems and it is used in at least three hospitals.Results: The mentioned software presents valuable data in accordance to the needs of patients. Some of the advantages of this software include:-          Customization of education as their reading is easier.-          Simplicity of use with software can increase the availability of data for the patients.-          This software helps the nurses to guide the patients to receive the trainings in each stage of care process.Conclusion: Implementation of intelligent education system of patient reduces the frequency of visit to health centers and unnecessary admissions and this effectiveness cost of this system can save time and energy of disabled patients and increase the efficiency of nurses.

  7. A mixed methods study of patient-provider communication about opioid analgesics. (United States)

    Hughes, Helen Kinsman; Korthuis, Philip Todd; Saha, Somnath; Eggly, Susan; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Beach, Mary Catherine


    To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes toward patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers' attitudes toward patients. 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialog suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient's experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95% CI: 0.27-0.95) when opioids were discussed. Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients. Empathy and pain acknowledgment are tools that clinicians can use to facilitate productive discussions of pain management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study. (United States)

    Sayin, Yazile; Aksoy, Güler


    In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  9. Approaches to health-care provider education and professional development in perinatal depression: a systematic review


    Legere, Laura E.; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn


    Background Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of...

  10. Integration/Inclusion Needs Assessment: Providing Education for Everyone in Regular Schools (PEERS). Revised Edition. (United States)

    Halvorsen, Ann T.; And Others

    This needs assessment instrument was developed as part of the PEERS (Providing Education for Everyone in Regular Schools) Project, a California project to integrate students with severe disabilities who were previously at special centers into services at regular school sites and students who were in special classes in regular schools into general…

  11. Naptime Data Meetings to Increase the Math Talk of Early Care and Education Providers (United States)

    Trawick-Smith, Jeffrey; Oski, Heather; DePaolis, Kim; Krause, Kristen; Zebrowski, Alyssa


    Classroom conversations about mathematics--math talk--between early care and education providers and young children have been associated with growth in mathematical thinking. However, professional development opportunities to learn about math teaching and learning are limited in many community-based child development centers. New approaches that…

  12. Teacher's Attitude into Different Approach to Providing Feedback to Students in Higher Education (United States)

    Chaqmaqchee, Zina Adil


    Feedback within higher education has an effective role in teaching staffs mode. The treatise on teachers' methods of feedback is represented to demonstrate how the novel feedback can help the academic staffs to provide an effective feedback for students in their assignments and written draft. The study investigates the academic staff's methods of…

  13. The Politics of Resistance to Workplace Cultural Diversity Education for Health Service Providers: An Australian Study (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga


    This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals,…

  14. Assessing an Infant Feeding Web Site as a Nutrition Education Tool for Child Care Providers (United States)

    Clark, Alena; Anderson, Jennifer; Adams, Elizabeth; Baker, Susan; Barrett, Karen


    Objective: Determine child care providers' infant feeding knowledge, attitude and behavior changes after viewing the infant feeding Web site and determine the effectiveness of the Web site and bilingual educational materials. Design: Intervention and control groups completed an on-line pretest survey, viewed a Web site for 3 months, and completed…

  15. Confusion in the Field! Providing Clarity on Constructivism and Constructionism in Religious Education (United States)

    Hyde, Brendan


    Constructivism and constructionism are two distinct epistemologies. Yet, within religious education many have tended to use these terms interchangeably or as being complementary to one another. This article provides conceptual clarity in relation to both epistemologies by comparing each in terms of their origins and epistemological premises, their…

  16. Using patients as educators for communication skills: Exploring dental students' and patients' views. (United States)

    Coelho, C; Pooler, J; Lloyd, H


    A qualitative study to explore the issues for patients and students when giving feedback on the communication of dental students. The Department of Health and National Institute for Health Research are committed to involving patients in improving clinical education, research and service delivery. Yet, there is a limited body of evidence on the perceptions of patients when asked to be involved in this way, and specifically when asked to provide feedback on the communication skills of dental students. This study seeks to address this gap and heighten the understanding of the issues faced by patients when asked to be involved in clinical education. Data were collected using focus groups with dental students (n=10) and patients (n=8) being treated by these students. Both groups were asked about their thoughts, feelings and beliefs about patients being asked to provide feedback on the communication skills of dental students. Data analysis involved inductive thematic analysis of transcribed audio recordings. Four themes emerged from the data: "legitimacy," "co-educators," "maintaining the equilibrium of the patient-student relationship" and the "timing of patient feedback." Support for involving patients in giving feedback on students' communication skills was established, with patients considering they were best placed to comment on the communication skills of dental students. Patients and students do not want to provide feedback alone and want support to assist them, especially if feedback was negative. Issues of anonymity, confidentiality and ownership of the feedback process were worrisome, and the positioning of patient feedback in the programme was seen as critical. Patients and students are willing to engage in patient feedback on students' communication skills, and with support and training, the concerns around this are not insurmountable and the benefits could potentially profit both groups. These findings have resonance with other healthcare educators when

  17. Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study. (United States)

    McGough, Shirley; Wynaden, Dianne; Wright, Michael


    The need for mental health clinicians to practice cultural safety is vital in ensuring meaningful care and in moving towards improving the mental health outcomes for Aboriginal people. The concept of cultural safety is particularly relevant to mental health professionals as it seeks to promote cultural integrity and the promotion of social justice, equity and respect. A substantive theory that explained the experience of providing cultural safety in mental health care to Aboriginal patients was developed using grounded theory methodology. Mental health professionals engaged in a social psychological process, called seeking solutions by navigating the labyrinth to overcome the experience of being unprepared. During this process participants moved from a state of being unprepared to one where they began to navigate the pathway of cultural safety. The findings of this research suggest health professionals have a limited understanding of the concept of cultural safety. The experience of providing cultural safety has not been adequately addressed by organizations, health services, governments, educational providers and policy makers. Health services, organizations and government agencies must work with Aboriginal people to progress strategies that inform and empower staff to practice cultural safety. © 2017 Australian College of Mental Health Nurses Inc.

  18. Factors Influencing the Food Purchases of Early Care and Education Providers. (United States)

    Otten, Jennifer J; Hirsch, Tad; Lim, Catherine


    With the majority of US children enrolled in some form of early care and education, the settings for early care and education represent a valuable opportunity to positively impact young children's diets and their interactions with food. Little evidence exists on how early care and education providers make food purchasing and service decisions for this population of young children. Our aim was to explore the factors that influence early care and education providers' food purchasing and service decisions. A qualitative design consisting of individual, in-person, and semi-structured interviews with providers and on-site observations was used. Sixteen early care and education providers-selected across a variety of characteristics that might affect food selection (eg, size of site, participation in reimbursement programs, presence of staff assigned to foodservice) using maximum variation purposive sampling-based in the Puget Sound region, Washington, were interviewed from June to September 2014. Provider perspectives on food purchasing and service decisions. Inductive analysis of transcribed interviews using TAMS Analyzer software (GPL version 2, 2012) to identify themes. Ten main influencers emerged from the data. These were grouped into four categories based on an ecological framework: macro-level environments (ie, regulations; suppliers and vendors, including stores); physical environment and settings (ie, organizational mission, budget, and structure; the facility itself); social environments (ie, professional networks; peers; the site-specific parent and child community); and individual factors at both a provider and child-level (ie, providers' skills, behaviors, motivations, attitudes, knowledge, and values; child food preferences; and, child allergies). A model was then developed to identify potential pathways of intervention and underscore the need for a comprehensive approach to improve early care and education nutrition. This study suggests that a more

  19. Patient-Centred Communication and Provider Avoidance: Does Body Mass Index Modify the Relationship? (United States)

    Phibbs, Sandi Cleveland; Faith, Jennifer; Thorburn, Sheryl


    Objective: Poor quality communication with healthcare providers has been associated with provider avoidance. Because obesity is stigmatised in healthcare settings, this association may differ for patients who are overweight or obese compared to patients who are normal weight. Our objective was to determine if associations between patient-centred…

  20. Internet and education for the patient

    Directory of Open Access Journals (Sweden)

    Bastos, Bárbara Guimarães


    Full Text Available Introduction: The process of education of a patient aims to improve knowledge and skill of the patient and/or family, in a way to influence attitudes and behaviors needed to maintain or improve health. Must be a integral part of interpersonal communication between health professionals and patients, and this can happen through interpersonal communication and various other means such as pamphlets, manuals and, more recently, computer resources. Goal: This update article approach the patient education and the internet potential for this process, still presenting some initiatives in the audiology área. Discussion: The informations, related to health are popular in the internet, and include interactive websites, portals, e-mails, telehealth aplications, and others. The education of the patients supported by the internet can help to solve a big ethical, political and economic issue: the problem to conciliate the needs and the expectations of the patients with the characteristics and limitations of the health system. Although the use of internet in the education of the patient is promising, this is not a solution to be used without careful planning, monitoring and evaluation. In audiology there are few initiatives with the use of e-mails and websites for complement of the patient education. Final Considerations: The health professionals, including the speech therapists, must check if their patients use internet resources, recognize that behavior change and prepare not only to discuss the information obtained with the patient, but also suggest websites with reliable information and help them to evaluate the quality of the information available online.

  1. Evaluation and lessons learned from an undergraduate service learning course providing youth-focused relationship education. (United States)

    McElwain, Alyssa; Finnegan, Vanessa; Whittaker, Angela; Kerpelman, Jennifer; Adler-Baeder, Francesca; Duke, Adrienne


    Adolescent romantic relationships are known to have a significant impact on individual well-being and development. However, few teens experience formal education about the knowledge and skills necessary for building healthy romantic relationships. In response, a statewide relationship education initiative was developed at a large university in a Southeastern state. Undergraduates who enrolled in a service learning course in Human Development and Family Studies partnered with this initiative and implemented a relationship education program targeting high school students. A service learning model is used in this initiative because it offers opportunities for students' professional development and experiential learning. The present article provides a formative and illustrative summative evaluation of the service learning program. Specifically, the primary aims of this paper are to 1) provide an overview of the service learning course components; 2) describe preparation of the service learning students and their implementation of the relationship education program; 3) discuss challenges and lessons learned; and 4) offer initial evidence of effectiveness by showing change in targeted outcomes for the high school student recipients of the relationship education program. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Patients' Perception of Chronic-Pain-Related Patient-Provider Communication in Relation to Sociodemographic and Pain-Related Variables: A Cross-Sectional Nationwide Study. (United States)

    Jonsdottir, Thorbjorg; Gunnarsdottir, Sigridur; Oskarsson, Gudmundur K; Jonsdottir, Helga


    Pain is a personal experience and patient-provider communication therefore an essential part of diagnosis and treatment where the patient's perspective needs to be central. The aim of this descriptive cross-sectional study was to investigate chronic-pain-related patient-provider communication in the context of sociodemographic variables, pain variables, perceived outcome of care, and satisfaction with health care providers. A postal questionnaire measuring socio-demographic variables, pain characteristics, pain-related health care utilization and patient-provider communication was sent to a sample of 4,500 individuals randomly drawn from the national population of Iceland. A subsample reporting chronic pain and having visited a health care provider for pain the previous six months (n = 401) was analyzed. Relationships between patient-provider communication and other measured variables were tested using bivariate and multivariate statistics. The more chronic pain impaired health-related quality of life, the more provider control the patients perceived in the patient-provider communication. There was also a strong negative relationship between patients' perception of providers' support and openness to discussing symptoms, and satisfaction with health care provider. Patients' perception of their own control in patient-provider communication and involvement in decisions regarding care was related to sociodemographic variables (specifically, education and residence) but not to pain related variables. This study highlights the importance of assessing chronic pain in a broad spectrum, listening, and giving patients time and support to communicate chronic pain and how it affects their life situation. The more interfering the pain is, the more important this is. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Evaluating a Sexual Health Patient Education Resource


    Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty


    This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncolo...

  4. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti


    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  5. The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening (United States)

    Underhill, Meghan L.; Kiviniemi, Marc T.


    Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

  6. Students with intellectual disability in higher education: adult service provider perspectives. (United States)

    Sheppard-Jones, Kathleen; Kleinert, Harold Lawrence; Druckemiller, Wendy; Ray, Megan Kovacevich


    Postsecondary education (PSE) is increasingly becoming an option for students with intellectual disability (ID; Grigal & Hart, 2012 ). Postsecondary education offers the promise of pursuing a valued social role (that of college student), enhanced social networks, and, most significantly, increased employment options. To date, research and practice in the area of transition to PSE for students with ID has focused primarily upon the sending (public school systems) and receiving (colleges or universities) agencies ( Oertle & Bragg, 2014 ; Thoma et al., 2011 ). Yet adults with ID often require ongoing supports through state and federally funded developmental disability waivers, and agency providers of waiver services have, for the most part, not been part of this vital conversation. This study represents an exploratory study of directors of developmental disability provider agencies in one midwestern state to assess their knowledge of PSE for individuals with ID. A total of 87 directors responded; quantitative results are presented and, based on these findings, we provide implications for the future.

  7. Dexmedetomidine provides optimum conditions during awake fiberoptic intubation in simulated cervical spine injury patients

    Directory of Open Access Journals (Sweden)

    Pooja Chopra


    Conclusions: Dexmedetomidine provides optimum sedation without compromising airway or hemodynamic instability with better patient tolerance and satisfaction for AFOI. It also preserves patient arousability for the postintubation neurological assessment.

  8. Can the Internet be used effectively to provide sex education to young people in China? (United States)

    Lou, Chao-hua; Zhao, Quan; Gao, Er-Sheng; Shah, Iqbal H


    To assess the feasibility and effectiveness of sex education conducted through the Internet. Two high schools and four colleges of a university in Shanghai were selected as the research sites. Half of these were assigned to the intervention group and the other half to the control group. The interventions consisted of offering sexual and reproductive health knowledge, service information, counseling and discussion to all grade one students in the intervention group. The intervention phase lasted for 10 months and was implemented through a special website, with web pages, online videos, Bulletin Board System (BBS) and expert mailbox. In total, 624 students from the intervention, and 713 from the control schools and colleges participated in the baseline survey, and about 97% of them were followed up in postintervention survey to assess changes that can be attributed to the sex education interventions provided through the Internet. The median scores of the overall knowledge and of each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group as compared with those in the control group at postintervention (p .05). Group by time interaction effects in ordinal logistic regression analysis were found on knowledge score (p people. Providing sex education to students in Shanghai through the Internet was found feasible and effective. The Internet-based sex education program increased students' reproductive health knowledge effectively and changed their attitudes toward sex-related issues in terms of being less liberal toward sex and more favorable to providing services to unmarried young people. The Internet thus offers an important and hitherto untapped potential for providing sex education to students and young people in China.

  9. A Survey of Nurses' and Patients' Opinions about Patient Education and Training and Possible Barriers in Madani Cardiovascular Health and Education Center

    Directory of Open Access Journals (Sweden)

    Afkham Varghaei-Paidar


    from nurses' viewpoint was that managers do not provide enough nurses for wards (%48.2. Conclusion: Patients' preference to receive education from their physicians, lack of content understanding because of patients' illiteracy or low literacy, communication difficulties and lack of patients' knowledge about their rights to receive education, lack of enough time for patient education, physical and mental fatigue of nurses due to high duties, lack of rewards for nurses who educate patients were important barriers for patient education. Due to the numerous benefits of patient education for patients, families, doctors and nurses and its impact on improving patient satisfaction, we need to remove barriers regarding patient education by appropriate measures.

  10. Provider-patient in-office discussions of response to hepatitis C antiviral therapy and impact on patient comprehension. (United States)

    Hamilton, Heidi E; Nelson, Meaghan; Martin, Paul; Cotler, Scott J


    Providers need to communicate projected response rates effectively to enable patients with hepatitis C virus to make informed decisions about therapy. This study used interactional sociolinguistics (1) to evaluate how gastroenterologists and allied health professionals communicate information regarding response rates to antiviral therapy, (2) to determine how these discussions relate to where the patient is in the continuum of evaluation and treatment, (3) to assess whether patients were aligned with providers in their perceptions of response rates after office visits, and (4) to identify factors that improve provider-patient alignment. Gastroenterologists, allied health professionals, and patients with hepatitis C virus were videotaped and audiotaped during regularly scheduled visits. Postvisit interviews were conducted separately with patients and providers. Visits and postvisits were transcribed and analyzed using validated sociolinguistic techniques. The phase of hepatitis C virus treatment shaped the benchmarks of response talk, although across the treatment continuum providers overwhelmingly made strategic use of positive statistics, providing motivation. In postvisit interviews, 55% of providers and patients were aligned on response rates. Patients with a favorable outcome and patients who asked response-related questions in the visit were more likely to be aligned with providers. Areas identified for improvement included the tendency to discuss response rates before an individualized assessment could be made, balancing motivation and accuracy, and assessing the patient's perspective before delivering any bad news, if necessary. Sociolinguistic analysis provides a powerful tool to evaluate provider-patient interactions and to identify ways to improve in-office communication regarding antiviral therapy.

  11. What Influences Patients' Decisions When Choosing a Health Care Provider? Measuring Preferences of Patients with Knee Arthrosis, Chronic Depression, or Alzheimer's Disease, Using Discrete Choice Experiments. (United States)

    Groenewoud, Stef; Van Exel, N Job A; Bobinac, Ana; Berg, Marc; Huijsman, Robbert; Stolk, Elly A


    To investigate what influences patients' health care decisions and what the implications are for the provision of information on the quality of health care providers to patients. Dutch patient samples between November 2006 and February 2007. Discrete choice experiments were conducted in three patient groups to explore what influences choice for health care providers. Data were obtained from 616 patients with knee arthrosis, 368 patients with chronic depression, and 421 representatives of patients with Alzheimer's disease. The three patients groups chose health care providers on a different basis. The most valued attributes were effectiveness and safety (knee arthrosis); continuity of care and relationship with the therapist (chronic depression); and expertise (Alzheimer's disease). Preferences differed between subgroups, mainly in relation to patients' choice profiles, severity of disease, and some background characteristics. This study showed that there is substantial room for (quality) information about health care providers in patients' decision processes. This information should be tailor-made, targeting specific patient segments, because different actors and factors play a part in their search and selection process. © Health Research and Educational Trust.

  12. Glaucoma patient-provider communication about vision quality-of-life. (United States)

    Sleath, Betsy; Sayner, Robyn; Vitko, Michelle; Carpenter, Delesha M; Blalock, Susan J; Muir, Kelly W; Giangiacomo, Annette L; Hartnett, Mary Elizabeth; Robin, Alan L


    The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Challenges, Dilemmas and Factors Involved in PGD Decision-Making: Providers' and Patients' Views, Experiences and Decisions. (United States)

    Klitzman, Robert


    Providers and patients are considering and pursuing PGD for ever-more conditions, but questions arise concerning how they make, view and experience these decisions, and what challenges they may face. Thirty-seven in-depth semi-structured interviews were conducted (with 27 IVF providers and 10 patients). Patients and providers struggled with challenges and dilemmas about whether to pursue PGD in specific cases, and how to decide. Respondents varied in how they viewed, experienced and made these choices, and for which conditions to pursue PGD (from lethal, childhood-onset conditions to milder, treatable, or adult-onset disorders). Several factors were involved, including differences in gene penetrance, predictability, and phenotypic expression, and disease severity, age of onset, treatability, stigma and degree of disability. Providers and patients face questions regarding possibilities of screening for more than one condition in one set of embryos, and limitations of PGD (e.g., inaccurate results). Characteristics of providers (e.g., amount of PGD experience, understandings of genetics, and use of genetic counselors), and of patients (e.g., related to broader moral and social attitudes) can also affect these decisions. These data, the first to examine several key questions concerning PGD, suggest that providers and patients confront several dilemmas. These findings have critical implications for future practice, guidelines, education and research.

