ABSTRACT
Juvenile dermatomyositis is an idiopathic inflammatory myopathy of childhood not previously described in a patient with sickle cell disease. We present a case of an 11-year-old girl with sickle cell disease who was diagnosed subsequently with juvenile dermatomyositis, and highlight the diagnostic and therapeutic challenges of these concurrent chronic diseases.
Subject(s)
Anemia, Sickle Cell/complications , Anemia, Sickle Cell/diagnosis , Dermatomyositis/complications , Dermatomyositis/diagnosis , Anemia, Sickle Cell/therapy , Child , Dermatomyositis/therapy , Female , HumansABSTRACT
PURPOSE: Many hospitals are adopting family-centered rounds (FCRs). Limited studies suggest that FCRs improve family and staff satisfaction. No study has investigated residents' opinions about FCRs. We sought to elicit house staff opinions regarding structure, teaching, and patient care with FCRs. METHOD: In fall 2006, FCRs were implemented at Alfred I duPont Hospital for Children, a freestanding children's hospital. Between March and June 2008, a cross-sectional study was mailed to pediatrics and medicine-pediatric residents. RESULTS: Nearly all (89%) respondents supported FCRs somewhat (50%) or strongly (39%). House staff cited improved relationships with other providers, increased parent/family satisfaction, decreased need for plan clarification, and improved, "nondidactic" teaching. Concerns persisted about didactic teaching and efficiency. The most important factor associated with resident satisfaction was the attending physician. CONCLUSIONS: Residents support the use of FCRs.Training for inpatient attending physicians should include facilitation of FCRs. Concerns about efficiency and didactic teaching should be considered when implementing FCRs.