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2.
J Drugs Dermatol ; 21(8): 917-918, 2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35946965

ABSTRACT

Research fellowships among prospective dermatology residency applicants are becoming increasingly popular. These fellowships provide opportunities for mentorship, publications, and clinical experience, but unpaid positions impose a significant financial burden. We advocate for a more holistic analysis of dermatology applicants, with less emphasis on publication quantity, and propose allocating funds for post-residency fellowships in underserved areas of dermatology.


Subject(s)
Dermatology , Internship and Residency , Students, Medical , Dermatology/education , Fellowships and Scholarships , Humans , Patient Care , Prospective Studies
3.
Sud Med Ekspert ; 65(4): 9-13, 2022.
Article in Russian | MEDLINE | ID: mdl-35947402

ABSTRACT

The objective of the study is to analyze 220 forensic medical examinations on criminal and civil cases and pre-investigation checks concerning the quality of emergency trauma care, involving an orthopedic traumatologist as a member of the expert panel. The main aspects of the forensic evaluation of medical care for patients with musculoskeletal injuries are described, including a thorough review of medical documentation data, completeness of past and present medical history in the medical records, injury mechanism, and completeness of the trauma course description in the medical records. The reasons for the forensic examinations, the causes of the main types of defects in medical care, and their relation to adverse outcomes were determined.


Subject(s)
Criminals , Orthopedics , Documentation , Forensic Medicine , Humans , Patient Care
4.
Rheum Dis Clin North Am ; 48(3): 617-636, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35953227

ABSTRACT

Since the first systemic lupus erythematosus (SLE) guidelines published by the American College of Rheumatology in 1999, accumulating data from observational and randomized-controlled studies, including the advent of biological agents, have stimulated the production of recommendations by various committees and task forces. Still, several areas relating to the diagnosis, treatment, and monitoring of SLE remain uncertain due to limited or inconclusive evidence, therefore emphasizing the role of expert consensus in reaching balanced and informative statements. This review outlines the most recent SLE recommendations highlighting key differences and important challenges that will also need to be considered in future updates.


Subject(s)
Lupus Erythematosus, Systemic , Rheumatology , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/therapy , Patient Care , Research Design
5.
BMJ Open ; 12(8): e060226, 2022 08 03.
Article in English | MEDLINE | ID: mdl-35922109

ABSTRACT

INTRODUCTION: In partnership with Cancer Council Western Australia (WA), the East Metropolitan Health Service in Perth, WA has developed a clinical simulation training programme 'Talking Together' using role play scenarios with trained actors as patients/carers. The aim of the training is to improve clinicians' communication skills when having challenging conversations with patients, or their carers, in relation to goals of care in the event of clinical deterioration. METHODS AND ANALYSIS: A multisite, longitudinal mixed-methods study will be conducted to evaluate the impact of the communication skills training programme on patient, family/carer and clinician outcomes. Methods include online surveys and interviews. The study will assess outcomes in three areas: evaluation of the 'Talking Together' workshops and their effect on satisfaction, confidence and integration of best practice communication skills; quality of goals of patient care conversations from the point of view of clinicians, carers and family/carers; and investigation of the nursing/allied role in goals of patient care. ETHICS AND DISSEMINATION: This study has received ethical approval from the Royal Perth Hospital, St John of God and Curtin University Human Research Ethics Committees. The outputs from this project will be a series of research papers and conference presentations.


Subject(s)
Goals , Simulation Training , Communication , Hospitals, Public , Humans , Patient Care , Western Australia
6.
BMJ Open ; 12(8): e051833, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35914920