  14. Exploring the Uptake of Long-Acting Reversible Contraception in South Dakota Women and the Importance of Provider Education. (United States)

    Weber, Tess L; Briggs, Ashley; Hanson, Jessica D


    Long-acting reversible contraception (LARC) methods, including the intrauterine device (IUD) and the birth control implant, are the most effective form of prescribed birth control for pregnancy prevention. However, uptake of this highly effective form of birth control is slow. The purpose of this study was to explore use of the LARC methods in South Dakota women prescribed contraception and the importance of the provider in promoting this type of contraception. This was a cross-sectional study of female patients who had been prescribed contraception at one of five locations in a South Dakota hospital system. Records were obtained through electronic health records for a six-month period. Descriptive analysis was performed using chi-square with counts and percentages. Logistic regression was used to determine differences in LARC prescriptions by patient age and provider title. A total of 2,174 individual patients were included in analysis. Of the 378 (17.4 percent) who were prescribed LARC methods, most (78.6 percent) were prescribed an IUD. Younger women (aged 11-19) were less likely to be prescribed LARCs compared to women aged 30-34. There were also significant differences in LARC prescriptions by provider type. Futhermore, we noted differences in LARC prescriptions for a provider who received a specific education and training on LARC from the American College of Obstetrics and Gynecology. There are many important factors to consider by the patient when choosing the most appropriate contraceptive method, including safety, effectiveness, accessibility, and affordability. Provider education may play an important role in promoting LARC methods.

  15. Partnering to provide simulated learning to address Interprofessional Education Collaborative core competencies. (United States)

    Murphy, Judy I; Nimmagadda, Jayashree


    Learning to effectively communicate and work with other professionals requires skill, yet interprofessional education is often not included in the undergraduate healthcare provider curriculum. Simulation is an effective pedagogy to bring students from multiple professions together for learning. This article describes a pilot study where nursing and social work students learned together in a simulated learning activity, which was evaluated to by the Readiness for Interprofessional Learning Scale (RIPLS). The RIPLS was used before and after the simulated activity to determine if this form of education impacted students' perceptions of readiness to learn together. Students from both professions improved in their RIPLS scores. Students were also asked to identify their interprofessional strengths and challenges before and after the simulation. Changes were identified in qualitative data where reports of strengths and challenges indicated learning and growth had occurred. In conclusion, this pilot study suggests that interprofessional simulation can be an effective method to integrate Interprofessional Education Collaborative core competencies into the curriculum.

  16. Perspectives from the Patient and the Healthcare Professional in Multiple Sclerosis: Social Media and Patient Education. (United States)

    Kantor, Daniel; Bright, Jeremy R; Burtchell, Jeri


    A diagnosis of multiple sclerosis (MS) is life-altering. Because the course of MS is heterogeneous, patients may face uncertainty in terms of long-term physical and cognitive challenges, potential loss of employment, and the risk of social isolation. Patients often turn to the Internet and social media for information about MS and its management, and to seek out fellow patients and support groups. Here, we examine the use of social media and the Internet among patients with MS, considering its impact on patient education. We consider the access that these conduits provide not only to other patients with MS but also to a wealth of disease-related information online. These themes are further illustrated with first-hand experiences of the patient author and her physician. We also explore the impact of the Internet and social media on the education and support of patients with MS from the healthcare professional's (HCP's) perspective, including opportunities for HCPs to promote disease education among their patients, and the advantages that arise from patients being better informed about their disease. The rise of the Internet and social media has changed the patient experience, helping patients to support each other, to educate themselves proactively about their condition, and to participate more actively in decisions relating to disease management than perhaps was the case historically. Funding Novartis Pharmaceuticals Corporation.

  17. Gender differences in patient-provider symptom agreement in reporting respiratory complaints on a questionnaire. (United States)

    Canaris, Gay J; Tape, Thomas G; Smith, Lynette M; Nickol, Devin R; Wigton, Robert S


    Men and women communicate differently, but it is unclear whether this influences health care outcomes. Because women patients frequently choose women health care providers, we examined whether this preference was affected by communication styles. We focused on communication of disease-specific symptoms, hypothesizing that symptom agreement between women patients and women health care providers would be greater than between other patient-provider gender combinations. Patients attending outpatient clinics were recruited as part of a study of respiratory illness at 7 university-affiliated sites during 3 consecutive influenza seasons (2000-2003). Individuals aged > or = 19 years were offered enrollment if they sought care for cold or flu symptoms at a participating study site. Patients were eligible to participate in the study if they reported any 1 of 6 symptoms: cough, runny nose, fever (subjective), muscle aches, sore throat, and/or exhaustion. Using separate questionnaires, patients and their health care providers recorded the patients' respiratory symptoms (as present or absent). Patients recorded their symptoms before visiting their health care provider, and providers recorded patient symptoms after the visit. Symptom agreement was compared using general estimating equations across all gender combinations. A total of 327 patients (220 women, 107 men) and 84 health care providers (37 women, 47 men) participated in the study. Overall symptom agreement for all patient-provider gender combinations was 81.9% (95% CI, 79.6%-84.2%). For each symptom, the observed agreement significantly exceeded the agreement expected by chance alone (P difference in symptom agreement for most symptoms between the male-male and female-female patient-provider combinations. Based on these findings, symptom agreement alone does not explain why women patients select women health care providers.

  18. Comparison of the Content of Web Sites of Higher Education Institutions Providing for Sports Management Education: The Case of Turkish and English Universities (United States)

    Katirci, Hakan


    Considering various themes, this study aims to examine the content of web sites of universities that provide sports management education in higher education level in Turkey and in England. Within this framework, the websites of the higher education institutions that provide sports management education are analyzed by using the content analysis…

  19. Reaching out: a strategy to provide primary eye care through the indigenous educational system in Pakistan

    Directory of Open Access Journals (Sweden)

    Muhammad Tanweer Abdullah


    Full Text Available IntroductionIn Pakistan, there is a unique and indigenously established system of education called the madaris . It is the plural of madrassa, which is an Arabic word for a school system. In the context of Pakistan, it refers to an institutional set-up that runs in parallel to the conventional schooling system and is community-based. It is perhaps the oldest and the largest educational system of its kind whereby the students are provided with free religious education. Some institutions offer a combination of religious learning and regular schooling.The facilities and the curricula vary from one madrassa to another. Since a majority of the students studying here belong to the poor and neglected socio-economic level of society, many offer free accommodation and food to the students in hostels, and most of these provide free education. These institutions are mostly funded by philanthropists; the standard of living of the students, however, is not always satisfactory.A few madaris provide basic health care services to their students, but most are neglected both by the government and the voluntary sectors. It is difficult to find data on the health status of these students.This article reports a study on these madaris that was carried out in 2002 in the district of Peshawar, the capital of the North-West Frontier Province (NWFP of Pakistan which has a population of 2.5 million. It aimed to determine the prevalence of blindness and low vision among students in the age group of five to 15 years. It offers an agenda for primary eye care and highlights the importance of integrated health care reforms at the national level for this large non-government community education system that caters to an estimated half a million children throughout Pakistan.

  20. [Out-Patient Psychosocial Cancer Counseling Centers and their Clients - Services Provided and Service Utilization by Patients and Patients' Relatives]. (United States)

    Giesler, JürgenM; Weis, Joachim; Schreib, Melanie; Eichhorn, Svenja; Kuhnt, Susanne; Faust, Tanja; Mehnert, Anja; Ernst, Jochen


    Psychosocial cancer counseling centers represent an increasingly important part of comprehensive psychosocial cancer care. Research on the services provided by those centers is sparse, however, as is research on person-, disease-, and treatment-related characteristics of their clients. Therefore, the present study analyzes the services provided by 26 psychosocial cancer counseling centers temporarily being funded by the German Cancer Aid as well as selected characteristics of their clients. Analyses are based on data collected during 2011 by means of a documentation system specifically designed for the purposes of psychosocial cancer counseling. Testing focuses on whether cancer patients and cancer patients' relatives differ with respect to various characteristics and the services used. The results show that psychosocial and benefit counseling represent a major part of counseling services, followed by giving information and employing relaxation techniques. Clients seek counseling primarily in early phases of disease and treatment. Women with breast cancer are over-represented among clients. Analyses also reveal significant differences between cancer patients and patients' relatives. Psychotherapeutic interventions and grief-counseling are more frequent in counseling relatives, whereas benefit counseling is more frequent in working with patients. The results emphasize the relevance of outpatient psychosocial cancer counseling. They may also help support initiatives aiming at establishing psychosocial cancer counseling targeted to the needs of each individual client. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Differences in the rates of patient safety events by payer: implications for providers and policymakers. (United States)

    Spencer, Christine S; Roberts, Eric T; Gaskin, Darrell J


    The reduction of adverse patient safety events and the equitable treatment of patients in hospitals are clinical and policy priorities. Health services researchers have identified disparities in the quality of care provided to patients, both by demographic characteristics and insurance status. However, less is known about the extent to which disparities reflect differences in the places where patients obtain care, versus disparities in the quality of care provided to different groups of patients in the same hospital. In this study, we examine whether the rate of adverse patient safety events differs by the insurance status of patients within the same hospital. Using discharge data from hospitals in 11 states, we compared risk-adjusted rates for 13 AHRQ Patient Safety Indicators by Medicare, Medicaid, and Private payer insurance status, within the same hospitals. We used multivariate regression to assess the relationship between insurance status and rates of adverse patient safety events within hospitals. Medicare and Medicaid patients experienced significantly more adverse safety events than private pay patients for 12 and 7 Patient Safety Indicators, respectively (at P patients had significantly lower event rates than private payers on 2 Patient Safety Indicators. Risk-adjusted Patient Safety Indicator rates varied with patients' insurance within the same hospital. More research is needed to determine the cause of differences in care quality received by patients at the same hospital, especially if quality measures are to be used for payment.

  2. Chronic disease patient education: lessons from meta-analyses. (United States)

    Cooper, H; Booth, K; Fear, S; Gill, G


    Twelve meta-analyses were identified concerning education for people with chronic diseases where behaviour modification is a part of the treatment regime. By combining the results of these meta-analyses a second stage descriptive meta-analysis was conducted. The aim of the exercise was to explore the effects of patient education and implications for educational treatment. The results provided evidence of the gaps that exist in current research practice. These gaps include the need to utilise rigorous research designs to explore the quantitative effects of patient education, and the need to qualitatively explore the processes by which these effects have transpired. Where randomised controlled trials had been conducted the effects of patient education were usually small and were only known for 6 months of follow-up. In addition, the educational interventions tested were generally poorly described, and failed to adhere to theoretical models. The results of this review have highlighted the need for practitioners to use theoretically based teaching strategies which include behaviour change tactics that affect feelings and attitudes. In alignment with these conclusions, the review has provided guidelines for future research practice.

  3. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study. (United States)

    Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J


    Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

  4. Patient race and perceived illness responsibility: effects on provider helping and bias. (United States)

    Nazione, Samantha; Silk, Kami J


    Health care disparities represent a major issue impacting the quality of care in the USA. Provider biases have been identified as contributing to health care disparities. This study examined the helping intentions and biases reported by medical students based on patient race and perceived patient responsibility. The study was guided by the responsibility-affect-helping model (RAHM), which proposes that helping behaviour is a function of perceived responsibility and affect. In a 2 × 3 online experiment, medical students (n = 231) viewed a health chart and dialogue for either a Black or a White patient, in which the dialogue included a manipulation of the patient's rationales for his non-compliance with diet recommendations (responsible, not responsible, no responsibility assigned). After viewing the manipulation, medical students completed measures regarding perceived patient responsibility, affect, intention to help, perceptions of the patient and ethnocentrism. The RAHM was supported, such that increased perceived patient responsibility led to increased provider anger and reduced provider helping intentions, whereas decreased perceived patient responsibility led to increased provider empathy and helping intentions. Additionally, an interaction effect between race and perceived patient responsibility occurred such that bias toward the Black patient was most likely to occur in the control condition. Perceived patient responsibility affects provider helping intentions and interacts with patient race to influence provider perceptions of patient characteristics. Communication on rationales for non-compliance as associated with perceived responsibility may lead to better or worse patient care as providers make attributions about patients based on these factors. © 2013 John Wiley & Sons Ltd.

  5. Informing Education Policy in Afghanistan: Using Design of Experiments and Data Envelopment Analysis to Provide Transparency in Complex Simulation (United States)

    Marlin, Benjamin


    Education planning provides the policy maker and the decision maker a logical framework in which to develop and implement education policy. At the international level, education planning is often confounded by both internal and external complexities, making the development of education policy difficult. This research presents a discrete event…

  6. Education and Outreach for Breast Imaging and Breast Cancer Patients

    National Research Council Canada - National Science Library

    Farria, Dione


    .... This project evaluated the impact of visual educational aids during biopsy consent on patient understanding of the biopsy procedure, patient satisfaction with the biopsy experience, and patient anxiety...

  7. How Indonesian Accounting Education Providers Meet The Demand of The Industry (1-11)


    Dyah Setyaningrum; Ali Muktiyanto; Ancella A. Hermawan


    The purpose of this study is to evaluate performance of accounting education providers in Indonesia in producing graduates required by the industry. This study compares different perception between the employers, lecturers, junior auditors and students regarding:  (1) auditors’ early employment problem; (2) university performance; and (3) university improvement. We employ quantitative methods to present descriptive analysis of different perceptions of stakeholders regarding university perform...

  8. Effect of providing feedback and prescribing education on prescription writing: An intervention study. (United States)

    Ajemigbitse, Adetutu A; Omole, Moses Kayode; Erhun, Wilson O


    Accurate medication prescribing important to avoid errors and ensure best possible outcomes. This is a report of assessment of the impact of providing feedback and educational intervention on prescribing error types and rates in routine practice. Doctors' prescriptions from selected wards in two tertiary hospitals in central Nigeria were prospectively reviewed for a 6-month period and assessed for errors; grouped into six categories. Intervention was by providing feedback and educational outreach on the specialty/departmental level at one hospital while the other acted as the control. Chi-squared statistics was used to compare prescribing characteristics pre- and post-intervention. At baseline, error rate was higher at the control site. At the intervention site, statistically significant reductions were obtained for errors involving omission of route of administration (P error rate post intervention (P = 0.984). Though House Officers and Registrars wrote most prescriptions, highest reduction in prescribing error rates post intervention was by the registrars (0.93% to 0.29%, P prescriptions that lacked essential details was common. Intervention resulted in modest changes. Routinely providing feedback and continuing prescriber education will likely sustain error reduction.

  9. Implementation of a Family Planning Clinic-Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives. (United States)

    Miller, Elizabeth; McCauley, Heather L; Decker, Michele R; Levenson, Rebecca; Zelazny, Sarah; Jones, Kelley A; Anderson, Heather; Silverman, Jay G


    Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers. Copyright © 2017 by the Guttmacher Institute.

  10. International experience in controlling pharmaceutical expenditure: influencing patients and providers and regulating industry - a systematic review. (United States)

    Lee, Iyn-Hyang; Bloor, Karen; Hewitt, Catherine; Maynard, Alan


    To review international policies to control expenditure on pharmaceuticals by influencing the behaviour of patients and providers and regulating the pharmaceutical industry. Systematic review of experimental and quasi-experimental studies. Published studies were identified with an electronic search strategy using MEDLINE and EMBASE from 1980 to May 2012. Studies were eligible if they assessed the effect of policies aimed at influencing the behaviour of patients and providers, and regulating the pharmaceutical industry. Outcome measures included pharmaceutical expenditure, prices or utilization; other resource use relating to pharmaceuticals; and health outcomes and patients' or providers' behaviour relating to pharmaceutical use. Quality assessment criteria for each study design were developed based on the standard criteria recommended by the Cochrane Effective Practice and Organisation of Care (EPOC) group. The review includes studies based on randomized controlled trials and rigorous quasi-experimental designs (interrupted time-series and controlled before-and-after studies). Studies were excluded if they were conducted within a single hospital or practice; related to pharmaceutical care services or disease management; had less than 6 months of follow-up period (or less than 12 months overall for interrupted time series); if data in controlled before-and-after studies were not collected contemporaneously or if no rationale was stated for the choice of control group; or if relevant and interpretable data were not presented. A total of 255 studies met the inclusion criteria for this review. The majority of the studies relating to patients evaluated cost sharing interventions such as user charges (52 studies). User charges do reduce utilization of pharmaceuticals, and reduce public expenditure by shifting costs to patients. But they reduce the use of essential as well as non-essential drugs, and without adequate exemptions they affect vulnerable groups

  11. Intensive medical student involvement in short-term surgical trips provides safe and effective patient care: a case review

    Directory of Open Access Journals (Sweden)

    Macleod Jana B


    Full Text Available Abstract Background The hierarchical nature of medical education has been thought necessary for the safe care of patients. In this setting, medical students in particular have limited opportunities for experiential learning. We report on a student-faculty collaboration that has successfully operated an annual, short-term surgical intervention in Haiti for the last three years. Medical students were responsible for logistics and were overseen by faculty members for patient care. Substantial planning with local partners ensured that trip activities supplemented existing surgical services. A case review was performed hypothesizing that such trips could provide effective surgical care while also providing a suitable educational experience. Findings Over three week-long trips, 64 cases were performed without any reported complications, and no immediate perioperative morbidity or mortality. A plurality of cases were complex urological procedures that required surgical skills that were locally unavailable (43%. Surgical productivity was twice that of comparable peer institutions in the region. Student roles in patient care were greatly expanded in comparison to those at U.S. academic medical centers and appropriate supervision was maintained. Discussion This demonstration project suggests that a properly designed surgical trip model can effectively balance the surgical needs of the community with an opportunity to expose young trainees to a clinical and cross-cultural experience rarely provided at this early stage of medical education. Few formalized programs currently exist although the experience above suggests the rewarding potential for broad-based adoption.

  12. Patient and provider perceptions of care for diabetes: results of the cross-national DAWN Study

    DEFF Research Database (Denmark)

    Peyrol, Mark; Rubin, Richard R.; Lauritzen, Torsten


    , Europe and North America. Participants were randomly selected adults with type 1 or type 2 diabetes (n=5,104), and randomly selected diabetes-care providers, including primary-care physicians (n=2,070), diabetes specialist physicians (n=635) and nurses (n=1,122). Multivariate analysis was used to examine....... Patients reported moderate levels of collaboration among providers, and providers indicated that several specialist disciplines were not readily available to them. Patients reported high levels of collaboration with providers in their own care. Provider endorsement of primary prevention strategies for type......Aims/hypothesis We assessed country-level and individual-level patterns in patient and provider perceptions of diabetes care. Methods The study used a cross-sectional design with face-to-face or telephone interviews of diabetic patients and healthcare providers in 13 countries from Asia, Australia...

  13. Communication at an online infertility expert forum: provider responses to patients' emotional and informational cues. (United States)

    Aarts, J W M; van Oers, A M; Faber, M J; Cohlen, B J; Nelen, W L D M; Kremer, J A M; van Dulmen, A M


    Online patient-provider communication has become increasingly popular in fertility care. However, it is not known to what extent patients express cues or concerns and how providers respond. In this study, we investigated cues and responses that occur in online patient-provider communication at an infertility-specific expert forum. We extracted 106 threads from the multidisciplinary expert forum of two Dutch IVF clinics. We performed the following analyses: (1) thematic analysis of patients' questions; and (2) rating patients' emotional and informational cues and subsequent professionals' responses using an adaptation of the validated Medical Interview Aural Rating Scale. Frequencies of themes, frequencies of cues and responses, and sequences (what cue is followed by what response) were extracted. Sixty-five infertile patients and 19 providers participated. The most common themes included medication and lifestyle. Patients gave more informational than emotional cues (106 versus 64). Responses to informational cues were mostly adequate (61%). The most common response to emotional cues was empathic acknowledgment (72%). Results indicate that an online expert forum could have a positive effect on patient outcomes, which should guide future research. Offering infertile patients an expert forum to communicate with providers can be a promising supplement to usual care in both providing information and addressing patients' concerns.