ABSTRACT

OBJECTIVE: To determine the budget impact of virtual care. METHODS: We conducted a budget impact analysis of virtual care from the perspective of a large teaching hospital in the Netherlands. Virtual care included remote monitoring of vital signs and three daily remote contacts. Net budget impact over 5 years and net costs per patient per day (costs/patient/day) were calculated for different scenarios: implementation in one ward, in two different wards, in the entire hospital, and in multiple hospitals. Sensitivity analyses included best-case and worst-case scenarios, and reducing the frequency of daily remote contacts. RESULTS: Net budget impact over 5 years was €2 090 000 for implementation in one ward, €410 000 for two wards and €-6 206 000 for the entire hospital. Costs/patient/day in the first year were €303 for implementation in one ward, €94 for two wards and €11 for the entire hospital, decreasing in subsequent years to a mean of €259 (SD=€72), €17 (SD=€10) and €-55 (SD=€44), respectively. Projecting implementation in every Dutch hospital resulted in a net budget impact over 5 years of €-445 698 500. For this scenario, costs/patient/day decreased to €-37 in the first year, and to €54 in subsequent years in the base case. CONCLUSIONS: With present cost levels, virtual care only saves money if it is deployed at sufficient scale or if it can be designed such that the active involvement of health professionals is minimised. Taking a greenfield approach, involving larger numbers of hospitals, further decreases costs compared with implementing virtual care in one hospital alone.


Subject(s)
Budgets , Inpatients , Cost-Benefit Analysis , Hospitals , Humans , Netherlands , Patient Care
7.
Int J Mol Sci ; 23(15)2022 Jul 31.
Article in English | MEDLINE | ID: mdl-35955641

ABSTRACT

The implementation of high-throughput diagnostic sequencing has led to the generation of large amounts of mutational data, making their interpretation more complex and responsible for long delays. It has been important to prioritize certain analyses, particularly those of "actionable" genes in diagnostic situations, involving specific treatment and/or management. In our project, we carried out an objective assessment of the clinical actionability of genes involved in myopathies, for which only few data obtained methodologically exist to date. Using the ClinGen Actionability criteria, we scored the clinical actionability of all 199 genes implicated in myopathies published by FILNEMUS for the "National French consensus on gene Lists for the diagnosis of myopathies using next generation sequencing". We objectified that 63 myopathy genes were actionable with the currently available data. Among the 36 myopathy genes with the highest actionability scores, only 8 had been scored to date by ClinGen. The data obtained through these methodological tools are an important resource for strategic choices in diagnostic approaches and the management of genetic myopathies. The clinical actionability of genes has to be considered as an evolving concept, in relation to progresses in disease knowledge and therapeutic approaches.


Subject(s)
High-Throughput Nucleotide Sequencing , Muscular Diseases , Consensus , Humans , Muscular Diseases/diagnosis , Muscular Diseases/genetics , Muscular Diseases/therapy , Mutation , Patient Care
8.
BMJ Open Qual ; 11(Suppl 1)2022 08.
Article in English | MEDLINE | ID: mdl-35914815

ABSTRACT

BACKGROUND: ST-elevation myocardial infarction (STEMI) is a highly time-sensitive and life-threatening condition. Early recognition and timely management are challenging in a busy emergency department (ED), especially in low/middle-income countries where emergency systems are often fragmented. The aim of our quality improvement (QI) project was to increase the percentage of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) with door to balloon (D2B) time of <90 min by 30% over 12 months. METHODS: As part of the first step in QI, baseline data were collected at different points in the process of care. Using process maps and fishbone analysis, delays in patient registration, ECG and communication with cardiology were identified as some bottlenecks, and change ideas were tested using plan-do-study-act cycles using point-of-care QI methodology. The majority of the change ideas focused on interventions in the ED like strengthening triage, training frontline staff, early diagnosis and quick transportation of patients. RESULTS: During the baseline phase, 22.22% of patients were found to have a D2B time of <90 min. We achieved an increase of 47.78% in patients receiving PCI within 90 min and hence increased to 70% at the end of the intervention phase. Data collected for 4 months after the intervention phase were found to have sustained the effort. CONCLUSION: Significant improvement in the door to reperfusion time resulted from a meticulous assessment of emergency care processes by drawing process flow chart and implementation of change ideas like introduction of fast-track policy for patients with chest pain, reducing staff turnover in the triage area, formal training of staff, continuous engagement with cardiology team and by interchanging of processes which led to a reduction in time to ECG.


Subject(s)
Emergency Medical Services , Myocardial Infarction , Percutaneous Coronary Intervention , ST Elevation Myocardial Infarction , Electrocardiography , Humans , Myocardial Infarction/diagnosis , Myocardial Infarction/therapy , Patient Care , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/therapy , Tertiary Care Centers , Time Factors
9.
BMC Med Educ ; 22(1): 600, 2022 Aug 04.
Article in English | MEDLINE | ID: mdl-35927659

ABSTRACT

BACKGROUND: Rounds are a foundational practice in patient care and education in the inpatient healthcare environment, but increased demands on inpatient teams have led to dissatisfaction with inefficient, ineffective rounds. In this study, we describe the design, implementation, and evaluation of a novel rounding framework ("NET Rounding") that provides behaviorally-based strategies to inpatient teams to achieve efficient rounds while preserving patient safety and education. METHODS: NET Rounding consists of nine recommendations divided into three categories: Novel rounding strategies, shared Expectations, and Time management. This framework was introduced as a bundled intervention at a single-site, quaternary-care, academic hospital from March-May 2021. Eighty-three residents and 64 attendings rotated on the inpatient teaching service during the intervention period. Participants were surveyed before, during, and after their rotation about rounding's contribution to educational value, patient safety, resident duty hour violations and rotation experience. Additionally, rounding duration was recorded daily by team attendings. RESULTS: Thirty-two residents (38.5%) and 45 attendings (70%) completed post-intervention surveys. Rounding duration was recorded on 529/626 rounding days (80.6%) and resulted in achieving efficient rounds on 412/529 days (77.9%). Residents reported improvement in perceived patient safety (54 to 84%, p = 0.0131) and educational value of rounds (38 to 69%, p = 0.0213) due to NET Rounding; no change was observed amongst attendings in these areas (79 to 84% and 70 to 80%, p = 0.7083 and 0.4237, respectively). Overall, 29/32 residents (91%) and 33/45 attendings (73%) reported a positive impact on rotation experience. CONCLUSIONS: NET Rounding enabled inpatient teaching teams to complete rounds more efficiently while preserving patient safety and education.


Subject(s)
Internship and Residency , Teaching Rounds , Humans , Patient Care , Surveys and Questionnaires
10.
JCO Clin Cancer Inform ; 6: e2200006, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35917480

ABSTRACT

PURPOSE: The advancement of natural language processing (NLP) has promoted the use of detailed textual data in electronic health records (EHRs) to support cancer research and to facilitate patient care. In this review, we aim to assess EHR for cancer research and patient care by using the Minimal Common Oncology Data Elements (mCODE), which is a community-driven effort to define a minimal set of data elements for cancer research and practice. Specifically, we aim to assess the alignment of NLP-extracted data elements with mCODE and review existing NLP methodologies for extracting said data elements. METHODS: Published literature studies were searched to retrieve cancer-related NLP articles that were written in English and published between January 2010 and September 2020 from main literature databases. After the retrieval, articles with EHRs as the data source were manually identified. A charting form was developed for relevant study analysis and used to categorize data including four main topics: metadata, EHR data and targeted cancer types, NLP methodology, and oncology data elements and standards. RESULTS: A total of 123 publications were selected finally and included in our analysis. We found that cancer research and patient care require some data elements beyond mCODE as expected. Transparency and reproductivity are not sufficient in NLP methods, and inconsistency in NLP evaluation exists. CONCLUSION: We conducted a comprehensive review of cancer NLP for research and patient care using EHRs data. Issues and barriers for wide adoption of cancer NLP were identified and discussed.