  14. Driving While Impaired (DWI) Intervention Service Provider Orientations: The Scales of the DWI Therapeutic Educator Inventory (DTEI) (United States)

    DeMuro, Scott; Wanberg, Kenneth; Anderson, Rachel


    The therapeutic educator who provides services to driving while impaired (DWI) offenders is a unique professional hybrid, combining education and therapeutic service delivery. In an effort to understand and address this service provider, a 69-item DWI Therapeutic Educator Inventory (DTEI) was constructed. Using principal components and common…

  15. Health care providers underestimate symptom intensities of cancer patients: A multicenter European study

    NARCIS (Netherlands)

    Laugsand, E.A.; Sprangers, M.A.G.; Bjordal, K.; Skorpen, F.; Kaasa, S.; Klepstad, P.


    ABSTRACT: BACKGROUND: Many patients with advanced cancer depend upon health care providers for symptom assessment. The extent of agreement between patient and provider symptom assessments and the association of agreement with demographic- and disease-related factors was examined. METHODS: This

  16. Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior

    NARCIS (Netherlands)

    Tai-Seale, M.; Elwyn, G.; Wilson, C.J.; Stults, C.; Dillon, E.C.; Li, M.; Chuang, J.; Meehan, A.; Frosch, D.L.


    Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary

  17. The relative effect of health literacy and patient activation on provider choice in the Netherlands.

    NARCIS (Netherlands)

    Rademakers, J.; Nijman, J.; Brabers, A.E.M.; Jong, J.D. de; Hendriks, M.


    Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their rightto, choose. Both health literacy and patient activation are likely to have an impact on the choiceprocess.In,this article

  18. Elements of patient-health-care provider communication related to cardiovascular rehabilitation referral. (United States)

    Pourhabib, Sanam; Chessex, Caroline; Murray, Judy; Grace, Sherry L


    Cardiovascular rehabilitation has been designed to decrease the burden of cardiovascular disease. This study described (1) patient-health-care provider interactions regarding cardiovascular rehabilitation and (2) which discussion elements were related to patient referral. This was a prospective study of cardiovascular patients and their health-care providers. Discussion utterances were coded using the Roter Interaction Analysis System. Discussion between 26 health-care providers and 50 patients were recorded. Cardiovascular rehabilitation referral was related to greater health-care provider interactivity (odds ratio = 2.82, 95% confidence interval = 1.01-7.86) and less patient concern and worry (odds ratio = 0.64, 95% confidence interval = 0.45-0.89). Taking time for reciprocal discussion and allaying patient anxiety may promote greater referral. © The Author(s) 2014.

  19. Addressing Barriers to Shared Decision Making Among Latino LGBTQ Patients and Healthcare Providers in Clinical Settings (United States)

    Lopez, Fanny Y.; DeMeester, Rachel H.; Jia, Justin L.; Peek, Monica E.; Vela, Monica B.


    Abstract Effective shared decision making (SDM) between patients and healthcare providers has been positively associated with health outcomes. However, little is known about the SDM process between Latino patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), and their healthcare providers. Our review of the literature identified unique aspects of Latino LGBTQ persons’ culture, health beliefs, and experiences that may affect their ability to engage in SDM with their healthcare providers. Further research needs to examine Latino LGBTQ patient–provider experiences with SDM and develop tools that can better facilitate SDM in this patient population. PMID:27617356

  20. The patient-provider relationship and antenatal care uptake at two ...

    African Journals Online (AJOL)

    Background In post-stroke patients, impairment of quality of life (QOL) has been associated with functional impairment, age, anxiety, depression, and fatigue. Good social support, higher education, and better socioeconomic status are associated with better QOL among stroke survivors. In Africa, studies from Nigeria and ...

  1. Patients who feel judged about their weight have lower trust in their primary care providers. (United States)

    Gudzune, Kimberly A; Bennett, Wendy L; Cooper, Lisa A; Bleich, Sara N


    To evaluate whether overweight and obese patients have less trust in their primary care providers (PCPs) if they feel judged about their weight by these PCPs. We conducted a national internet-based survey of 600 adults engaged in primary care with a BMI ≥ 25 kg/m(2) in 2012. Our dependent variable was high patient trust in their PCP (score ≥ 8/10). Our independent variable was "feeling judged about my weight by my PCP" dichotomized as "often/sometimes" versus "never." We conducted a multivariate logistic regression model adjusted for patient and PCP factors using survey weights. Overall, 21% felt that their PCP judged them about their weight. Respondents who perceived judgment were significantly less likely to report high trust in their PCP [OR 0.55, 95% CI 0.31-0.98]. While only a fifth of overweight and obese patients perceived weight-related judgment from their PCPs, these patients were significantly less likely to report high trust in these providers. Given patients' decreased trust in providers who convey weight-related judgment, our results raise concerns about potential effects on the doctor-patient relationship and patient outcomes. Addressing provider stigma toward patients with obesity could help build trust in these patient-provider relationships and improve quality of care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care. (United States)

    Dawson-Rose, Carol; Cuca, Yvette P; Webel, Allison R; Solís Báez, Solymar S; Holzemer, William L; Rivero-Méndez, Marta; Sanzero Eller, Lucille; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B; Ntsayagae, Esther I; Shaibu, Sheila; Corless, Inge B; Wantland, Dean; Lindgren, Teri


    Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives. (United States)

    Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J


    Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.

  4. Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease. (United States)

    Cass, Sarah; Ball, Lauren; Leveritt, Michael


    Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

  5. The effects of patient education on patient safety: can we change patient perceptions and attitudes?: Lessons from the Armed Forces Capital Hospital in Korea. (United States)

    An, JinOk; Kim, Seung Ju; Park, Sohee; Moon, Ki Tae; Park, Eun-Cheol


    Strategies to promote patient involvement in medical error prevention have been implemented, but little is known about the effects of education on changes in perceptions and attitudes about patients' own safety. We administered a survey to military personnel admitted to the Armed Forces Capital Hospital. Responses were classified according to perception and attitude. Single military hospital in Korea. A total of 483 completed surveys were included in our study; 252 of the respondents received safety education at admission. We provided educational program material to one-half of the patients at admission (intervention group). The other one-half of patients received no safety education (non-intervention group). We then performed two rounds of a self-administered survey, based on whether the patient received patient safety education. Cronbach's alpha was calculated to determine scale score reliability. Regression analysis was used to evaluate associations between education and change in scores. Scores for perception and attitude were greater in the intervention group. The results of the regression analysis revealed that compared with the non-intervention respondents, the respondents who received education had higher perception (estimate: 7.809, P patient education was associated with higher scores in both perception and attitudes about safety. To improve patient engagement in this area, efficient methods that encourage patient empowerment should be developed. Specialized health care providers who provide patient level education are needed to achieve a satisfactory patient safety climate.

  6. [Review of drug information provided to patients from the viewpoint of hospital pharmacists]. (United States)

    Orii, Takao


    Risks for patients and consumers can be minimized depending on how they are provided appropriate drug information. Therefore, from the viewpoint of hospital pharmacists, I would like to report on how information should be provided in order to minimize patient risk. For example, there is an ongoing opinion that the provision of easy-to-understand drug information to patients and consumers "does not appear necessary". The reasons for this include the following: Because the level of understanding varies greatly among patients, it is difficult to define what "easy-to-understand" information entails; rather, it may cause misunderstanding. These problems occur repeatedly if they are resolved by individual institutions. Therefore, it is essential to standardize the drug information provided to patients, that is, to establish a system to transmit drug information to patients and consumers. Regardless of whether the development of a hospital information system is in progress or not, it can be said that the development of such information systems is gradually spreading outside of hospitals and the situation is changing. From the viewpoint of patients, medical services are not limited to those from hospitals. Patient-centered collaboration between hospitals/clinics and pharmacies (but not the collaboration between hospital pharmacists and community pharmacists (why not?)) can provide good medical services only if patient information is shared. It is essential to establish a system for providing a drug guide for patients, in order to have patients understand drug information. The preparation of Drug Information for Patients would provide health care specialists a communication tool that helps minimize patient risk.

  7. Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support

    DEFF Research Database (Denmark)

    Byrne, J. L.; Davies, Melanie J; Willaing, I.


    : The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management......Aims: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Methods: A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17...... in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different...

  8. Colorectal cancer screening at US community health centers: Examination of sociodemographic disparities and association with patient-provider communication. (United States)

    Lin, Sue C; McKinley, Duane; Sripipatana, Alek; Makaroff, Laura


    Colorectal cancer (CRC) screening rates are low among underserved populations. High-quality patient-physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient-provider communication on the receipt of CRC screening among HC patients. Using 2014 Health Center Patient Survey data, bivariate and multivariate analyses examined the association of sociodemographic variables (sex, race/ethnicity, age, geography, preferred language, household income, insurance, and employment status) and patient-provider communication with the receipt of CRC screening. Patients between the ages of 65 and 75 years (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.33-4.64) and patients not in the labor force (aOR, 2.32; 95% CI, 1.37-3.94) had higher odds of receiving CRC screening, whereas patients who were uninsured (aOR, 0.33; 95% CI, 0.18-0.61) and patients who were non-English-speaking (aOR, 0.42; 95% CI, 0.18-0.99) had lower odds. Patient-provider communication was not associated with the receipt of CRC screening. The CRC screening rate for HC patients was 57.9%, whereas the rate was 65.1% according to the 2012 Behavioral Risk Factor Surveillance System and 58.2% according to the 2013 National Health Interview Survey. The high ratings of patient-provider communication, regardless of the screening status, suggest strides toward a patient-centered medical home practice transformation that will assist in a positive patient experience. Addressing the lack of insurance, making culturally and linguistically appropriate patient education materials available, and training clinicians and care teams in cultural competency are critical for increasing future CRC screening rates. Cancer 2017

  9. If you teach them, they will come: providers' reactions to incorporating pleasure into youth sexual education. (United States)

    Oliver, Vanessa; van der Meulen, Emily; June, Larkin; Flicker, Sarah


    Sexual pleasure and satisfaction are integral components of the human sexual experience, yet these crucial aspects of sexuality are rarely placed on sexual education agendas. The objective of this paper is to explore the ways in which various groups of Service Providers (SPs) participating in the Toronto Teen Survey (TTS) understand the role of pleasure in sexual education for youth, highlighting the challenges and benefits of teaching pleasure in diverse settings. The TTS employed a community-based research (CBR) methodology. Between December 2006 and August 2007, 1,216 surveys were collected from youth in over 90 different community-based settings across Toronto by youth peer researchers. In 2008, 13 follow-up focus groups were conducted with 80 service providers from 55 different agencies around the Greater Toronto Area. All transcripts were input into qualitative data management software, NVIVO. Coding and analysis of data employed the constant comparative method. SPs had a number of competing opinions about the inclusion of pleasure in sexual health education and programming. These concerns can be divided into three major areas: placing pleasure on the agenda; the role of gender in pleasure education; and the appropriate spaces and professionals to execute a pleasure-informed curriculum. Access to resources, training and personal background determine SPs' willingness and ability to engage in the pedagogy of sexual pleasure. Medically trained clinicians were less likely to see themselves as candidates for instructing youth on issues of pleasure, believing that public health and health promotion professionals were more adequately trained and organizationally situated to deliver those services.

  10. Providing Effective Professional Development for Teachers through the Lunar Workshops for Educators (United States)

    Canipe, Marti; Buxner, Sanlyn; Jones, Andrea; Hsu, Brooke; Shaner, Andy; Bleacher, Lora


    In order to integrate current scientific discoveries in the classroom, K-12 teachers benefit from professional development and support. The Lunar Workshops for Educators is a series of weeklong workshops for grade 6-9 science teachers focused on lunar science and exploration, sponsored by the Lunar Reconnaissance Orbiter (LRO) and conducted by the LRO Education and Public Outreach (E/PO) Team. The Lunar Workshops for Educators, have provided this professional development for teachers for the last five years. Program evaluation includes pre- and post- content tests and surveys related to classroom practice, daily surveys, and follow-up surveys conducted during the academic year following the summer workshops to assess how the knowledge and skills learned at the workshop are being used in the classroom. The evaluation of the workshop shows that the participants increased their overall knowledge of lunar science and exploration. Additionally, they gained knowledge about student misconceptions related to the Moon and ways to address those misconceptions. The workshops impacted the ways teachers taught about the Moon by providing them with resources to teach about the Moon and increased confidence in teaching about these topics. Participants reported ways that the workshop impacted their teaching practices beyond teaching about the Moon, encouraging them to include more inquiry and other teaching techniques demonstrated in the workshops in their science classes. Overall, the program evaluation has shown the Lunar Workshops for Educators are effective at increasing teachers’ knowledge about the Moon and use of inquiry-based teaching into their classrooms. Additionally, the program supports participant teachers in integrating current scientific discoveries into their classrooms.

  11. Differences between patient and provider perceptions of informed decision making about epidural analgesia use during childbirth. (United States)

    Goldberg, Holly Bianca; Shorten, Allison


    The objective of this study was to determine whether differences exist between patient and provider perceptions regarding the decision-making process around use of epidural analgesia during childbirth. The dyadic patient-provider Decisional Conflict Scale was modified to measure first-time mother (n = 35) and maternity care provider (n = 52) perceptions. Providers perceived a greater degree of informed decision making than patients (84.97 vs. 79.41, p = .04) and were more likely to recall they upheld patients' rights to make informed choices than patients were to perceive their rights had been upheld (85.95 vs. 71.73, p < .01). This incongruity highlights the need to align legal principles with practice to create mutual agreement between stakeholder perceptions of informed decision making.

  12. Evaluating Patient Preferences for Different Incentive Programs to Optimize Pharmacist-Provided Patient Care Program Enrollment. (United States)

    Tomaszewski, Daniel; Cernohous, Tim; Vaidyanathan, Rajiv


    Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM). To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference. This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTM-eligible beneficiaries from 2 employer groups and included MTM-naive and MTM-experienced participants. Incentive preference was measured based on 3 bipolar scales that compared 3 incentives: $100 gift certificates, $8 copay reduction for 6 months, and $100 added to paycheck. A total of 72 participants completed the survey: 34 participants were MTM experienced, and 38 were MTM naive. Overall participant preference reporting resulted in inconsistencies. Copay reduction was preferred to a gift certificate (55.6% vs. 37.5%); money in paycheck was preferred over copay reduction (48.6% vs. 40.3%); and gift certificates were preferred over money in paycheck (56.9% vs. 22.2%). However, subgroup analysis resulted in a more consistent preference reporting, with MTM-experienced participants consistently preferring copay reduction over gift certificates (67.6% vs. 23.5%) and money in paycheck (55.9% vs. 29.4%). MTM-naive participants preferred a gift certificate over copay reduction (51.4% vs. 44.7%) and cash in paycheck (68.4% vs. 23.7%). The results of this study suggest that gift certificates were preferred by MTM-naive participants, which supports the use of gift certificates as an incentive for MTM-naive patients to enroll in an MTM program. Conversely, the use of a copay reduction program was preferred by MTM

  13. Treating patients with traumatic life experiences: providing trauma-informed care. (United States)

    Raja, Sheela; Hoersch, Michelle; Rajagopalan, Chelsea F; Chang, Priscilla


    and Overview Dentists frequently treat patients who have a history of traumatic events. These traumatic events (including childhood sexual abuse, domestic violence, elder abuse and combat history) may influence how patients experience oral health care and may interfere with patients' engagement in preventive care. The purpose of this article is to provide a framework for how dentists can interact sensitively with patients who have survived traumatic events. The authors propose the trauma-informed care pyramid to help engage traumatized patients in oral health care. Evidence indicates that all of the following play an important role in treating traumatized patients: demonstrating strong behavioral and communication skills, understanding the health effects of trauma, engaging in interprofessional collaboration, understanding the provider's own trauma-related experiences and understanding when trauma screening should be used in oral health practice. Dental patients with a history of traumatic experiences are more likely to engage in negative health habits and to display fear of routine dental care. Although not all patients disclose a trauma history to their dentists, some patients might. The trauma-informed care pyramid provides a framework to guide dental care providers in interactions with many types of traumatized patients, including those who choose not to disclose their trauma history in the context of oral health care.

  14. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. (United States)

    Hesselink, Gijs; Flink, Maria; Olsson, Mariann; Barach, Paul; Dudzik-Urbaniak, Ewa; Orrego, Carola; Toccafondi, Giulio; Kalkman, Cor; Johnson, Julie K; Schoonhoven, Lisette; Vernooij-Dassen, Myrra; Wollersheim, Hub


    Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process. A qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data. The barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process. Our findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients' and families' capabilities, needs and preferences. Future interventions should be directed at healthcare providers' attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families, and between hospital and community care providers.

  15. Applying justice and commitment constructs to patient-health care provider relationships. (United States)

    Holmvall, Camilla; Twohig, Peter; Francis, Lori; Kelloway, E Kevin


    To examine patients' experiences of fairness and commitment in the health care context with an emphasis on primary care providers. Qualitative, semistructured, individual interviews were used to gather evidence for the justice and commitment frameworks across a variety of settings with an emphasis on primary care relationships. Rural, urban, and semiurban communities in Nova Scotia. Patients (ages ranged from 19 to 80 years) with varying health care needs and views on their health care providers. Participants were recruited through a variety of means, including posters in practice settings and communication with administrative staff in clinics. Individual interviews were conducted and were audiotaped and transcribed verbatim. A modified grounded theory approach was used to interpret the data. Current conceptualizations of justice (distributive, procedural, interpersonal, informational) and commitment (affective, normative, continuance) capture important elements of patient-health care provider interactions and relationships. Justice and commitment frameworks developed in other contexts encompass important dimensions of the patient-health care provider relationship with some exceptions. For example, commonly understood subcomponents of justice (eg, procedural consistency) might require modification to apply fully to patient-health care provider relationships. Moreover, the results suggest that factors outside the patient-health care provider dyad (eg, familial connections) might also influence the patient's commitment to his or her health care provider.

  16. Patient-provider perceptions on engagement in HIV care in Argentina. (United States)

    Bofill, Lina Margarita; Lopez, Maria; Dorigo, Analia; Bordato, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernandez; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones, Deborah


    Approximately 30% of patients participating in the national antiretroviral therapy (ART) program in Argentina fail to achieve an undetectable viral load, and approximately 25% are not retained in care. This qualitative study was designed to explore and identify factors associated with engagement and retention in public and private health care in Buenos Aires, Argentina. Qualitative data from key informants (n = 12) and focus groups (n = 4 groups) of patients and providers from private and public HIV treatment facilities were recorded and transcribed. Predetermined and arising themes related to adherence, engagement, and retention in care were coded and analyzed using qualitative data analysis software. Reasons identified for patients' lack of adherence or engagement in care differed between patients and providers, and patients attributed limitations to low self-efficacy, fear and concerns about HIV, and lack of provider involvement in treatment. In contrast, providers viewed themselves as decision-makers in patient care and patients as responsible for their own nonadherence due to lack of commitment to their own health or due to medication side effects. Patients reported health care system limitations and HIV concerns contributed to a lack of engagement, and providers identified limited HIV literacy and stigma as additional problems. Both agreed that chronic illness and substance addiction impacted adherence and retention, and agreed on the importance of trust, honesty, and communication in the patient-provider relationship. Results support the incorporation of system-, provider-, and patient-focused components into interventions to facilitate patient engagement, adherence, and retention in public and private settings in Argentina.