Subject(s)
Natural Language Processing , Neoplasms , Electronic Health Records , Humans , Information Storage and Retrieval , Neoplasms/diagnosis , Neoplasms/therapy , Patient Care
11.
Enferm. intensiva (Ed. impr.) ; 33(3): 151-162, Jul - Sep 2022. tab
Article in Spanish | IBECS | ID: ibc-VR-294

ABSTRACT

Introducción: El proceso enfermero constituye el método científico propio de la disciplina enfermera. Y, aunque en los últimos años ha experimentado una rápida expansión en determinados espacios, no ha ocurrido así en unidades especiales como la unidad de cuidados intensivos. Objetivo: Determinar los motivos por los que las enfermeras muestran poca sensibilización hacia la incorporación de la metodología enfermera en las unidades de cuidados intensivos. Método: Revisión bibliográfica realizada entre noviembre y diciembre de 2020 en las bases de datos Pubmed, Cinahl, Cuiden, Lilacs, Cochrane, Sicelo, Web of Science, además de una búsqueda en literatura gris y en revistas electrónicas. Se emplearon los operadores booleanos AND y OR y se aplicó el limitador temporal de los últimos 10 años (2010-2020). Resultados: Se seleccionaron un total de 20 artículos. Las enfermeras de la unidad de cuidados intensivos percibieron una falta de conocimientos sobre el uso de la metodología enfermera cuyo problema comienza desde la formación universitaria y se prolonga dentro de las instituciones con la escasa formación continuada. Mientras que la sobrecarga de trabajo restó tiempo para poder emplear esta herramienta que se encuentra entre las últimas prioridades de las enfermeras. Conclusiones: Se hace necesario realizar estudios de investigación sobre las soluciones que, en palabras de los/as enfermeros/as podrían ser útiles para abordar este problema, así como el impacto que los programas de formación en metodología tienen sobre su aplicación en la práctica.(AU)


Introduction: The nursing process is the scientific method specific to the nursing discipline. However, although in recent years it has rapidly expanded in certain areas, this has not been the case in special units such as the intensive care unit. Objective: To determine the reasons nurses show little awareness of incorporating nursing methodology in Intensive Care Units. Method: Literature review conducted between November and December 2020 in the databases Pubmed, Cinahl, Cuiden, Lilacs, Cochrane, Sicelo, Web of Science, in addition to a search of grey literature and electronic journals. Boolean operators AND and OR were used and the temporal limiter of the last 10 years (2010-2020) was applied. Results: A total of 20 articles were selected. Intensive Care Units nurses perceived a lack of knowledge on how to use nursing methodology. This problem begins in university education and continues in the institutions with little continuing education. Nurses’ work overload takes time from being able to use this tool, which is among the lowest of their priorities. Conclusions: Research studies are required on solutions that, in the nurses’ words, could be useful in tackling this problem, and on the impact that training programmes in methodology have on its application in practice.(AU)


Subject(s)
Sensitivity and Specificity , Nurses , Women , Nursing Methodology Research , Nursing Care , Quality of Life , Patient Care , Education , Intensive Care Units , Critical Care Nursing
12.
Am J Health Syst Pharm ; 79(16): 1304-1305, 2022 08 05.
Article in English | MEDLINE | ID: mdl-35849123
13.
Ann Fam Med ; 20(4): 319-327, 2022.
Article in English | MEDLINE | ID: mdl-35879087

ABSTRACT

PURPOSE: To describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in US primary care. METHODS: This was an observational registry study using data from the Chronic Obstructive Pulmonary Disease (COPD) Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience COPD registry is derived. Registry patients were aged ≥35 years at diagnosis. Electronic health record data were collected from both registries, supplemented with patient-reported information/outcomes from the Advancing the Patient Experience registry from 5 primary care groups in Texas, Ohio, Colorado, New York, and North Carolina (June 2019 through November 2020). RESULTS: Of 17,192 patients included, 1,354 were also in the Advancing the Patient Experience registry. Patients were predominantly female (56%; 9,689/17,192), White (64%; 9,732/15,225), current/ex-smokers (80%; 13,784/17,192), and overweight/obese (69%; 11,628/16,849). The most commonly prescribed maintenance treatments were inhaled corticosteroid with a long-acting ß2-agonist (30%) and inhaled corticosteroid with a long-acting muscarinic antagonist (27%). Although 3% (565/17,192) of patitents were untreated, 9% (1,587/17,192) were on short-acting bronchodilator monotherapy, and 4% (756/17,192) were on inhaled corticosteroid monotherapy. Despite treatment, 38% (6,579/17,192) of patients experienced 1 or more exacerbations in the last 12 months. These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high or very high impact of disease on their health (43%; 580/1,322), a breathlessness score 2 or more (45%; 588/1,315), and 1 or more exacerbation in the last 12 months (50%; 646/1,294). CONCLUSIONS: Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by COPD patients managed in US primary care, and the need for more real-life effectiveness trials to support decision making at the primary care level.