  17. "Delivering knowledge and advice": Healthcare providers' experiences of their interaction with patients' management of rheumatoid arthritis. (United States)

    Bergsten, Ulrika; Bergman, Stefan; Fridlund, Bengt; Arvidsson, Barbro


    Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers' perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers' experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers' attitudes and patients' responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers' experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients' expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

  18. The need to educate primary care physicians to provide oncologic services: a changing focus. (United States)

    Rafla, S; Khafif, R; Ross, P; McGroarty, K


    The traditional role of primary care physicians (PCPs) in cancer care has been primarily cancer detection, and their training and education were similarly oriented. Propelled by the changing health care delivery system, this role is now expanding substantially. A survey of 31 health maintenance organizations active in the New York market area was performed. The HMOs were grouped into three main categories according to method of payment of the physician. Patient care responsibilities vary depending on the method of payment but stay constant within the group. Of 19 HMOs that responded to the survey, 13 had shifted much of the responsibilities for diagnosis and treatment decisions to the PCP. A national survey of all academic radiation oncology program directors in the United States, as well as training programs of primary care physicians, showed a unanimous lack of educational or training programs or opportunities to familiarize the PCP with radiation oncology as a therapeutic discipline and with its after-therapy requirements. This deficiency extended also to multimodality training and other aspects. The internal medicine programs surveyed scored only an average of 1.25 out of a possible 5 in education areas directly related to oncology training. These programs comprised 78% of the residents of all programs surveyed. The information gathered from these surveys reveals a shift towards mandating the provision of oncologic services by PCPs, who have inadequate training in oncology, with no system in place to remedy the deficiencies except on-the-job training. The inevitability of the changing role of the PCP must be accompanied by either an expansion of residency programs to encompass training in important aspects of oncology care or expansion and formalization of continuing education programs to achieve the same objective.

  19. [Development of Internet-based system to collect and provide drug information for patients/consumers]. (United States)

    Kurimoto, Fuki; Hori, Satoko; Satoh, Hiroki; Miki, Akiko; Sawada, Yasufumi


    For drug fostering and evolution, it is important to collect information directly from patients on the efficacy and safety of drugs as well as patient needs. At present, however, information gathered by healthcare professionals, pharmaceutical companies, or governments is not sufficient. There is concern that patients may fail to recognize the importance of providing information voluntarily. The present study was conducted to provide drug information to patients/consumers, to enlighten them on the importance of providing drug information by themselves, and to develop an Internet website, called "Minkusu," for collecting drug information from patients. This website is based on a registration system (free of charge). It is designed to provide information on proper drug use, and to collect opinions about drugs. As of May 31, 2012, a total of 1149 people had been registered. The male/female ratio of registered members was approximately 1:1, and patients/consumers accounted for 23%. According to the results of a questionnaire survey, several patient/consumer members appreciated the usefulness of the information service, and they took an opportunity to know of the concepts of drug development and evolution (Ikuyaku, in Japanese) through the information services provided by this site. In conclusion, the developed information system would contribute to the proper use of drugs by patients/consumers and to the promotion of drug development and evolution.

  20. Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial. (United States)

    Allen, Kelli D; Oddone, Eugene Z; Coffman, Cynthia J; Jeffreys, Amy S; Bosworth, Hayden B; Chatterjee, Ranee; McDuffie, Jennifer; Strauss, Jennifer L; Yancy, William S; Datta, Santanu K; Corsino, Leonor; Dolor, Rowena J


    A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. To examine whether patient-based, provider-based, and patient-provider interventions improve osteoarthritis outcomes. Cluster randomized trial with assignment to patient, provider, and patient-provider interventions or usual care. ( NCT01435109). 10 Duke University Health System community-based primary care clinics. 537 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved electronic delivery of patient-specific osteoarthritis treatment recommendations to providers. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score at 12 months. Secondary outcomes were objective physical function (Short Physical Performance Battery) and depressive symptoms (Patient Health Questionnaire). Linear mixed models assessed the difference in improvement among groups. No difference was observed in WOMAC score changes from baseline to 12 months in the patient (-1.5 [95% CI, -5.1 to 2.0]; P = 0.40), provider (2.5 [CI, -0.9 to 5.9]; P = 0.152), or patient-provider (-0.7 [CI, -4.2 to 2.8]; P = 0.69) intervention groups compared with usual care. All groups had improvements in WOMAC scores at 12 months (range, -3.7 to -7.7). In addition, no differences were seen in objective physical function or depressive symptoms at 12 months in any of the intervention groups compared with usual care. The study involved 1 health care network. Data on provider referrals were not collected. Contrary to a previous study of a combined patient and provider intervention for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically

  1. Educational Needs Assessment of Family Health Providers in Tabriz Health Care Centers in 2015

    Directory of Open Access Journals (Sweden)

    Faranak Ghoreyshyzadeh


    at the same period, staff performance were not desirable in some processes and/or sub-processes. Conclusion: This study demonstrated the educational needs of family health providers in 6 task processes and prioritized them according to their views. Regular and comprehensive educational needs assessments are required to revise staff training programs, in order to give quality services to general population.

  2. High-fidelity multiactor emergency preparedness training for patient care providers. (United States)

    Scott, Lancer A; Maddux, P Tim; Schnellmann, Jennifer; Hayes, Lauren; Tolley, Jessica; Wahlquist, Amy E


    Providing comprehensive emergency preparedness training (EPT) for patient care providers is important to the future success of emergency preparedness operations in the United States. Disasters are rare, complex events involving many patients and environmental factors that are difficult to reproduce in a training environment. Few EPT programs possess both competency-driven goals and metrics to measure life-saving performance during a multiactor simulated disaster. The development of an EPT curriculum for patient care providers-provided first to medical students, then to a group of experienced disaster medical providers-that recreates a simulated clinical disaster using a combination of up to 15 live actors and six high-fidelity human simulators is described. Specifically, the authors detail the Center for Health Professional Training and Emergency Response's (CHPTER's) 1-day clinical EPT course including its organization, core competency development, medical student self-evaluation, and course assessment. Two 1-day courses hosted by CHPTER were conducted in a university simulation center. Students who completed the course improved their overall knowledge and comfort level with EPT skills. The authors believe this is the first published description of a curriculum method that combines high-fidelity, multiactor scenarios to measure the life-saving performance of patient care providers utilizing a clinical disaster scenario with > 10 patients at once. A larger scale study, or preferably a multicenter trial, is needed to further study the impact of this curriculum and its potential to protect provider and patient lives.

  3. Impact of the 'Providing Access to Continued Education' Programme on Repeat Teenage Pregnancy in the Bahamas. (United States)

    Sakharkar, V P; Frankson, M A; Sakharkar, P R


    To determine the relationship of determinants such as age, ethnicity, education and sexual behaviour with repeat teenage pregnancy and to determine the impact of 'Providing Access to Continued Education' (PACE) programme in reducing repeat teenage pregnancy amongst its participants in The Bahamas. This retrospective cohort study included 397 attendees of the Adolescent Health Centre (AHC). Eighty-eight out of 139 registered participants completed the PACE programme. Data on age, ethnicity, education, sexual behaviour and repeat pregnancy in two years were analysed for descriptive statistics, and association of demographic characteristics and participation in the PACE programme with repeat pregnancy using the Chi-squared test. Mean age of participants was 16.4 ± 1.1 years; median school grade and mean grade point average (GPA) was 11 and 1.97 ± 0.7, respectively. The mean age at the first sexual activity was 14.9 ± 1.2 years. The mean age and number of sexual partners were 21 ± 4.3 years and 2 ± 1, respectively. Overall, repeat pregnancy rate was 39%: 37.4% amongst PACE registered and 31.8% amongst PACE completed mothers. No significant difference was observed in repeat pregnancy between registered and non-registered as well as those who completed the programme and those who did not. The odds ratio of 0.525 suggested that completion of the PACE programme had a moderate protective effect on reducing repeat pregnancy. Age, ethnicity, education and sexual behaviour showed no association with repeat pregnancy. The PACE programme did not reduce repeat pregnancy rate significantly. However, completion of the programme offered a moderate protection.

  4. Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care. (United States)

    Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T


    The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

  5. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Ben Mathews

    Full Text Available Early childhood care and education providers (CCPs work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control. Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93; large effect size 0.95, p < 0.001; the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22; negligible effect size 0.03, p = 0.684. Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05. Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior.US National Institutes of Health NCT02225301.

  6. Occupational stress in intensive care nurses who provide direct care to critical patients

    National Research Council Canada - National Science Library

    Inoue, Kelly Cristina; Versa, Gelena Lucinéia Gomes da Silva; Murassaki, Ana Cláudia Yassuko; Melo, Willian Augusto de; Matsuda, Laura Misue


    In order to identify the stress level of nurses that provide direct care to critically ill patients, it was carried out a descriptive and exploratory study in five hospitals of the western region of the state of Paraná...

  7. Providing Dental Care to Pregnant Patients: A Survey of Oregon General Dentists

    National Research Council Canada - National Science Library

    Huebner, Colleen E; Milgrom, Peter; Conrad, Douglas; Lee, Rosanna Shuk Yin


    A growing number of studies and reports indicate preventive, routine and emergency dental procedures can be provided safely to pregnant patients to alleviate dental problems and promote oral health...

  8. Functional Recovery in Major Depressive Disorder: Providing Early Optimal Treatment for the Individual Patient (United States)

    Katzman, Martin A; Habert, Jeffrey; McIntosh, Diane; MacQueen, Glenda M; Milev, Roumen V; McIntyre, Roger S; Blier, Pierre


    Abstract Major depressive disorder is an often chronic and recurring illness. Left untreated, major depressive disorder may result in progressive alterations in brain morphometry and circuit function. Recent findings, however, suggest that pharmacotherapy may halt and possibly reverse those effects. These findings, together with evidence that a delay in treatment is associated with poorer clinical outcomes, underscore the urgency of rapidly treating depression to full recovery. Early optimized treatment, using measurement-based care and customizing treatment to the individual patient, may afford the best possible outcomes for each patient. The aim of this article is to present recommendations for using a patient-centered approach to rapidly provide optimal pharmacological treatment to patients with major depressive disorder. Offering major depressive disorder treatment determined by individual patient characteristics (e.g., predominant symptoms, medical history, comorbidities), patient preferences and expectations, and, critically, their own definition of wellness provides the best opportunity for full functional recovery. PMID:29024974

  9. Dr. Google and Premature Consent: Patients Who Trust the Internet More Than They Trust Their Provider. (United States)

    Davis, John K


    A growing number of patients make up their minds about some medical issue before they see their provider, either by googling their symptoms or asking a friend. They've made up their minds before coming in, and they resist their provider's recommendations even after receiving information and advice from their provider. This is a new kind of medical autonomy problem; it differs from cases of standard consent, futility, or conscientious refusal. Providers sometimes call this problem "Dr. Google." I call it premature consent. Providers may wonder whether these patient decisions command the same deference and respect as other patient decisions. The answer is "no," for these patients are neither fully competent nor properly informed. They typically appear to be competent, but competence includes the ability to deliberate, and they are not deliberating well when they make up their minds before consulting a qualified provider. They seem informed, especially after talking to their provider, but they are misinformed about what sources of medical advice to trust. Moreover, being informed requires believing the information one has received, and these patients sometimes don't believe the information their provider gives them.

  10. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    Anne Kumurenzi


    Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study.Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills.Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

  11. Testing of a Model with Latino Patients That Explains the Links Among Patient-Perceived Provider Cultural Sensitivity, Language Preference, and Patient Treatment Adherence. (United States)

    Nielsen, Jessica D Jones; Wall, Whitney; Tucker, Carolyn M


    Disparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers. The purpose of this study was to examine whether patients' perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients. Data from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients. No significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence. These results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.

  12. External Providers' Sexuality Education Teaching and Pedagogies for Primary School Students in Grade 1 to Grade 7 (United States)

    Goldman, Juliette D. G.


    Many primary school teachers avoid teaching sexuality education. In light of the earlier maturing of both boys and girls, and the educationally and personally significant effects of their experience of puberty, this is unfair to children. In response to this avoidance, however, some schools employ external providers of sexuality education, who…

  13. Older hospitalized patients' experiences of dialogue with healthcare providers in hospitals

    DEFF Research Database (Denmark)

    Nielsen, Gitte; Larsen, Karen Lyng; Uhrenfeldt, Lisbeth


    REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well-being.Specifi......REVIEW QUESTION/OBJECTIVE:: The objective is to identify and synthesize findings from qualitative studies of older (over 65 years) hospitalized patients' experiences of the barriers and facilitators to their dialogues with healthcare providers (HCPs) concerning their health and well...

  14. [The Internet and shared decision-making between patients and healthcare providers]. (United States)

    Silber, Denise


    Insurance companies like Kaiser Permanente in the United States remunerate physicians for their email correspondence with patients, increasing the efficiency of office visits. A survey by the French National Board of Physicians regarding the computerization of medical practices in April 2009, confirms that both physicians and patients in France are very favorable to the development of these tools. When patients can manage and/or access their medical files and determine which providers can access them, they become a true partner.

  15. Internationally Educated Nurses’ and Their Contributions to the Patient Experience (United States)

    Njie-Mokonya, Ndolo


    Internationally educated nurses (IEN) are a group who reflect Canada’s diverse population as a result of rising immigration trends. There is increasing diversity of the general population in Canada and health service disparities exist. Reducing these disparities among the healthcare workforce and the patients they care for is important to meet language and other cultural needs of patients from different ethnic backgrounds. This article describes a study that examined internationally educated nurses’ transition experiences in the field of nursing with the objective of describing their unique contributions to the patient care experience. A review of the literature provides background information, followed by the study methods, findings, and discussion. Descriptive phenomenology guided this qualitative study that included 11 participants. Findings from this study illustrate how IENs perceive themselves as an asset to nursing and patient care. Implications for the future of nursing education, practice, research, and administration are offered. Healthcare providers that reflect the diversity of Canada’s population and can offer unique cultural perspective have potential to improve the patient experience during a hospital stay.

  16. Negotiating substance use stigma: the role of cultural health capital in provider-patient interactions. (United States)

    Chang, Jamie; Dubbin, Leslie; Shim, Janet


    Diverse aspects of life and lifestyles, including stigmatised attributes and behaviors are revealed as providers and patients discuss health. In this article, we examine how the stigma associated with substance use issues shapes clinical interactions. We use the theoretical framework of cultural health capital (CHC) to explain how substance use stigma is created, reinforced and sometimes negotiated as providers and patients engage in health interactions. We present two main findings using examples. First, two theoretical concepts--habitus and field--set the social position and expectations of providers and patients in ways that facilitate the stigmatisation of substance use. Second, we found both providers and patients actively exchanged CHC as a key strategy to reduce the negative effects of stigma. In some clinical encounters, patients possessed and activated CHC, providers acknowledged patient's CHC and CHC was successfully exchanged. These interactions were productive and mutually satisfying, even when patients were actively using substances. However, when CHC was not activated, acknowledged and exchanged, stigma was unchallenged and dominated the interaction. The CHC theoretical framework allows us to examine how the stigma process is operationalized and potentially even counteracted in clinical interactions. © 2015 Foundation for the Sociology of Health & Illness.

  17. Hospital-community interface: a qualitative study on patients with cancer and health care providers' experiences. (United States)

    Admi, Hanna; Muller, Ella; Ungar, Lea; Reis, Shmuel; Kaffman, Michael; Naveh, Nurit; Shadmi, Efrat


    Patients with cancer must deal with complex and fragmented healthcare systems in addition to coping with the burden of their illness. To improve oncology treatment along the care continuum, the barriers and facilitators for streamlined oncologic care need to be better understood. This study sought to gain insight into the hospital-community interface from the point of view of patients with cancer, their families, and health care providers on both sides of the interface i.e., the community and hospital settings. The sample comprised 37 cancer patients, their family members, and 40 multidisciplinary health care providers. Twelve participants were interviewed individually and 65 took part in 10 focus groups. Based on the grounded theory approach, theoretical sampling and constant comparative analyses were used. Two major concepts emerged: "ambivalence and confusion" and "overcoming healthcare system barriers." Ambiguity was expressed regarding the roles of health care providers in the community and in the hospital. We identified three main strategies by which these patients and their families overcame barriers within the system: patients and families became their own case managers; patients and health care providers used informal routes of communication; and nurse specialists played a significant role in managing care. The heavy reliance on informal routes of communication and integration by patients and providers emphasizes the urgent need for change in order to improve coordinating mechanisms for hospital-community oncologic care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.

    LENUS (Irish Health Repository)

    Carney, John


    Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.

  19. [Patients, clients, doctors and providers: is it just a question of terminology?]. (United States)

    Ayuzo Del Valle, Cipatli


    With the modernization of healthcare and management of a Hospital as a bussiness, There is the risk of changing the words "patient" and "doctor" into "client" and "provider", risking the humanitarian care, thrustworthiness, and doctor-patient relationship. Using first and last names could be an option for communication.

  20. Qualities of care managers in chronic disease management: patients and providers' expectations. (United States)

    Dejesus, Ramona S; Vickers, Kristin S; Howell, Lisa A; Stroebel, Robert J


    The collaborative care model has been shown in studies to be effective in achieving sustained treatment outcomes in chronic disease management. Its success is highly dependent on active patient engagement, provider endorsement and effective care management. This study sought to ask patients and providers what qualities they look for in a care manager. A questionnaire with 3 open ended questions was mailed out randomly to 1000 patients residing in Olmsted County, MN identified through the registry to have type 2 diabetes mellitus. Forty-two primary care providers received similar questionnaire with 2 open ended questions. Answers were qualitatively analyzed using coding and identification of major themes. One hundred seventy-five patients and 22 providers responded. Both groups listed being knowledgeable, having good communication skills and certain personality traits as common themes on what are desirable qualities in a care manager. Patients felt that a care manager would be most helpful by being accessible. Providers listed undesirable qualities to include not being a team player and not knowing practice limitations. Both patients and providers have clear expectations of a care manager which carry significant implications in recruiting and training care managers for chronic disease management. Copyright © 2012 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  1. The relation between patient education, patient empowerment and patient satisfaction: A cross-sectional-comparison study. (United States)

    Yeh, Mei-Yu; Wu, Shu-Chen; Tung, Tao-Hsin


    Patient empowerment is a paradigm of clinical practice. The goal of patient empowerment is to lead patients' health and wellbeing. The aim of this study is to evaluate the relation between patient education, patient empowerment and patient satisfaction based on multi-hospital cross-sectional study design in Taiwan. In this cross-sectional survey, 609 inpatients in four teaching hospitals in northern Taiwan from August 2009 to July 2010 were recruited. Data were collected using Chinese version of the Patient Perceptions of Empowerment Scale (PPES), Sufficiency of Patient Education Questionnaire (SPEQ) and Patient Satisfaction Questionnaire (PSQ). The multiple linear regression model was used to assess the independent effects of relevant factors on patient empowerment after controlling for the covariates. The overall mean empowerment scores was 44.80±5.94. There was a significant difference between the total scores and four dimensions of patient empowerment at different hospitals (t=5.44, p≤0.01). Sufficient patient education (β=0.568, 95%CI: 0.486-0.649) and patient satisfaction (β=0.317, 95%CI: 0.259-0.375) could significantly predict patient empowerment based on the multiple linear regression analysis, with a total variance was 54.4%. In conclusion, both sufficient patient education and patient satisfaction were positively related to patient empowerment. Hospitals in Taiwan should try to improve their patients' active involvement toward empowerment. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The meaning of providing caring to obese patients to a group of nurses

    Directory of Open Access Journals (Sweden)

    Emilly Souza Marques


    Full Text Available This qualitative study was performed with six nurses of a public hospital, with the objective to describe their view of the meaning of providing care to obese patients. Interviews were conducted using a semi-structured script. The data were organized under themes extracted from the subjects’ statements, after being thoroughly read. Symbolic Interactionism was adopted to interpret the findings. The results from the analysis were organized under the following themes: Being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. The grasped meanings can interfere in the care provided. The nurses, however, recognize the need to work as a team to deliver comprehensive care. Making positive changes to the meanings found in this study is possible, thus, contributing to providing prejudice-free nursing care to obese patients. Descriptors: Obesity; Nursing Care; Hospital Care.