Subject(s)
Adrenergic beta-2 Receptor Agonists , Pulmonary Disease, Chronic Obstructive , Administration, Inhalation , Adrenal Cortex Hormones/therapeutic use , Adrenergic beta-2 Receptor Agonists/adverse effects , Bronchodilator Agents/therapeutic use , Female , Humans , Male , Patient Care , Patient Outcome Assessment , Primary Health Care , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/epidemiology , Registries
14.
Ned Tijdschr Geneeskd ; 1662022 06 16.
Article in Dutch | MEDLINE | ID: mdl-35899742

ABSTRACT

Five years ago, we described the skin-to-skin caesarean section, a procedure in which parental participation, slow delivery and direct skin-to-skin contact are important aspects. By multiple research, the skin-to-skin CS has been shown to have positive outcomes for the child and parents, as long as there is attention for neonatal thermal regulation. These outcomes should lead to cost reduction, versus the extra personnel costs for the nurse. However, a proper cost-effectiveness analysis has not yet been described. There are still many local differences in availability and performance of the skin-to-skin CS in the Netherlands, often caused by logistical challenges. In the meanwhile the protocol has been further optimized. In our opinion, the skin-to-skin caesarean section is better care for parents and their child, and should be available anywhere anytime, as long as the fetal and maternal condition permits this.


Subject(s)
Cesarean Section , Patient Care , Cesarean Section/methods , Child , Female , Humans , Infant, Newborn , Netherlands , Pregnancy
15.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 49(3): 100752, Jul - Sep 2022. ilus, graf
Article in Spanish | IBECS | ID: ibc-205912

ABSTRACT

La pandemia por la COVID-19 generó un cambio de forma brusca en la práctica asistencial habitual de nuestra unidad de uroginecología, y a raíz de esta situación se ideó un nuevo modelo asistencial para adaptarnos a la nueva etapa epidemiológica. Se acordó, como eje central del nuevo modelo, la disminución de la presencialidad hospitalaria, ofreciendo la misma calidad asistencial mediante la introducción de la telemedicina.Para conseguir tal fin, se elaboró un modelo con tres tipos de visitas nuevas: primera visita médica telemática, visitas de seguimiento de tratamientos conservadores y farmacológicos telemáticas, y creación de visita pack (pack STUI, el pack posparto y el pack postalta) que incluye visitas y pruebas diagnósticas uroginecológicas que se realizan todas el mismo día.El pack STUI va dirigido a todas las pacientes con síntomas del tracto urinario inferior, asociados o no a prolapso de órganos pélvicos. Consta de dos visitas (enfermería y médica), y dos pruebas diagnósticas avanzadas (urodinamia y ecografía de suelo pélvico).El pack posparto va dirigido a mujeres con síntomas de incontinencia urinaria, incontinencia anal, prolapso y/o alteraciones de la sexualidad tras el parto. También incluye mujeres asintomáticas con antecedente de trauma perineal obstétrico. Consta de una visita médica, una ecografía de suelo pélvico y una visita por la fisioterapeuta.El pack postalta se realiza al mes de la cirugía e incluye dos pruebas (ecografía de suelo pélvico y flujometría) y una visita médica.Los tratamientos de fisioterapia y otras visitas que por motivos médicos lo requirieran, han mantenido su presencialidad.(AU)