  3. Reasons military patients with primary care access leave an emergency department waiting room before seeing a provider. (United States)

    Varney, Shawn M; Vargas, Toni E; Pitotti, Rebecca L; Bebarta, Vikhyat S


    Our objective was to assess patients' understanding of emergency department (ED) wait times and why patients may leave the waiting room before seeing a provider. Survey of patients in the ED waiting room of an urban tertiary care military hospital where civilian and military patients are treated. A total of 508/517 surveys (98%) were completed. Age ranges were 18 to 35 years (49%), 36 to 60 (31%), or older than 60 (20%). Education levels were high school (20%), some college (37%), or college graduate (39%). Of 503 respondents, 125 (25%) had left an ED waiting room before seeing a provider. The reasons included excessive wait times (91%) and family responsibilities (5%). Five hundred eight reported the factors that would motivate them to wait to see the physician (not leave without being seen [LWOBS]) were the severity of illness (64%), and if they received an update of wait times (26%); 82% (391/480) understood that severely ill patients were seen first. Patients attributed long wait times to doctors and nurses caring for other patients (292/583, 50%) and insufficient physician and nurse staffing (245, 42%). Of 802 responses for ideas to improve the wait, 34% said regular updates on estimated wait times, 21% said television shows or movies to view, 20% said books and magazines to read, and 11% said computers to access. Long wait times were the primary reason that patients left before seeing a provider, despite having ready access to care. Respondents attributed long wait times to patient volume and inadequate staffing. Regular updates on wait times and material for entertainment may improve the waiting experience and reduce LWOBS.

  4. Oncology nursing: educating advanced practice nurses to provide culturally competent care. (United States)

    Yeo, Theresa Pluth; Phillips, Janice; Delengowski, Anne; Griffiths, Margaret; Purnell, Larry


    More than 37 million persons or 12.4% of the U.S. population are older than 65 years. These numbers are expected to reach 71.5 million (20% of the population) by 2030. This older population is becoming more racially and ethnically diverse as the overall minority and culturally diverse populations increase. Although the incidence and mortality rates from several major cancers have declined due to advances in cancer care, these advances have lagged among the underserved and more vulnerable racially and culturally diverse populations. Moreover, the disparity between the gender and the racial mix of nurses and the overall population continues to widen. Thus, a growing need for professional nurses and advanced practice nurses with formal educational preparation in all areas of oncology nursing exists. This article (a) highlights significant cancer disparities among diverse populations, (b) describes how cultural belief systems influence cancer care and decision making, and (c) explicates the need to prepare advanced practice nurses for careers that include cancer care of diverse and vulnerable populations through formal oncology educational programs. The "Top 10" reasons for becoming an advanced practice nurse specializing in the oncologic care of patients from diverse and underserved populations are presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Education of Elderly Patients Within Nursing Care in Slovakia

    Directory of Open Access Journals (Sweden)

    Kaduchová Petra


    Full Text Available Introduction: The paper deals with the issues of the education of senior patients within nursing care. The aim of the paper is to find out the level of nurses’ knowledge and skills in educating elderly patients and to discover how these are reflected in the reality of clinical practice. It is a case study focused on showing the current real state of clinical practice related to the given topic. Methods: This paper will introduce the outcomes of a qualitative research (semistructured interview, semi-structured observation, documents analysis based on theoretical background. The research was carried out during the survey fellowship in the Slovak Republic and the respondents were nurses working in standard hospital departments. Certain phenomena, relations and influencing factors were clarified through the follow-up analysis. The gathered data were processed by using qualitative methods in the form of case studies. Results: The qualitative survey has revealed certain deficiencies in nurses’ knowledge and in the reality of the education of elderly patients in clinical practice. Discussion: The deficiencies in knowledge and skills are essential in the reality of clinical practice. Limitations: The research sample was made up of educating nurse/nurses working in geriatrics, in long-term care departments or internal departments. It included a total of 16 respondents. Conclusions: Sufficient attention should be paid to the training of nurses which should be focused on the specificities of educating seniors/senior patients as well as on the reality of education that is performed. It is necessary to provide training for working with this specific age group even in pre-gradual nursing education.

  6. Feasibility of Providing Web-Based Information to Breast Cancer Patients Prior to a Surgical Consult. (United States)

    Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Mahoney, Jane E; Neuman, Heather B


    Patients facing decisions for breast cancer surgery commonly search the internet. Directing patients to high-quality websites prior to the surgeon consultation may be one way of supporting patients' informational needs. The objective was to test an approach for delivering web-based information to breast cancer patients. The implementation strategy was developed using the Replicating Effective Programs framework. Pilot testing measured the proportion that accepted the web-based information. A pre-consultation survey assessed whether the information was reviewed and the acceptability to stakeholders. Reasons for declining guided refinement to the implementation package. Eighty-two percent (309/377) accepted the web-based information. Of the 309 that accepted, 244 completed the pre-consultation survey. Participants were a median 59 years, white (98%), and highly educated (>50% with a college degree). Most patients who completed the questionnaire reported reviewing the website (85%), and nearly all found it helpful. Surgeons thought implementation increased visit efficiency (5/6) and would result in patients making more informed decisions (6/6). The most common reasons patients declined information were limited internet comfort or access (n = 36), emotional distress (n = 14), and preference to receive information directly from the surgeon (n = 7). Routine delivery of web-based information to breast cancer patients prior to the surgeon consultation is feasible. High stakeholder acceptability combined with the low implementation burden means that these findings have immediate relevance for improving care quality.

  7. Barriers of healthcare providers against end-of-life discussions with pediatric cancer patients. (United States)

    Yoshida, Saran; Shimizu, Ken; Kobayashi, Mariko; Inoguchi, Hironobu; Oshima, Yoshio; Dotani, Chikako; Nakahara, Rika; Takahashi, Tomomi; Kato, Masashi


    End-of-life discussions with patients can be one of the most difficult and stressful tasks for the oncologist. However, little is known about the discussions that healthcare providers have with patients in such situations and the difficulties they face. The primary end points of this study were to describe the contents of end-of-life discussion in the pediatric setting and the barriers to end-of-life discussion for pediatric patients, as perceived by pediatric healthcare providers. Participants were 10 healthcare providers. Semi-structured interviews were conducted, and the KJ method was performed to analyze the data. We found 23 barriers against end-of-life discussion with pediatric cancer patients. These barriers were classified as follows: healthcare provider factors, patient factors, parent factors and institutional or cultural factors. In addition to barriers found in previous studies, some unique barriers were uncovered such as, 'Lack of confidence to face the patient after the discussion', 'Uncertain responsibility for treatment decision-making' and 'No compelling reason to discuss'. Healthcare providers actively discussed the purpose of treatment and the patients' wishes and concerns; however, they were reluctant to deal with the patients' own impending death and their estimated prognosis. End-of-life discussion with pediatric patients differs from that with adult patients. Further studies are required to analyze pediatric cases associated with end-of-life discussion and carefully discuss its adequacy, pros and cons. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  8. Expanding The Rubric of "Patient-Centered Care" (PCC) to "Patient and Professional Centered Care" (PPCC) to Enhance Provider Well-Being. (United States)

    Post, Stephen G; Roess, Michael


    Burnout among physicians, nurses, and students is a serious problem in U.S. healthcare that reflects inattentive management practices, outmoded images of the "good" provider as selflessly ignoring the care of the self, and an overarching rubric of Patient Centered Care (PCC) that leaves professional self-care out of the equation. We ask herein if expanding PCC to Patient and Professional Centered Care (PPCC) would be a useful idea to make provider self-care an explicit part of mission statements, a major part of management strategies and institutional goal setting, and of educational programs. We offer several practical suggestions for PPCC implementation, including structuring healthcare systems so as to nurture professional meaning, integrity, and inter-personal reflective emotional processing as a buffer against burnout and as a key to better patient care. It should not bring into question the primacy of practitioner commitment to the good of patients, nor should it be taken to suggest in any way a shift in focus away from patients' values and respect for patient autonomy. PPCC asserts that the respect for patient's values and autonomous choices properly remains the ethical benchmark of modern healthcare systems, along with altruistic professional commitment to the optimal care of patients. However, it enunciates an explicit commitment to structuring systems that allow for and actively encourage the professional well-being and wellness upon which good patient care depends.

  9. Patient and Referring Provider Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery: A Systematic Review (United States)

    Funk, Luke M.; Jolles, Sally; Fischer, Laura E.; Voils, Corrine I


    Importance Although bariatric surgery is the most cost-effective treatment for severe obesity, less than 1% of severely obese patients undergo it. Reasons for low utilization are unclear. Objectives To identify patient and referring provider characteristics associated with the likelihood of undergoing bariatric surgery. Evidence Review PubMed, PsycINFO, CINAHL, and the Cochrane databases were searched for reports published between January 1, 1998, and December 31, 2014. Reports were eligible if they presented descriptive data regarding facilitators or barriers to bariatric surgery or if they reported statistical associations between patient or provider characteristics and referral to or receipt of bariatric surgery. Frequency effect sizes were calculated as the proportion of studies reporting a finding. Findings Of the 7,212 reports identified in the initial search, 53 were included in full-text review. Nine reports met our inclusion criteria and were included in analyses. Of those, four included descriptive findings, six reported statistical associations, and one included both. One report included providers as study participants, whereas eight included patients. Four of nine studies identified an association between female gender and a greater willingness to undergo bariatric surgery. Lack of knowledge about bariatric surgery was a barrier in two studies. Five of nine cited patient concerns about the outcomes and safety of bariatric surgery as a barrier to undergoing it. Patients were more likely to pursue bariatric surgery when it was recommended by referring providers. Providers who believed that obesity treatment should be covered by insurance were more likely to recommend bariatric surgery. Conclusions and Relevance Limited patient and referring provider knowledge about the safety and effectiveness of bariatric surgery are important barriers to bariatric surgery utilization. Future efforts focused on improving knowledge and identification of the critical

  10. Patient-provider discussions about colorectal cancer screening: who initiates elements of informed decision making? (United States)

    Katz, Mira L; Broder-Oldach, Ben; Fisher, James L; King, Justin; Eubanks, Kathy; Fleming, Kelly; Paskett, Electra D


    Colorectal cancer (CRC) screening rates remain low among low-income minority populations. To evaluate informed decision making (IDM) elements about CRC screening among low-income minority patients. Observational data were collected as part of a patient-level randomized controlled trial to improve CRC screening rates. Medical visits (November 2007 to May 2010) were audio-taped and coded for IDM elements about CRC screening. Near the end of the study one provider refused recording of patients' visits (33 of 270 patients). Among all patients in the trial, agreement to be audio taped was 43.5 % (103/237). Evaluable patient (n = 100) visits were assessed for CRC screening discussion occurrence, IDM elements, and who initiated discussion of each IDM element. Patients were African American (72.2 %), female (63.7 %), with annual household incomes IDM elements was five; however, only two visits included five elements. The most common IDM element discussed in addition to the nature of the decision was the assessment of the patient's understanding in 16 (33.3 %) of the visits that included a CRC discussion. A patient activation intervention initiated CRC screening discussions with health care providers; however, limited IDM occurred about CRC screening during medical visits of minority and low-income patients.

  11. Family physicians' self-perceived importance of providing genetic test information to patients: a cross-sectional study from Slovenia. (United States)

    Klemenc-Ketis, Zalika; Peterlin, Borut


    Management of patients with genetic problems, including provision of genetic testing, is increasingly becoming a part of primary health care. The aim of this study was to determine the family physicians' (FPs) self-perceived importance of providing genetic test information to their patients. This was an observational cross-sectional postal study in the whole population of Slovenian family physicians (N=950). Its main outcome measure was the perceived importance of providing genetic test information on each of 10 items on a 5-point Likert scale. There were 271 (27.1% response rate) FPs that completed the questionnaire, out of which 205 (75.6%) were women. Mean age of the sample was 45.5 ± 10.6 years. More than 90% of Slovene FPs felt that it was their professional duty to discuss genetic testing issues with their patients. They were particularly prone to discuss clinical implications of positive and negative test results, as well as giving the patients information about the risk of passing a mutation onto children. Most Slovene family physicians feel responsible and willing to offer and discuss genetic testing and implications with their patients. Additional education should be provided to empower them for this task.

  12. Patient education process in teaching hospitals of Tehran University of Medical Sciences. (United States)

    Seyedin, Hesam; Goharinezhad, Salime; Vatankhah, Soodabeh; Azmal, Mohammad


    Patient education is widely recognized as a core component of nursing. Patient education can lead to quality outcomes including adherence, quality of life, patients' knowledge of their illness and self-management. This study aimed to clarify patient education process in teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) in Iran. This cross-sectional study was conducted in 2013. In this descriptive quantitative study, the sample covered 187 head nurses selected from ten teaching hospitals through convenience sampling. Data were collected with a questionnaire developed specifically for this study. The questionnaire measured patient education process in four dimensions: need assessment, planning, implementing and evaluating. The overall mean score of patient education was 3.326±0.0524. Among the four dimensions of the patient education process, planning was in the highest level (3.570±0.0591) and the lowest score belonged to the evaluation of patient education (2.840 ±0.0628). Clarifying patient education steps, developing standardized framework and providing easily understandable tool-kit of the patient education program will improve the ability of nurses in delivering effective patient education in general and specialized hospitals.

  13. Providing physicians with feedback on how they supervise students during patient contacts. (United States)

    Dolmans, D H J M; Wolfhagen, H A P; Gerver, W J; De Grave, W; Scherpbier, A J J A


    In this descriptive study an instrument is presented that has been developed to provide physicians with feedback about their strengths and weaknesses in facilitating student learning during patient contacts. The instrument is strongly theory based, i.e. it is based on current general theories of context-bound learning environments, and forms of facilitation promoting transfer of knowledge to actual professional practice. In addition, it has been developed in cooperation with physicians supervising students during patient contacts. The authors have shown how physicians can be provided with individualized feedback on their performance in supervising students during patient contacts.

  14. “Let Me Tell You About My…” Provider Self-Disclosure in the Emergency Department Builds Patient Rapport

    Directory of Open Access Journals (Sweden)

    Zink, Korie


    Full Text Available As patients become increasingly involved in their medical care, physician-patient communication gains importance. A previous study showed that physician self-disclosure (SD of personal information by primary care providers decreased patient rating of the provider communication skills. The objective of this study was to explore the incidence and impact of emergency department (ED provider self-disclosure on patients’ rating of provider communication skills. A survey was administered to 520 adult patients or parents of pediatric patients in a large tertiary care ED during the summer of 2014. The instrument asked patients whether the provider self-disclosed and subsequently asked patients to rate providers’ communication skills. We compared patients’ ratings of communication measurements between encounters where self-disclosure occurred to those where it did not. Patients reported provider SD in 18.9% of interactions. Provider SD was associated with more positive patient perception of provider communication skills (p<0.05, more positive ratings of provider rapport (p<0.05 and higher satisfaction with provider communication (p<0.05. Patients who noted SD scored their providers’ communication skills as “excellent” (63.4% compared to patients without selfdisclosure (47.1%. Patients reported that they would like to hear about their providers’ experiences with a similar chief complaint (64.4% of patients, their providers’ education (49%, family (33%, personal life (21% or an injury/ailment unlike their own (18%. Patients responded that providers self-disclose to make patients comfortable/at ease and to build rapport. Provider self-disclosure in the ED is common and is associated with higher ratings of provider communication, rapport, and patient satisfaction. [West J Emerg Med. 2017;18(143-49.

  15. Patient satisfaction with the quality of dental treatment provided by interns

    Directory of Open Access Journals (Sweden)

    Kun-Tsung Lee


    Conclusion: Medical centers should guide interns in clinical cases and provide structured training. These measures could enhance the public's confidence in interns and improve patient satisfaction with interns through improved clinical skills, and provide an excellent work force for the dental field.

  16. The Nurse Education and Transition (NEAT) model: educating the hospitalized patient with diabetes. (United States)

    Krall, Jodi Stotts; Donihi, Amy Calabrese; Hatam, Mary; Koshinsky, Janice; Siminerio, Linda


    The number of patients with a diabetes mellitus (DM)-related diagnosis is increasing, yet the number of hospital-based diabetes educators is being reduced. Interest in determining effective ways for staff nurses to deliver diabetes education (DE) is mounting. The purpose of this multi-phase feasibility study was to develop and evaluate the Nurse Education and Transition (NEAT) inpatient DM education model. Exploratory focus groups were conducted with staff nurses from inpatient units at academic tertiary and community hospitals to gain insight into barriers, content, delivery and support mechanisms related to providing DE to hospitalized patients. Findings informed the development of the NEAT model, which included a delivery protocol and toolkit with brief educational videos on key diabetes topics uploaded onto iPads, patient assessments and "teach back" tools, a discharge survival skills summary sheet, and guidelines for electronic medical record documentation and scheduling outpatient DE visits. Trained staff nurses used NEAT to deliver DE to hospitalized patients with DM and then participated in follow-up focus groups to assess their experiences, with particular attention to the usefulness of NEAT in meeting the needs of nurses related to the delivery of diabetes survival skill education. Information generated was analyzed to identify emerging key themes. Exploratory focus groups revealed that staff nurses view teaching patients with DM as part of their job, but report barriers. Nurses agreed that inpatient DE should be designed to assure safety after discharge and advised that it be patient-centered, targeted, assessment-based and user friendly. Nurses who participated in the delivery of NEAT found that the process and tools met the majority of the basic DE needs of their patients while relieving their workload. In particular, they reported that video and iPad technology provided a convenient and standardized method for facilitating teaching at the bedside, but

  17. Impact of increased patient choice of providers in Sweden: cataract surgery. (United States)

    Hanning, Marianne; Åhs, Annika; Winblad, Ulrika; Lundström, Mats


    Choice of provider was introduced in Sweden in 2001. Our aim was to describe the scope and character of patient flows and to analyze any differences between patients who chose to move outside of their home county (movers) and those who did not (non-movers) with regard to age, sex, waiting time and level of need. Use of cataract operations between 2005 and 2008 based on data from the National Cataract Register. Data were analysed using descriptive statistics, odds ratios and multivariate regression analysis to compare movers and non-movers. Information on contracting between county councils and providers in other counties was obtained from a survey. Only 4% of cataract patients were treated by a provider outside their home county. Patient flows were mainly determined by contracts between county councils and providers, and only 1% were considered to be 'true' movers (i.e. patients who were not part of any special contracting agreement). Movers differed from non-movers in that they were on average younger, had less serious visual problems and had shorter waiting times. Though patient flows are minor in scope, the possibility of changing provider has probably been important in tackling long waits in some counties. However, the reform may threaten the equity of health care use.

  18. Patient greeting preferences for themselves and their providers in a military family medicine clinic. (United States)

    Laird, John E; Tolentino, Jerlyn C; Gray, Cynthia


    Using the proper greeting may be important to help establish rapport between health care providers and their patients. It may be particularly useful for family medicine physicians working in a military medical facility, where military rank and traditions are important. A total of 259 anonymous surveys were collected from patients treated at a military family medicine clinic. Most of the patients who completed the survey preferred to shake hands with their provider, be greeted using only their first name, and preferred that the provider introduce themselves using their last name only. Active duty patients were more likely than civilians to prefer a handshake (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.46-6.39) and officers were more likely to prefer a handshake compared to enlisted service members (OR 3.29; 95% CI 1.18-9.20). Respondents who were older were more likely to prefer a formal introduction by their provider compared to respondents under 35 years old (OR 2.92, 95% CI 1.35-6.31). Although most patients in this facility expressed a preference for how they would like to be greeted, providers are still encouraged to ask their patients how they would prefer to be addressed. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  19. Development of the Moffitt Cancer Network as a Telemedicine and Teleconferencing Educational Tool for Health Care Providers

    National Research Council Canada - National Science Library

    Krischer, Jeffrey


    The Moffitt Cancer Network's (MCN) goal is to provide up-to-date oncology related information, resources, and education to oncology health care providers and researchers for the prevention and cure of cancer...