The COVID-19 pandemic caused a sudden change in the usual care practice of our urogynaecology unit. Therefore, we designed a new healthcare model to adapt our practice to the epidemiological situation. The central axis of the new model was reduced hospital attendance, offering the same healthcare quality through the introduction of telemedicine.To achieve this aim, we made the following changes: a first telematic medical visit was the first step, telematic monitoring visits for conservative and pharmacological treatments and pack visit. We created the following packs: LUTS, postpartum and post-discharge pack. All packs included visits and diagnostic tests performed on the same day.The LUTS pack is indicated in patients with lower urinary tract symptoms, associated or not with pelvic organ prolapse. It includes two visits (nursing and medical) and two tests (urodynamics and pelvic floor ultrasound).The postpartum pack is indicated in women with symptoms of urinary incontinence, anal incontinence, pelvic organ prolapse and sexual disfunctions after delivery, as well as asymptomatic patients with a history of obstetric perineal trauma. It includes a medical visit, a pelvic floor ultrasound and a visit with the physiotherapist.The post-discharge pack is scheduled a month after the surgery and includes two tests (pelvic floor ultrasound and uroflowmetry) and a medical visit.Some face-to-face visits were maintained, as were physiotherapy treatments and other visits following medical criteria.(AU)


Subject(s)
Humans , Female , Remote Consultation , Telemedicine , Pandemics , Betacoronavirus , Coronavirus Infections , SARS Virus , Pelvic Floor , Patient Care , Gynecology , Obstetrics
16.
Eur J Gen Pract ; 28(1): 203-208, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35815445

ABSTRACT

Digital health is the convergence of digital technologies with health, healthcare, living, and society. Contrasting with the slow trend during the last decades, in the last few years, we have observed an expansion and widespread adoption and implementation. In this paper, we revisit the potential that digital health presents for the delivery of higher quality, safer and more equitable care. Focussing on three examples - patient access to health records, big data analytics, and virtual care - we discuss the emerging opportunities and challenges of digital health, and how they can change primary care. We also reflect on the implications for research to evaluate digital interventions: the need to evaluate clear outcomes in light of the six dimensions of quality of care (patient-centredness, efficiency, effectiveness, safety, timeliness, and equity); to define clear populations to understand what works and for which patients; and to involve different stakeholders in the formulation and evaluation of the research questions. Finally, we share five wishes for the future of digital care in General Practice: the involvement of primary healthcare professionals and patients in the design and maintenance of digital solutions; improving infrastructure, support, and training; development of clear regulations and best practice standards; ensuring patient safety and privacy; and working towards more equitable digital solutions, that leave no one behind.


Subject(s)
Telemedicine , Delivery of Health Care , Digital Technology , Humans , Patient Care , Primary Health Care/methods , Telemedicine/methods
18.
Article in English | MEDLINE | ID: mdl-35897296

ABSTRACT

BACKGROUND: There is a need to familiarize medical students with the specifics of video consultations. This paper presents the concept and tests of a digitally synchronous distance seminar in which medical students practice video consultations as an aid to a family physician's activity in a patient-oriented manner. The aim of the evaluation was to analyze the strengths, weaknesses, opportunities, and threats (S.W.O.T.) of the teaching concept. METHODS: A total of 12 students carried out video consultations independently and under medical supervision. The seminar included two elements: (A) All students and teachers were video consulted in a family practice; (B) A small group performed a video consultation in a patient´s home environment. The students' evaluation was conducted with two questionnaires (pre/post), which were analyzed with descriptive statistics and qualitative content analysis. The S.W.O.T. analysis was elaborated by the author team based on the results of the questionnaires and the interviews with the teachers. RESULTS: Students learned the limits and possibilities of teleconsultations and deepened their family medical knowledge. Strengths: Among others; increase interest in video consultations, patient contact, focused work. Weaknesses: Among others; technical difficulties and the time it requires. OPPORTUNITIES: Among others; involve students with multiple workloads in patient teaching. RISKS: Among others; no integration into the curriculum yet, few personnel resources. CONCLUSIONS: The learning model familiarizes medical students with competences in family medical patient care using video communication. The results of S.W.O.T. analyses can be weighted differently. Project groups can decide individually if they want to integrate the learning concept into their curriculum and which further improvements are necessary.