  20. Development of the Moffitt Cancer Network as a Telemedicine and Teleconferencing Educational Tool for Health Care Providers

    National Research Council Canada - National Science Library

    Krischer, Jeffrey


    The Moffitt Cancer Network's (MCN) goal is to provide up-to-date oncology related information, resources, and education to oncology health care providers and researchers for the prevention and cure of cancer...

  1. Patient and provider perspectives on the relationship between multiple morbidity management and disease prevention. (United States)

    Schoenberg, Nancy E; Tarasenko, Yelena N; Bardach, Shoshana H; Fleming, Steven T


    Despite competing demands of multiple morbidity (MM) management and disease prevention, our recent survey of 1,153 Appalachian residents aged 50 to 76 documented that individuals with MM were more likely to obtain colorectal cancer screening (CRCS) than those without MM. Nearly two thirds of respondents obtained CRCS, and the more MM, the greater the likelihood of screening. To gain insight into this relationship, we conducted nine focus groups, six with providers and three with patients. Three main explanations emerged: (a) patients' MM increases providers' vigilance for other health vulnerabilities; (b) having MM increases patients' own vigilance; and (c) patients' vigilance may stem from experiencing more symptoms, having a family history of cancer, and having successfully obtained health care. More frequent contact with health care providers appears to encourage preventive referral, especially in low-income populations that otherwise may not receive such counselling. We highlight participant recommendations to improve MM management and prevention. © The Author(s) 2013.

  2. Characteristics of electronic patient-provider messaging system utilisation in an urban health care organisation

    Directory of Open Access Journals (Sweden)

    Sean Patrick Mikles


    Full Text Available Introduction Research suggests that electronic messaging can improve patient engagement. Studies indicate that a ‘digital divide’ may exist, where certain patient populations may be using electronic messaging less frequently. This study aims to determine which patient characteristics are associated with different levels of usage of an electronic patient-provider messaging system in a diverse urban population.Methods Cross-sectional electronic health record data were extracted for patients 10 years of age or older who live in New York City and who visited a set of clinics between 1 July 2011 and 30 June 2012. Regression analyses determined which participant characteristics were associated with the sending of electronic messages.Results Older, female, English-speaking participants of white race who received more messages, had any diagnoses, more office visits and a provider who sent messages were more likely to send more messages. Non-Millennial, non-white participants who received fewer messages, had more office visits, any diagnoses, a provider who saw fewer patients with patient portal accounts, lived in a low socioeconomic status neighbourhood, and did not have private insurance were more likely to send zero messages.Conclusion This study found significant differences in electronic messaging usage based on demographic, socioeconomic and health-related patient characteristics. Future studies are needed to support these results and determine the causes of observed associations.

  3. Transitions from hospital to community care: the role of patient-provider language concordance. (United States)

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat


    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  4. Using a Financial Health Model to Provide Context for Financial Literacy Education Research: A Commentary (United States)

    Huston, Sandra J.


    In the article, "Enhancing links between research and practice to improve consumer financial education and well-being" Billy J. Hensley, Director of Education at National Endowment for Financial Education® (NEFE®), outlines his perspective on the current relation between financial education and financial outcome (downstream financial…

  5. Scientific support, soil information and education provided by the Austrian Soil Science Society (United States)

    Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie


    The Austrian Soil Science Society (ASSS), founded in 1954, is a non-profit organisation aiming at furthering all branches of soil science in Austria. The ASSS provides information on the current state of soil research in Austria and abroad. It organizes annual conferences for scientists from soil and related sciences to exchange their recent studies and offers a journal for scientific publications. Annually, ASSS awards the Kubiena Research Prize for excellent scientific studies provided by young scientists. In order to conserve and improve soil science in the field, excursions are organized, also in cooperation with other scientific organisations. Due to well-established contacts with soil scientists and soil science societies in many countries, the ASSS is able to provide its members with information about the most recent developments in the field of soil science. This contributes to a broadening of the current scientific knowledge on soils. The ASSS also co-operates in the organisation of excursions and meetings with neighbouring countries. Several members of the ASSS teach soil science at various Austrian universities. More detail on said conferences, excursions, publications and awards will be given in the presentation. Beside its own scientific journal, published once or twice a year, and special editions such as guidebooks for soil classification, the ASSS runs a website providing information on the Society, its activities, meetings, publications, awards and projects. Together with the Environment Agency Austria the ASSS runs a soil platform on the internet. It is accessible for the public and thus informs society about soil issues. This platform offers a calendar with national and international soil events, contacts of soil related organisations and networks, information on national projects and publications. The society has access to products, information material and information on educational courses. Last but not least information on specific soil

  6. A qualitative study on feedback provided by students in nurse education. (United States)

    Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong


    This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  7. Tell Us™: A Web-Based Tool for Improving Communication Among Patients, Families, and Providers in Hospice and Palliative Care Through Systematic Data Specification, Collection, and Use (United States)

    Dy, Sydney M.; Roy, Jayashree; Ott, Geoffrey E.; McHale, Michael; Kennedy, Christine; Kutner, Jean S.; Tien, Allen


    Context Routine electronic patient-reported outcome collection in patients with advanced disease could improve communication among patients, caregivers and providers and improve the timeliness of identifying problems and effectiveness of follow-up. Objective To develop a web-based tool to collect symptoms and need data and provide feedback to hospice and palliative care patients, caregivers and providers. Methods We developed Tell Us™ based on an existing pure web technology platform, the Medical Decision Logic, Inc. (“mdlogix”) Health Science Process Framework (HSPF™). The software development process included eliciting information on systems and needs and mapping care processes with three diverse hospices, and soliciting ideas for the software from clinicians and researchers. We developed a prototype software product, incorporated the hospices’ processes, assessment questions, and educational materials, and refined the product with feedback from other hospice and palliative care professionals. Results Tell Us includes modules for authoring and deploying clinical queries and completion schedules; for enrolling clinical sites and patients for patients and/or families to complete assigned assessments on a scheduled basis; and for providers to view patient-reported data. Tell Us provides customizable automated provider e-mail alerts based on patient responses (such as uncontrolled symptoms or need for medication refills) and provides educational materials targeted to patient needs. Conclusions This web-based toolset may be useful for improving communication between hospice and palliative care patients, caregivers, and providers and proactive patient management. Future research will involve integrating the software into care and evaluating its feasibility and use for data collection, patient education, and improving outcomes. PMID:21458214

  8. The Role of Safety Culture in Influencing Provider Perceptions of Patient Safety. (United States)

    Bishop, Andrea C; Boyle, Todd A


    To determine how provider perceptions of safety culture influence their involvement in patient safety practices. Health-care providers were surveyed in 2 tertiary hospitals located in Atlantic Canada, composed of 4 units in total. The partial least squares (PLS) approach to structural equation modeling was used to analyze the data. Latent variables provider PLS model encompassed the hypothesized relationships between provider characteristics, safety culture, perceptions of patient safety practices, and actual performance of patient safety practices, using the Health Belief Model (HBM) as a guide. Data analysis was conducted using SmartPLS. A total of 113 health-care providers completed a survey out of an eligible 318, representing a response rate of 35.5%. The final PLS model showed acceptable internal consistency with all four latent variables having a composite reliability score above the recommended 0.70 cutoff value (safety culture = 0.86, threat = 0.76, expectations = 0.83, PS practices = 0.75). Discriminant validity was established, and all path coefficients were found to be significant at the α = 0.05 level using nonparametric bootstrapping. The survey results show that safety culture accounted for 34% of the variance in perceptions of threat and 42% of the variance in expectations. This research supports the role that safety culture plays in the promotion and maintenance of patient safety activities for health-care providers. As such, it is recommended that the introduction of new patient safety strategies follow a thorough exploration of an organization's safety culture.

  9. Nurses' attitude and practice in providing tobacco cessation care to patients. (United States)

    Sreedharan, J; Muttappallymyalil, J; Venkatramana, M


    Patients respond very positively with nurses when they talk to them about their health related problems. This cross sectional study was carried out among nurses working in Gulf Medical College hospital and Research centre, Ajman, UAE to assess the their attitude in providing tobacco cessation counselling or advise to their patients and potential barriers they face in providing tobacco cessation care. 108 nurses participated in the study. Among the nurses 87% were females, the majority were aged between 25 and 34 years, and 46.3% had a work experience of less than 5 years. Among the nurses who participated in the survey, 99.1% felt that the hospital stay was a suitable time for nurses to create awareness on tobacco and health to the patients and had a positive attitude towards creating awareness on tobacco and health to the patients. Only 0.9% had a negative attitude towards creating awareness on tobacco and health and they felt that patients might not listen to them. All nurses, irrespective of their socio-demographic characteristics had a positive attitude to motivating patients to quit tobacco use. Currently, 70.4% regularly advise their patients to avoid tobacco products. Potential barriers pointed out by nurses were: lack of time (6.3%) patients may not appreciate it (90.6%) and not part of their job (3.1%). The study concludes that nurses have a positive attitude in providing tobacco cessation care to their patients and they can utilize their unique knowledge and know-how to promote tobacco cessation and prevent the spread of this public health crisis. Providing advice and support for tobacco cessation by nurses would increase the chance of patients stopping tobacco use. This will create an enabling environment and greater potential for public health persons to fight the epidemic with greater vigour

  10. Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units. (United States)

    Abuatiq, Alham


    The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care

  11. Attitudes of patients and care providers to enhanced recovery after surgery programs after major abdominal surgery. (United States)

    Hughes, Michael; Coolsen, Marielle M E; Aahlin, Eirik K; Harrison, Ewen M; McNally, Stephen J; Dejong, C H C; Lassen, Kristoffer; Wigmore, Stephen J


    Enhanced recovery after surgery (ERAS) is a well-established pathway of perioperative care in surgery in an increasing number of specialties. To implement protocols and maintain high levels of compliance, continued support from care providers and patients is vital. This survey aimed to assess the perceptions of care providers and patients of the relevance and importance of the ERAS targets and strategies. Pre- and post-operative surveys were completed by patients who underwent major hepatic, colorectal, or oesophagogastric surgery in three major centers in Scotland, Norway, and The Netherlands. Anonymous web-based and article surveys were also sent to surgeons, anesthetists, and nurses experienced in delivering enhanced recovery protocols. Each questionnaire asked the responder to rate a selection of enhanced recovery targets and strategies in terms of perceived importance. One hundred nine patients and 57 care providers completed the preoperative survey. Overall, both patients and care providers rated the majority of items as important and supported ERAS principles. Freedom from nausea (median, 10; interquartile range [IQR], 8-10) and pain at rest (median, 10; IQR, 8-10) were the care components rated the highest by both patients and care providers. Early return of bowel function (median, 7; IQR, 5-8) and avoiding preanesthetic sedation (median, 6; IQR, 3.75-8) were scored the lowest by care providers. ERAS principles are supported by both patients and care providers. This is important when attempting to implement and maintain an ERAS program. Controversies still remain regarding the relative importance of individual ERAS components. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial. (United States)

    Allen, Kelli D; Yancy, William S; Bosworth, Hayden B; Coffman, Cynthia J; Jeffreys, Amy S; Datta, Santanu K; McDuffie, Jennifer; Strauss, Jennifer L; Oddone, Eugene Z


    Management of osteoarthritis requires both medical and behavioral strategies, but some recommended therapies are underused. To examine the effectiveness of a combined patient and provider intervention for improving osteoarthritis outcomes. Cluster randomized clinical trial with assignment to osteoarthritis intervention and usual care groups. ( NCT01130740). Department of Veterans Affairs Medical Center in Durham, North Carolina. 30 providers (clusters) and 300 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved delivery of patient-specific osteoarthritis treatment recommendations to primary care providers through the electronic medical record. The primary outcome was total score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 12 months. Secondary outcomes were WOMAC function and pain subscale scores, physical performance (Short Physical Performance Battery), and depressive symptoms (Patient Health Questionnaire-8). Linear mixed models that were adjusted for clustering of providers assessed between-group differences in improvement in outcomes. At 12 months, WOMAC scores were 4.1 points lower (indicating improvement) in the osteoarthritis intervention group versus usual care (95% CI, -7.2 to -1.1 points; P = 0.009). WOMAC function subscale scores were 3.3 points lower in the intervention group (CI, -5.7 to -1.0 points; P = 0.005). WOMAC pain subscale scores (P = 0.126), physical performance, and depressive symptoms did not differ between groups. Although more patients in the osteoarthritis intervention group received provider referral for recommended osteoarthritis treatments, the numbers who received them did not differ. The study was conducted in a single Veterans Affairs medical center. The combined patient and provider intervention resulted in

  13. Opening cultural doors: providing culturally sensitive healthcare to Arab American and American Muslim patients. (United States)

    Hammoud, Maya M; White, Casey B; Fetters, Michael D


    Differences in the social and religious cultures of Arab Americans and American Muslims raise challenges to healthcare access and delivery. These challenges go far beyond language to encompass entire world views, concepts of health, illness, and recovery and even death. Medical professionals need a more informed understanding and consideration of the rich and diverse array of beliefs, expectations, preferences, and behavioral make up of the social cultures of these patients to ensure that they are providing the best and most comprehensive care possible. Improved understanding will enhance a provider's ability to offer quality healthcare and to build trusting relationships with patients. Here, we provide a broad overview of Arab culture and Islamic religious beliefs that will assist providers in delivering culturally sensitive healthcare to these groups. We offer insight into the behaviors, requirements, and preferences of Arab American and American Muslim patients, especially as they apply to women's health.

  14. The Effects of Health Education on Patients with Hypertension in China: A Meta-Analysis (United States)

    Xu, L. J.; Meng, Q.; He, S. W.; Yin, X. L.; Tang, Z. L.; Bo, H. Y.; Lan, X. Y.


    Objective: This study collected on from all research relating to health education and hypertension in China and, with the aid of meta-analysis tools, assessed the outcomes of such health education. The analysis provides a basis for the further development of health-education programmes for patients with hypertension. Methods: Literature searches…

  15. Communication during patient-provider encounters regarding diabetes self-management. (United States)

    Kruse, Robin L; Olsberg, Joshua E; Shigaki, Cheryl L; Parker Oliver, Debra R; Vetter-Smith, Molly J; Day, Tamara M; LeMaster, Joseph W


    Diabetes is a common chronic illness with potentially severe complications. The risk of complications is reduced through controlling blood sugar, lipids, and blood pressure. While medical intervention is important, substantial self-management on the part of patients is required to achieve good control. Patients often find self-management difficult, particularly diet and exercise modification. Clinicians face barriers as well, including lack of time, poor reimbursement, and difficulty changing their clinical practice patterns. We hypothesized that a strong focus on readily measured disease indicators competes with patients' agendas relating to symptoms and their day-to-day social context. We recorded clinical encounters to study communication about self-management in context. Recordings were transcribed verbatim and analyzed, primarily using a grounded theory approach. We found that clinicians often focused their communication on quantitative measures such as blood pressure and glycosylated hemoglobin but that patients found it difficult to relate these measures to how they were feeling physically. Patients' social contexts influenced their self-management activities, in particular heavy caregiving responsibilities and work schedules. Supporting self-management of patients with diabetes requires providers to link clinical measurements to patients' symptoms and likely outcomes. It is difficult for providers to know what support or assistance their patients need without knowledge of patients' social contexts.

  16. The IRIS Education and Outreach Program: Providing access to data and equipment for educational and public use (United States)

    Taber, J.; Toigo, M.; Bravo, T. K.; Hubenthal, M.; McQuillan, P. J.; Welti, R.


    The IRIS Education and Outreach Program has been an integral part of IRIS for the past 10 years and during that time has worked to advance awareness and understanding of seismology and earth science while inspiring careers in geophysics. The focus on seismology and the use of seismic data has allowed the IRIS E&O program to develop and disseminate a unique suite of products and services for a wide range of audiences. One result of that effort has been increased access to the IRIS Data Management System by non-specialist audiences and simplified use of location and waveform data. The Seismic Monitor was one of the first Web-based tools for observing near-real-time seismicity. It continues to be the most popular IRIS web page, and thus it presents aspects of seismology to a very wide audience. For individuals interested in more detailed ground motion information, waveforms can be easily viewed using the Rapid Earthquake Viewer, developed by the University of South Carolina in collaboration with IRIS E&O. The Seismographs in Schools program gives schools the opportunity to apply for a low-cost educational seismograph and to receive training for its use in the classroom. To provide better service to the community, a new Seismographs in Schools website was developed in the past year with enhanced functions to help teachers improve their teaching of seismology. The site encourages schools to make use of seismic data and communicate with other educational seismology users throughout the world. Users can view near-real-time displays of other participating schools, upload and download data, and use the “find a teacher” tool to contact nearby schools that also may be operating seismographs. In order to promote and maintain program participation and communication, the site features a discussion forum to encourage and support the growing global community of educational seismograph users. Any data that is submitted to the Seismographs in Schools Website is also accessible

  17. Efficacy of neuroscience education (NE) in patients undergoing spinal surgery


    Haugvad, Lars


    Background: One in four patients with radiculopathy experience persistent pain and disability after lumbar surgery. Postoperative rehabilitation for lumbar radiculopathy has shown little effect on reducing pain and disability. Previous research provides evidence for Neuroscience Education (NE) as a way to decrease pain, disability and fear avoidance before surgery. Methods: A multiple Single Subject Experimental Design (SSED) with six participant was completed at Martina Hansen Hospital in No...

  18. Educating advanced practice nurses for collaborative practice in the multidisciplinary provider team. (United States)

    Spain, Margaret P; DeCristofaro, Claire; Smith, Carol A


    To describe the use of a clinical decision-making work sheet as a tool to teach communication skills to advanced practice nurse (APN) students. Achievement of competencies in communication and documentation that utilize language and communication strategies that are shared with other health professionals promotes effective collaborative practice among members of the multidisciplinary provider team. Review of the recent Institute of Medicine report on health professions education and other health professional literature. The Clinical Decision-Making Work Sheet helps APN students effectively communicate in real-world clinical settings. The clinical work sheet allows nurse practitioner students to communicate more effectively and efficiently, using a vocabulary that is shared with other members of the multidisciplinary health care provider team. Use of the tool in students' clinical-rotation settings facilitates effective application and refinement of the clinical decision-making skills that students learned in the advanced health assessment course. Faculty have the responsibility to assist nurses as they transition from traditional nursing to APN roles. The work sheet facilitates learning the common language for data collection, clinical decision making, documentation, and reporting that is shared with other health professionals. Using the tool, students learn to efficiently organize information that supports communication and documentation that enhances their clinical problem-solving skills. Case presentation and documentation using the work sheet provide a basis for preceptor and student interaction and for student evaluation.

  19. Facebook Discussion Groups Provide a Robust Worldwide Platform for Free Pathology Education. (United States)

    Gonzalez, Raul S; Amer, Sadiq M; Yahia, Nejib Ben; Costa, Felipe D'Almeida; Noatay, Manu; Qiao, Jian-Hua; Rosado, Flavia G; Rosen, Yale; Sedassari, Bruno Tavares; Yantiss, Rhonda K; Gardner, Jerad M


    - Facebook (Menlo Park, California) is one of many online sites that provide potential educational tools for pathologists. We have each founded Facebook groups dedicated to anatomic pathology, in which members can share cases, ask questions, and contribute to discussions. - To report our experiences in founding and maintaining these Facebook groups and to characterize the contributed content. - We circulated a survey among the group founders, then compiled and analyzed the responses. - The groups varied in membership and in the quality of member contribution. Most posts were of pathology cases, although other topics (such as research articles) were also shared. All groups remained active and received posts from users all over the world, although all groups had many noncontributing members and received unwanted messages (which were screened and removed). Most founders were glad they had founded the groups because they provided an opportunity to both teach and learn. - Each analyzed Facebook group had a different character, and some downsides exist, but the groups all provided a no-cost way for pathologists and others across the world to interact online with many colleagues.

  20. Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Allen Kelli D


    Full Text Available Abstract Background Osteoarthritis (OA of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some recommended therapies are under-utilized in clinical settings, and the majority of patients with hip and knee OA are overweight and physically inactive. Consequently, interventions at the provider-level and patient-level both have potential for improving outcomes. This manuscript describes two ongoing randomized clinical trials being conducted in two different health care systems, examining patient-based and provider-based interventions for managing hip and knee OA in primary care. Methods / Design One study is being conducted within the Department of Veterans Affairs (VA health care system and will compare a Combined Patient and Provider intervention relative to usual care among n = 300 patients (10 from each of 30 primary care providers. Another study is being conducted within the Duke Primary Care Research Consortium and will compare Patient Only, Provider Only, and Combined (Patient + Provider interventions relative to usual care among n = 560 patients across 10 clinics. Participants in these studies have clinical and / or radiographic evidence of hip or knee osteoarthritis, are overweight, and do not meet current physical activity guidelines. The 12-month, telephone-based patient intervention focuses on physical activity, weight management, and cognitive behavioral pain management. The provider intervention involves provision of patient-specific recommendations for care (e.g., referral to physical therapy, knee brace, joint injection, based on evidence-based guidelines. Outcomes are collected at baseline, 6-months, and 12-months. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function, and

  1. Discharge communication practices and healthcare provider and patient preferences, satisfaction and comprehension: A systematic review. (United States)

    Newnham, Harvey; Barker, Anna; Ritchie, Edward; Hitchcock, Karen; Gibbs, Harry; Holton, Sara


    To systematically review the available evidence about hospital discharge communication practices and identify which practices were preferred by patients and healthcare providers, improved patient and provider satisfaction, and increased patients' understanding of their medical condition. OVID Medline, Web of Science, ProQuest, PubMed and CINAHL plus. Databases were searched for peer-reviewed, English-language papers, published to August 2016, of empirical research using quantitative or qualitative methods. Reference lists in the papers meeting inclusion criteria were searched to identify further papers. Of the 3489 articles identified, 30 met inclusion criteria and were reviewed. Much research to date has focused on the use of printed material and person-based discharge communication methods including verbal instructions (either in person or via telephone calls). Several studies have examined the use of information technology (IT) such as computer-generated and video-based discharge communication practices. Utilizing technology to deliver discharge information is preferred by healthcare providers and patients, and improves patients' understanding of their medical condition and discharge instructions. Well-designed IT solutions may improve communication, coordination and retention of information, and lead to improved outcomes for patients, their families, caregivers and primary healthcare providers as well as expediting the task for hospital staff.

  2. Continuing education: preparing patients to choose a renal replacement therapy. (United States)

    Goovaerts, Tony; Bagnis Isnard, Corinne; Crepaldi, Carlo; Dean, Jessica; Melander, Stefan; Mooney, Andrew; Prieto-Velasco, Mario; Trujillo, Carmen; Zambon, Roberto; Nilsson, Eva-Lena


    Patients with progressive chronic kidney disease face a series of treatment decisions that will impact the quality of life of themselves and their family. Renal replacement therapy option education (RRTOE), generally provided by nurses, is recommended by international guidelines To provide nurses with advice and guidance on running RRTOE. A consensus conference. Four nurses, 5 nephrologists and 1 clinical psychologist (9 renal units; 6 European countries) from units that had extensive experience in RRTOE or were performing research in this field. Experts brainstormed and discussed quality standards for the education team, processes, content/topics, media/material/funding and quality measurements for RRTOE. Conclusions and recommendations from these discussions that are particularly pertinent to nurses are presented in this paper. Through careful planning and smooth interdisciplinary cooperation, it is possible to implement an education and support programme that helps patients choose a form of RRT that is most suited to their needs. This may result in benefits in quality of life and clinical outcomes. There are large differences between renal units in terms of resources available and the demographics of the catchment area. Therefore, nurses should carefully consider how best to adapt the advice offered here to their own situation. Throughout this process, it is crucial to keep in mind the ultimate goal - providing patients with the knowledge and skill to make a modality choice that will enhance their quality of life to the greatest degree. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  3. Impact of patient requests on provider-perceived visit difficulty in primary care. (United States)

    Fenton, Joshua J; Franks, Peter; Feldman, Mitchell D; Jerant, Anthony; Henry, Stephen G; Paterniti, Debora A; Kravitz, Richard L


    "Difficult visits" are common in primary care and may contribute to primary care provider (PCP) career dissatisfaction and burnout. Patient requests occur in approximately half of primary care visits and may be a source of clinician-patient miscommunication or conflict, contributing to perceived visit difficulty. We aimed to determine associations between types of patient requests and PCP-perceived visit difficulty. This was an observational study, nested in a multicenter randomized trial of depression engagement interventions. We included 824 patient visits within 135 PCP practices in Northern California occurring from June 2010 to March 2012. PCP-perceived visit difficulty was quantified using a three-item scale (relative visit difficulty, amount of effort required, and amount of time required; Cronbach's α = 0.81). Using linear regression, the difficulty scale (score range 0-2 from least to most difficult) was modeled as a function of: patient requests for diagnostics tests, pain medications, and specialist referrals; PCP perception of likely depression or likely substance abuse; patient sociodemographics, comorbidity, depression; PCP characteristics and practice setting. Patients requested diagnostic tests, pain medications, and specialist referrals in 37.2, 20.0 and 30.0 % of visits, respectively. After adjustment for patient medical and psychiatric complexity, perceived difficulty was significantly higher when patients requested diagnostic tests [parameter estimate (PE) 0.11, (95 % CI: 0.03, 0.20)] but not when patients requested pain medications [PE -0.04 (95 % CI: -0.15, 0.08)] or referrals [PE 0.04 (95 % CI: -0.07, 0.25)]. PCP-perceived visit difficulty is associated with patient requests for diagnostic tests, but not requests for pain medications or specialist referrals. In this era of "choosing wisely," PCPs may be challenged to respond to diagnostic test requests in an evidence-based manner, while maintaining the provider-patient relationship

  4. Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls? (United States)

    Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel


    Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P < .001 and r = 0.543, P < .001). The remaining clinics were not significantly correlated but demonstrated a weak positive correlation (r = 0.098, P = .560 and r = 0.069, P = .671). Implementation and increased use of electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

  5. Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study. (United States)

    Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W


    There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  6. Understanding the cost of dermatologic care: A survey study of dermatology providers, residents, and patients. (United States)

    Steen, Aaron J; Mann, Julianne A; Carlberg, Valerie M; Kimball, Alexa B; Musty, Michael J; Simpson, Eric L


    The American Academy of Dermatology recommends dermatologists understand the costs of dermatologic care. This study sought to measure dermatology providers' understanding of the cost of dermatologic care and how those costs are communicated to patients. We also aimed to understand the perspectives of patients and dermatological trainees on how cost information enters into the care they receive or provide. Surveys were systematically developed and distributed to 3 study populations: dermatology providers, residents, and patients. Response rates were over 95% in all 3 populations. Dermatology providers and residents consistently underestimated the costs of commonly recommended dermatologic medications but accurately predicted the cost of common dermatologic procedures. Dermatology patients preferred to know the cost of procedures and medications, even when covered by insurance. In this population, the costs of dermatologic medications frequently interfered with patients' ability to properly adhere to prescribed regimens. The surveyed population was limited to the northwestern United States and findings may not be generalizable. Cost estimations were based on average reimbursement rates, which vary by insurer. Improving dermatology providers' awareness and communication of the costs of dermatologic care might enhance medical decision-making, improve adherence and outcomes, and potentially reduce overall health care expenditures. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. Attitudes of Saudi Nursing Students on AIDS and Predictors of Willingness to Provide Care for Patients in Central Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mostafa A. Abolfotouh


    Full Text Available This study aimed to assess acquired immune deficiency syndrome (AIDS-related knowledge, attitudes, and risk perception among Saudi nursing students, and to identify predictors of their willingness to provide care for patients with AIDS. A cross-sectional study of 260 baccalaureate nursing students at King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was done using a previously validated instrument. Students’ knowledge percentage mean score (PMS on AIDS was 72.93 ± 10.67 reflecting an average level of knowledge. There were many misconceptions about how AIDS is transmitted, for example, use of same toilets and bathrooms and washing clothes together (24.9%, swimming (53.7%, and coughing and sneezing (49.6%. Nursing students reported an overall negative attitude toward AIDS, with a PMS of 43.48 ± 9.21. The majority of students agreed that AIDS patients should be isolated from other patients (83%, and should not share the room with other noninfected patients (81.8%, and some reported that people living with AIDS deserve what has happened to them (24.7%. After controlling for confounders, students’ poor knowledge and negative attitude were associated only with having never been given nursing education as their primary university education “Stream 2 students” (p = .012 and p = .01, respectively. These findings have implications for development of teaching strategies and curricular approaches for nursing to address this health care issue.

  8. Analysis of provider specialties in the treatment of patients with clinically diagnosed back and joint problems. (United States)

    Wilson, Fernando A; Licciardone, John C; Kearns, Cathleen M; Akuoko, Mathias


    Although several studies have compared patient outcomes by provider specialty in the treatment of back and joint pain, little is known about the cost-effectiveness of improving patient outcomes across specialties. This study uses a large-scale, nationally representative database to evaluate the cost-effectiveness of being treated by specific provider specialists for back and joint pain in the United States. The 2002-2012 Medical Expenditure Panel Surveys were used to examine patients diagnosed with back and/or joint problems seeking treatment from doctors (internal medicine, family/general, osteopathic medicine, orthopaedics, rheumatology, neurology) or other providers (chiropractor, physical therapist, acupuncturist, massage therapist). A total of 16,546 respondents aged 18 to 85 and clinically diagnosed with back/joint pain were examined. Self-reported measures of physical and mental health and general quality of life (measured by the EuroQol-5D) were compared with average total costs of treatment across medical providers. Total annual treatment costs per person ranged from $397 for family/general doctors to $1205 for rheumatologists. Cost-effectiveness analysis suggests that osteopathic, family/general, internal medicine doctors and chiropractors and massage therapists were more cost-effective than other specialties in improving physical function to back pain patients. For mental health measures, family/general and orthopaedic doctors and physical therapists were more cost-effective compared with other specialties. Similar to results on physical function, family/general, osteopathic and internal medicine doctors dominated other specialties. However, only massage therapy was cost-effective among non-doctor providers in improving quality of life measures. Patients seeking care for back and joint-related health problems face a wide range of treatments, costs and outcomes depending on which specialist provider they see. This study provides important insight on the

  9. Conflict and Care: Israeli Healthcare Providers and Syrian Patients and Caregivers in Israel. (United States)

    Young, Savannah S; Lewis, Denise C; Gilbey, Peter; Eisenman, Arie; Schuster, Richard; Seponski, Desiree M


    Israel has provided immediate healthcare to Syrian children, civilians and fighters since early 2013 despite being in an official state of war with Syria since 1973. We present qualitative findings from a larger mixed-methods phenomenological study to understand how the geopolitical and social history of Israel and Syria influences healthcare providers and Syrian patient caregivers in northern Israel. Theories of humanization and cognitive dissonance guided this study and frame the beliefs and experiences of healthcare providers who treated wounded Syrians in Israeli hospitals. Findings indicate healthcare providers and Syrian caregivers adjusted their beliefs to allow for positive healthcare experiences. Qualitative analysis revealed two major themes: supportive and hindering systemic elements contributing to the healthcare provider-patient-caregiver relationship. Internal psychological developments, contextual factors, and relational processes influenced humanization of the other within the relationship. This study illuminates unique ethical and humanitarian demands relevant for healthcare workers and those with whom they interact.

  10. Communication Between Low Income Hispanic Patients and Their Healthcare Providers Regarding Physical Activity and Healthy Eating. (United States)

    Gauri, Aliyah; Rodriguez, Xeniamaria; Gaona, Patricia; Maestri, Stephanie; Dietz, Noella; Stoutenberg, Mark


    U.S. Hispanics disproportionately show health burdens that may be decreased by discussing physical activity (PA) and healthy eating with their healthcare providers (HCPs). We examined the perceptions of both HCPs and low-income Hispanic patients regarding the dynamics of these communications. We surveyed 295 low-income Hispanic patients and interviewed 14 HCPs at three community health clinics. Patients were asked about their comfort level with HCPs, how often their HCP discussed PA and healthy eating, and the likelihood of following advice on PA and healthy eating. HCPs were asked about their delivery (frequency/duration) and perceived effectiveness in providing such advice. Patients reported feeling "most comfortable" with their physicians (57%) with a lower proportion (19%) feeling "most comfortable" with nurses. Nearly all patients (95%) reported being very likely to follow the advice of their physician. On average, HCPs (physicians and nurses) reported discussing PA and healthy eating with 85% and 80% of their patients, respectively. In contrast, a fewer proportion of patients (65.8%) reported that their physician discussed PA and healthy eating "some" or "a lot" of the time. Overall, physicians reported discussing PA and healthy eating for an average of 5 and 6 min, respectively; whereas nurses reported discussing PA and healthy eating for an average of 12 and 19 min, respectively. Further study on the content and delivery of conversations between HCPs and their low-income Hispanic patients regarding PA and healthy eating could be vital to optimally impact health behaviors.

  11. Variation in patient perceptions of healthcare provider endorsement of cardiac rehabilitation. (United States)

    Tsui, Courtney Kwan-Yee; Shanmugasegaram, Shamila; Jamnik, Veronica; Wu, Gilbert; Grace, Sherry L


    Cardiac rehabilitation (CR) is significantly underutilized. However, physician endorsement promotes greater patient utilization. This study examined perceptions of provider endorsement by patients (1) of sociodemographic groups who are often less represented in CR and by clinical indication and (2) by type of healthcare provider and place of referral. Referred cardiac (N = 1156) inpatients from 11 hospitals across Ontario completed a sociodemographic survey inhospital and a mailed followup survey 1 year later. Respondents self-reported perceived healthcare provider endorsement of CR on a 5-point Likert scale, type of referring healthcare provider, and where the referral was initiated. The overall perceived strength of healthcare provider endorsement to CR was 3.75 ± 1.15. Patients who perceived greater endorsement were significantly more likely to enrol (OR = 2.07) and attend a greater percentage of CR sessions (P endorsement of CR than their respective counterparts. Perception of CR endorsement did not differ significantly on the basis of location of referral initiation (P ≥ .05), but those who discussed CR with family doctors (P endorsement than those discussing CR with nurses. Given the proven benefits of CR, all healthcare providers are recommended to universally and strongly encourage CR participation among their patients in order to optimize utilization and subsequent recovery.

  12. Perceptions of health care providers concerning patient and health care provider strategies to limit out-of-pocket costs for cancer care


    Mathews, M.; Buehler, S.; West, R.


    Objective We aimed to describe the perceptions of health care providers concerning patient and health care provider strategies to limit out-of-pocket costs for cancer care. Methods We conducted semi-structured interviews with 21 cancer care providers (nurses, social workers, oncologists, surgeons, pharmacists, and dieticians) in Newfoundland and Labrador. Results Patients try to minimize costs by substituting or rationing medications, choosing radical treatments, lengthening the time between ...

  13. Patientś experiences of patient education on psychiatric inpatient wards;

    DEFF Research Database (Denmark)

    Kristiansen, S. T.; Videbech, P.; Kragh, M.


    Objective: To synthesize the evidence on how patients with serious mental disorders perceived patient education on psychiatric wards and to learn more about the patient perceived benefits and limitations related to patient education and how well patient education meets the perceived needs....... The results concerned the specific population with bipolar disorder or schizophrenia. Two explanatory syntheses were aggregated: (I) Benefits and perceived barriers to receiving education and (II) Educational needs of mental health patients. Patients reported mechanical information dissemination and lack...... of individual and corporative discussions. Patients preferred patient education from different educational sources with respect to individual needs. Conclusion: Patient education were most useful when it could be tailored to an individuaĺs specific needs and match patient preference for how to receive it...

  14. Patient safety education for undergraduate medical students: a systematic review

    Directory of Open Access Journals (Sweden)

    Zhang Mingming


    Full Text Available Abstract Background To reduce harm caused by health care is a global priority. Medical students should be able to recognize unsafe conditions, systematically report errors and near misses, investigate and improve such systems with a thorough understanding of human fallibility, and disclose errors to patients. Incorporating the knowledge of how to do this into the medical student curriculum is an urgent necessity. This paper aims to systematically review the literature about patient safety education for undergraduate medical students in terms of its content, teaching strategies, faculty availability and resources provided so as to identify evidence on how to promote patient safety in the curriculum for medical schools. This paper includes a perspective from the faculty of a medical school, a major hospital and an Evidence Based Medicine Centre in Sichuan Province, China. Methods We searched MEDLINE, ERIC, Academic Source Premier(ASP, EMBASE and three Chinese Databases (Chinese Biomedical Literature Database, CBM; China National Knowledge Infrastructure, CNKI; Wangfang Data from 1980 to Dec. 2009. The pre-specified form of inclusion and exclusion criteria were developed for literature screening. The quality of included studies was assessed using Darcy Reed and Gemma Flores-Mateo criteria. Two reviewers selected the studies, undertook quality assessment, and data extraction independently. Differing opinions were resolved by consensus or with help from the third person. Results This was a descriptive study of a total of seven studies that met the selection criteria. There were no relevant Chinese studies to be included. Only one study included patient safety education in the medical curriculum and the remaining studies integrated patient safety into clinical rotations or medical clerkships. Seven studies were of a pre and post study design, of which there was only one controlled study. There was considerable variation in relation to contents

  15. Effects of handholding and providing information on anxiety in patients undergoing percutaneous vertebroplasty. (United States)

    Kim, Bong-Hee; Kang, Hee-Young; Choi, Eun-Young


    This study evaluated the effects of handholding and spoken information provided on the anxiety of patients undergoing percutaneous vertebroplasty under local anaesthesia. A surgical intervention usually entails physical discomfort and psychological burden. Furthermore, patients under local anaesthesia are conscious during the surgical intervention, which leads to more anxiety, as patients are aware of their surroundings in the operating theatre. A quasi-experimental design with a nonequivalent control group was utilised. Amsterdam preoperative anxiety scale assessed psychological anxiety, while blood pressure and pulse were measured to evaluate physiological anxiety. Participants were 94 patients undergoing percutaneous vertebroplasty in a spine hospital in Gwangju Metropolitan City, South Korea. Thirty patients were assigned to Experimental Group I, 34 to the Experimental Group II and 30 to the control group. During a surgical intervention, nurses held the hands of those in Experimental Group I and provided them with spoken information. Patients in Experimental Group II experienced only handholding. Psychological anxiety in Experimental Group I was low compared to those in Experimental Group II and the control group. In addition, there were significant decreases in systolic blood pressure in both Experimental Groups compared to the control group. Handholding and spoken information provided during a surgical intervention to mitigate psychological anxiety, and handholding to mitigate physiological anxiety can be used in nursing interventions with patients undergoing percutaneous vertebroplasty. Handholding and providing nursing information are possibly very useful interventions that are easily implemented by circulating nurses during a surgical intervention. In particular, handholding is a simple, economical and appropriate way to help patient in the operating theatre. © 2015 John Wiley & Sons Ltd.

  16. Enhancing provider knowledge and patient screening for palliative care needs in chronic multimorbid patients receiving home-based primary care. (United States)

    Wharton, Tracy; Manu, Erika; Vitale, Caroline A


    This article describes a pilot model to increase palliative care (PC) knowledge and collaboration among providers and to systematically identify chronic multimorbid home care patients who would benefit from focused discussion of potential PC needs. Thirty health care providers from a home-based primary care team attended interdisciplinary trainings. The Palliative Performance Scale (PPS) tool was used to trigger discussions of potential palliative needs at team rounds for patients who scored below a cutoff point on the tool. Palliative Performance Scale implementation added little burden on nurses and triggered a discussion in 51 flagged patients. The tool successfully identified 75% of patients who died or were discharged. Screening was systematic and consistent and resulted in targeted discussions about PC needs without generating additional burden on our PC consult service. This model shows promise for enhancing collaborative patient care and access to PC. © The Author(s) 2013.