Subject(s)
Students, Medical , Telemedicine , Curriculum , Family Practice , Humans , Patient Care
19.
Hosp Pediatr ; 12(8): 703-710, 2022 Aug 01.
Article in English | MEDLINE | ID: mdl-35791770

ABSTRACT

BACKGROUND AND OBJECTIVES: Schwartz Rounds (SR) is an interdisciplinary program that focuses on compassionate care by allowing the formation of an interprofessional community around the human and emotional testimonies of caregivers. The purpose of this study was to examine the impact of implementing departmental SR on pediatric care providers at a tertiary care children's hospital in New York. METHODS: We applied the logic outcomes model for program evaluation to examine the impact of SR on pediatric providers. The standard evaluation form provided by the Schwartz Center was used to collect data after every SR. Descriptive statistics and qualitative data content analysis methods were used to analyze the evaluation data from the SR. RESULTS: A total of 820 standard evaluation forms were collected from 17 of the 23 SR sessions offered (response rate: 74.8%). Most participants felt that, during the SR sessions, challenging social and emotional aspects of patient care were discussed and that they gained better perspectives of their coworkers and their patients/families. They reported less isolation and more openness to express their feelings about patient care to their coworkers. The analysis of 299 written comments identified 5 themes: understanding other people's perspectives, the importance of communication, empathy and compassion, awareness of personal biases, and maintaining boundaries. CONCLUSIONS: Schwartz Rounds can provide an effective venue for pediatric care providers to gain insights into coworker and patient/family perspectives and process emotional experiences while providing patient care in a variety of circumstances.


Subject(s)
Teaching Rounds , Child , Communication , Emotions , Empathy , Humans , Patient Care , Teaching Rounds/methods
20.
BMC Health Serv Res ; 22(1): 947, 2022 Jul 26.
Article in English | MEDLINE | ID: mdl-35883061

ABSTRACT

BACKGROUND: An individual's health status varies with age, with most health problems increasing through different life stages. Yet, a key feature of the majority of conditions contributing burden to society globally, irrespective of life stage, is the predominance of chronic, non-communicable diseases (NCDs). An important response to this growing burden is the increasing recognition of addressing NCD prevention through a life-course perspective through primary care and public health. Naturopathy is a traditional medicine system originating from Europe, and its practitioners commonly provide primary care and focus on prevention and wellness. However, little is known about naturopathic practitioners (NPs) contribution to health care across different life stages. METHODS: This secondary analysis of a cross-sectional study aimed to describe the approach to the care of NPs based on the life stage of their patients. The primary study recruited NPs from 14 regions or countries, who were invited to complete a short survey about 20 consecutive patients. The multilingual survey included the following domains: patient demographics, reason for visit, prescribed or recommended treatments, and naturopathic interpretation of the health conditions. Descriptive statistics were tabulated as frequencies and percentages and chi square tests were used to test associations and compare groups. Effect size was determined by Cramer's V. RESULTS: Participant NPs (n = 56) provided consultation details for 854 patients encounters. There were differences in the patient's primary reason for visiting, the additional physiological systems the NP considered important in the management of the patient's health, and the treatments prescribed across all life stages. However, diet (45.1-70.0%) and lifestyle (14.3-60.0%) prescription were the most common categories of treatments across all patient groups. CONCLUSION: NPs provide care to patients across all life stages, and diverse conditions pertinent to those life stages while also demonstrating a holistic approach that considers broader health concerns and long term treatment practices. While there may be emerging evidence supporting and informing NP clinical outcomes, the breadth and diversity of health conditions, populations and treatments within the scope of naturopathic practice underscores a need for urgent and widescale research investigating naturopathic care across the life course.


Subject(s)
Naturopathy , Patient Care , Cross-Sectional Studies , Humans , Surveys and Questionnaires
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