  17. Power Relations and Health Care Communication in Older Adulthood: Educating Recipients and Providers. (United States)

    Eliassen, A Henry


    Unequal power relations lie just below the surface in much of today's discourse on health care communication with older adults. Focusing on pathologies or deficits tends to reinforce stereotypes of frailty and dependency, thus framing elders as a vulnerable group requiring special assistance. Implicit stereotyping frequently colors interactions of health care personnel with older clients and their families-interactions likely to affect elders' perceptions and health outcomes. Health care providers need to be attuned to the vast and growing diversity in today's older population, wherein many older adults are exemplars of what it takes to marshal resources and cope with multifaceted challenges. Thus, elders have the potential to teach medical personnel through narratives of resilience as well as tribulation. This potential can be fully realized, however, only in contexts where communication patterns characterized by paternalism, consumerism, and collaboration are mutually recognized and selectively challenged or implemented. Promising interventions to facilitate health care communication in older adulthood might well be directed toward (a) educating both recipients and providers to become more mindful of cues that evoke stereotypical thinking, (b) promoting an institutional culture that normalizes situationally appropriate assertive responses to stereotyping, and (c) formally ratifying older adults' life experience in the training of health care personnel. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  18. Simulation-based Education to Ensure Provider Competency Within the Health Care System. (United States)

    Griswold, Sharon; Fralliccardi, Alise; Boulet, John; Moadel, Tiffany; Franzen, Douglas; Auerbach, Marc; Hart, Danielle; Goswami, Varsha; Hui, Joshua; Gordon, James A


    The acquisition and maintenance of individual competency is a critical component of effective emergency care systems. This article summarizes consensus working group deliberations and recommendations focusing on the topic "Simulation-based education to ensure provider competency within the healthcare system." The authors presented this work for discussion and feedback at the 2017 Academic Emergency Medicine Consensus Conference on "Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes," held on May 16, 2017, in Orlando, Florida. Although simulation-based training is a quality and safety imperative in other high-reliability professions such as aviation, nuclear power, and the military, health care professions still lag behind in applying simulation more broadly. This is likely a result of a number of factors, including cost, assessment challenges, and resistance to change. This consensus subgroup focused on identifying current gaps in knowledge and process related to the use of simulation for developing, enhancing, and maintaining individual provider competency. The resulting product is a research agenda informed by expert consensus and literature review. © 2017 by the Society for Academic Emergency Medicine.

  19. Nutrition education and counselling provided during pregnancy: effects on maternal, neonatal and child health outcomes. (United States)

    Girard, Amy Webb; Olude, Oluwafunke


    Nutrition education and counselling (NEC) is a commonly applied strategy to improve maternal nutrition during pregnancy. However, with the exception special populations and specific diets, the effect of NEC on maternal, neonatal and child health outcomes has not been systematically reviewed. Using a modified Child Health Epidemiology Reference Group method we systematically reviewed the literature and identified and abstracted 37 articles. We conducted meta-analyses for the effect of NEC on maternal, neonatal and infant health outcomes including gestational weight gain, maternal anaemia, birthweight, low birthweight and preterm delivery. NEC significantly improved gestational weight gain by 0.45 kg, reduced the risk of anaemia in late pregnancy by 30%, increased birthweight by 105 g and lowered the risk of preterm delivery by 19%. The effect of NEC on risk of low birthweight was not significant. The effect of NEC was greater when provided with nutrition support, for example, food or micronutrient supplements or nutrition safety nets. The overall quality of the body of evidence was deemed low for all outcomes due to high heterogeneity, poor study designs and other biases. Additional well-designed research that is grounded in appropriate theories of behaviour change is needed to improve confidence in the effect of NEC. Further, cost-effectiveness research is needed to clarify the added benefit and sustainability of providing NEC with nutritional support and/or safety nets, especially in areas where food insecurity and gender bias may limit women's capacity to adhere to NEC messages. © 2012 Blackwell Publishing Ltd.

  20. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study. (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne


    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Measuring the quality of provided services for patients with chronic kidney disease. (United States)

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin


    The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and

  2. Stigmatized Attitude of Healthcare Providers: A Barrier for Delivering Health Services to HIV Positive Patients

    Directory of Open Access Journals (Sweden)

    Nooshin Zarei


    Full Text Available Abstract Background: Despite the success of developed countries in preventing the spread of HIV/AIDS, the disease is expanding in developing countries where an unfavorable attitude exists among people, health professionals and employees. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLWHA. Methods: The study is a cross-sectional survey. The data were gathered using a structured questionnaire. The study sample included 575 health care providers of public and private hospitals in Shiraz. The data were gathered using a structured questionnaire in spring 2014. Data analysis was carried out using the Statistical Package for Social Sciences, version 21. Results: The most dominant attitude of the health care providers toward HIV/AIDS patients was related to fear (42.42%. According to the results of this study, there was a significant relationship between stigmatized attitude of the health care providers and their religious beliefs, society stigmatized attitude, and knowledge of transmission routes. The relationship between social stigmatized attitude of health care providers and their knowledge of transmission routes, with their willingness to provide services to patients is significant, as well (P<0.05. 39.6% and 46.2% of the respondents preferred not to provide services to the prostitutes and homosexual patients. Conclusion: Fear of contamination and social stigmatized attitude are the main impediments to dealing with patients and providing services to them. Hence, it seems that creating an effective knowledge about transmission and correcting the socio-cultural beliefs of health providers are two key strategies to tackle this problem.

  3. The Obligation to Provide Free Basic Education in South Africa: An ...

    African Journals Online (AJOL)

    It is argued that learners in South Africa may come from different socio-economic backgrounds but as learners in the same public school domain and as equal bearers of their constitutional right to basic education all of them are entitled to the same type and quality of free basic education. KEYWORDS: Right to education; ...

  4. Individuals with Disabilities Education Act: Public School Application of Providing FAPE in the Least Restrictive Environment (United States)

    Teal, Christi B.


    The purpose of this study was to investigate how courts deal with issues related to the broad definition of free appropriate public education (FAPE) as it pertains to the least restrictive environment (LRE) for the provision of special education services as legislated though the Individuals with Disabilities Education Act (IDEA). The Supreme Court…

  5. Patient educational technologies and their use by patients diagnosed with localized prostate cancer. (United States)

    Baverstock, Richard J; Crump, R Trafford; Carlson, Kevin V


    Two urology practices in Calgary, Canada use patient educational technology (PET) as a core component of their clinical practice. The purpose of this study was to determine how patients interact with PET designed to inform them about their treatment options for clinically localized prostate cancer. A PET library was developed with 15 unique prostate-related educational modules relating to diagnosis, treatment options, and potential side effects. The PET collected data regarding its use, and those data were used to conduct a retrospective analysis. Descriptive analyses were conducted and comparisons made between patients' utilization of the PET library during first and subsequent access; Pearson's Chi-Square was used to test for statistical significance, where appropriate. Every patient (n = 394) diagnosed with localized prostate cancer was given access to the PET library using a unique identifier. Of those, 123 logged into the library and viewed at least one module and 94 patients logged into the library more than once. The average patient initially viewed modules pertaining to their diagnosis. Viewing behavior significantly changed in subsequent logins, moving towards modules pertaining to treatment options, decision making, and post-surgical information. As observed through the longitudinal utilization of the PET library, information technology offers clinicians an opportunity to provide an interactive platform to meet patients' dynamic educational needs. Understanding these needs will help inform the development of more useful PETs. The informational needs of patients diagnosed with clinically localized prostate cancer changed throughout the course of their diagnosis and treatment.

  6. It Takes Two to Tango: Engaging Patients and Providers With Portals. (United States)

    Shah, Sachin D; Liebovitz, David


    Patient portals are designed to be tools to more fully engage patients in their health care and help enable them to better manage their own health information. As the U.S. health care system rapidly adopted electronic health records (EHRs) over the past decade, many with linked patient portals, enthusiasm and expectations for this new technology as a means to engage and empower patients grew. Most patient portals have a set of core features designed to facilitate health care transactions, information tracking, and communication with care team members. The evidence supporting the anticipated benefits of patient portals on patient outcomes, however, remains mixed and incomplete. Moreover, a paradox exists in that, despite a high consumer interest in patient portals, widespread adoption remains relatively low. Potential reasons include the need for greater provider endorsement, examination and adaptation of clinical workflows, and the recognition of patient engagement as a reciprocal process. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  7. Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

    Directory of Open Access Journals (Sweden)

    Mostafa Mehrara


    Full Text Available Introduction: Although many protocols are available in the field of the prehospital medical care (PMC, there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC.Method: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.Results: 101 cases with the mean age of 56.7 ± 12.3 years (30-78 were audited (55.4% male. 61 (60.3% patients had chest pain and 40 (39.7% cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%, O2 therapy (32.8%, nitroglycerin administration (60.7%, and aspirin administration (52.5% in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%, O2 therapy (75%, cardiac monitoring (25%, pupils examination (25%, bedside glucometery (50%, and assessing for naloxone administration (55% in prehospital care of patients with LOC were fair to poor.Conclusion: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.

  8. [Physician and medical psychologist: complementary approaches in providing psychological care to cancer patient]. (United States)

    Chulkova, V A; Pesterëva, E V


    In providing psychological care to an oncological patient a physician and a medical psychologist come from a variety of professional positions that require different approaches and methods. It is proposed a three-phase model of the dynamics of the psychological state of the person in the situation of cancer reflecting the process of psychological adaptation of a particular patient. Focusing on this model, the authors conclude that psychological care to cancer patient, performed by a doctor and a medical psychologist, are different kinds of psychological care that does not replace but complement each other.

  9. Perception of primary care doctors and nurses about care provided to sickle cell disease patients (United States)

    Xavier Gomes, Ludmila Mourão; de Andrade Barbosa, Thiago Luis; Souza Vieira, Elen Débora; Caldeira, Antônio Prates; de Carvalho Torres, Heloísa; Viana, Marcos Borato


    Objective To analyze the perception of primary care physicians and nurses about access to services and routine health care provided to sickle cell disease patients. Methods This descriptive exploratory study took a qualitative approach by surveying thirteen primary care health professionals who participated in a focus group to discuss access to services and assistance provided to sickle cell disease patients. The data were submitted to thematic content analysis. Results Access to primary care services and routine care for sickle cell disease patients were the categories that emerged from the analysis. Interaction between people with sickle cell disease and primary care health clinics was found to be minimal and limited mainly to scheduling appointments. Patients sought care from the primary care health clinics only in some situations, such as for pain episodes and vaccinations. The professionals noted that patients do not recognize primary care as the gateway to the system, and reported that they feel unprepared to assist sickle cell disease patients. Conclusion In the perception of these professionals, there are restrictions to accessing primary care health clinics and the primary care assistance for sickle cell disease patients is affected. PMID:26190428

  10. Challenges in Providing HIV and Sexuality Education to Learners with Disabilities in South Africa: The Voice of Educators (United States)

    de Reus, Liset; Hanass-Hancock, Jill; Henken, Sophie; van Brakel, Wim


    People with disabilities are at increased risk of exposure to HIV, yet they lack access to HIV prevention, treatment care and support including sexuality education. Lack of knowledge, skills and confidence of educators teaching sexuality education to learners with disabilities is related to this increased vulnerability. This study identifies…

  11. The Charrette Design Model Provides a Means to Promote Collaborative Design in Higher Education

    Directory of Open Access Journals (Sweden)

    Webber Steven B.


    Full Text Available Higher education is typically compartmentalized by field and expertise level leading to a lack of collaboration across disciplines and reduced interaction among students of the same discipline that possess varying levels of expertise. The divisions between disciplines and expertise levels can be perforated through the use of a concentrated, short-term design problem called a charrette. The charrette is commonly used in architecture and interior design, and applications in other disciplines are possible. The use of the charrette in an educational context provides design students the opportunity to collaborate in teams where members have varying levels of expertise and consult with experts in allied disciplines in preparation for a profession that will expect the same. In the context of a competitive charrette, this study examines the effectiveness of forming teams of design students that possess a diversity of expertise. This study also looks at the effectiveness of integrating input from professional experts in design-allied disciplines (urban planning, architecture, mechanical and electrical engineering and a design-scenario-specific discipline (medicine into the students' design process. Using a chi-square test of goodness-of-fit, it is possible to determine student preferences in terms of the team configurations as well as their preferences on the experts. In this charrette context, the students indicated that the cross-expertise student team make-up had a positive effect for both the more experienced students and the less experienced students. Overall, the students placed high value on the input from experts in design-allied fields for the charrette. They also perceived a preference of input from external experts that had an immediate and practical implication to their design process. This article will also show student work examples as additional evidence of the successful cross-expertise collaboration among the design students and evidence

  12. Perspectives of Primary Care Providers Toward Palliative Care for Their Patients. (United States)

    Nowels, David; Jones, Jacqueline; Nowels, Carolyn T; Matlock, Daniel

    The need for all providers to deliver basic palliative care has emerged as patients' needs outstrip the capacity of specialty palliative care. Many patients with complex illnesses have unmet needs and are seen in primary care more than other settings. We explore primary care providers' willingness and perceived capacity to provide basic palliative care, and their concerns and perceived barriers. We performed semistructured telephone interviews with 20 primary care providers about their perceptions of palliative care, including needs, practices, experiences, access, and what would be helpful for their practices to systematically provide basic palliative care. We identified 3 major themes: (1) Participants recognize palliative needs in patients with complex problems. (2) They reactively respond to those needs using practice and community resources, believing that meeting those needs at a basic level is within the scope of primary care. (3) They can identify opportunities to improve the delivery of a basic palliative approach in primary care through practice change and redesign strategies used in enhanced primary care environments. Systematic attention along the multidimensional domains of basic palliative care might allow practices to address unmet needs in patients with complex illnesses by using existing practice improvement models, strategies, and prioritization. © Copyright 2016 by the American Board of Family Medicine.

  13. Educational Intervention for Nutrition Education in Patients Attending an Outpatient Wound Care Clinic: A Feasibility Study. (United States)

    Green, Lisa M; Ratcliffe, Desi; Masters, Kathleen; Story, Lachel


    The purpose of this study was to determine whether nurses could use a structured intervention to educate patients with wounds about foods that promote healing and whether this educational intervention could be provided in a cost-effective manner. Cross-sectional survey. The study was conducted at an outpatient wound care center located on a hospital campus in the Southern United States; 3 full-time nurses and 2 nurses employed on part-time status delivered the intervention. A nutrition education intervention was developed through collaborative efforts of a registered dietitian and a nurse. A cross-sectional survey design was used to (1) evaluate nurses' perceptions of the intervention and (2) identify barriers to implementation of the intervention. Direct costs related to materials and nursing time required to deliver the intervention were calculated. Participants indicated they were competent to deliver the structured intervention, and all were willing to continue its use. Survey results indicated that nurses believed the intervention was beneficial to their patients and they indicated that patients were responsive to the intervention. The intervention was found to be low cost ($8.00 per teaching session); no barriers to implementation of the intervention were identified. The results of this exploratory study suggest that a structured nutrition education intervention can be provided by nurses in outpatient wound clinics at low cost. Further study is needed to determine the impact of this intervention on nutritional intake and wound healing.

  14. From Introduction to Integration: Providing Community-Engaged Structure for Interprofessional Education

    Directory of Open Access Journals (Sweden)

    Daniel P. Griffin


    Full Text Available Background Training future healthcare profession students using interprofessional education (IPE is critical to improve quality of health care and patient safety. Objective The objective of this study was to implement an IPE program and determine student satisfaction with each session, including a clinical case requiring teams with members from each profession addressing clinical scenarios. Subjects The subjects of this study were students from Athletic Training, Medicine, Nursing, Pharmacy, Physical Therapy, Physician Assistant, Social Work, and Speech-Language Pathology. Methods Evaluations, administered to all participating students, consisted of Likert-style responses, rating agreement with a series of questions, and space for descriptive comments. Score differences for each question were compared using independent group t -tests with a P -value of 0.05 to determine statistical significance. Results There were statistically higher satisfaction ratings for the problem-based learning case when compared to less interactive sessions ( P < 0.0001. Conclusion Students perceived benefits of the IPE program. Perceptions improved when various students had the opportunity to work together on clinically relevant problems.

  15. [Practical chemistry education provided by team-based learning (TBL) and peer evaluation]. (United States)

    Yasuhara, Tomohisa; Konishi, Motomi; Nishida, Takahiro; Kushihata, Taro; Sone, Tomomichi; Kurio, Wasako; Yamamoto, Yumi; Nishikawa, Tomoe; Yanada, Kazuo; Nakamura, Mitsutaka


    Learning chemistry is cumulative: basic knowledge and chemical calculation skills are required to gain understanding of higher content. However, we often suffer from students' lack of learning skills to acquire these concepts. One of the reasons is the lack of adequate training in the knowledge and skills of chemistry, and one of the reasons for this lack is the lack of adequate evaluation of training procedures and content. Team-based learning (TBL) is a strong method for providing training in the knowledge and skills of chemistry and reaffirms the knowledge and skills of students of various levels. In our faculty, TBL exercises are provided for first-year students concurrently with lectures in physical chemistry and analytical chemistry. In this study, we researched the adoption of a peer evaluation process for this participatory learning model. Questionnaires taken after TBL exercises in the previous year showed a positive response to TBL. Further, a questionnaire taken after TBL exercises in the spring semester of the current year also yielded a positive response not only to TBL but also to peer evaluation. In addition, a significant correlation was observed between the improvement of students' grades in chemistry classes and the feeling the percentage (20%) of peer evaluation in overall evaluation low (logistic regression analysis, p=0.022). On the basis of the findings, we argue that TBL provides a generic, practical learning environment including an effective focus on learning strategy and evaluation of knowledge, skills, and attitudes, and studies on the educational effects of TBL and peer evaluation.

  16. The Medicinal Cannabis Treatment Agreement: Providing Information to Chronic Pain Patients Through a Written Document. (United States)

    Wilsey, Barth; Atkinson, J Hampton; Marcotte, Thomas D; Grant, Igor


    Pain practitioners would seem to have an obligation to understand and inform their patients on key issues of the evidence base on cannabinoid therapeutics. One way to fulfill this obligation might be to borrow from concepts developed in the prescription of opioids: the use of a written agreement to describe and minimize risks. Regrettably, the widespread adoption of opioids was undertaken while harmful effects were minimized; obviously, no one wants to repeat this misstep. This article describes a method of educating patients in a manner analogous to other treatment agreements. Surveys have demonstrated that pain is the most common indication for medical use of cannabis. As more individuals gain access to this botanical product through state ballot initiatives and legislative mandate, the pain specialist is likely to be confronted by patients either seeking such treatment where permitted, or otherwise inquiring about its potential benefits and harms, and alternative pharmaceuticals containing cannabinoids. PubMed searches were conducted using the following keywords: cannabis guidelines, harmful effects of cannabis, medical marijuana, medicinal cannabis, opioid cannabis interaction, cannabis dependence and cannabis abuse : The authors selected individual tenets a medicinal cannabis patient would be asked to review and acknowledge via signature. Undoubtedly, the knowledge base concerning risks will be an iterative process as we learn more about the long-term use of medicinal cannabis. But we should start the process now so that patients may be instructed about our current conception of what the use of medicinal cannabis entails.

  17. Benzodiazepines II: Waking Up on Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions in Transfer Patients

    Directory of Open Access Journals (Sweden)

    Jeffrey Guina


    Full Text Available This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision—sometimes mutually agreed-upon and sometimes unilateral—to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframe