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1.
Hu Li Za Zhi ; 66(6): 27-32, 2019 Dec.
Artículo en Chino | MEDLINE | ID: mdl-31802452

RESUMEN

This article reports on an effort to use the learning organization to change the existing mental model of a nursing team in order to transform from a nursing-oriented group to a patient-oriented group and to build shared vision, self-affirmation, and self-transcendence in order to change perspectives using team-learning spirit. The nursing group built partnerships with the patient group. The nursing group learning process fostered positive thinking logic and, under the inheritance of knowledge and technology, the patient-oriented group was successfully established. This model will be expanded to more patient-oriented groups. Through the experience sharing and joint supervision, this model may change lifestyles by implementing the concept of "My health, I care" and, ultimately, help patients achieve self-healthcare.


Asunto(s)
Aprendizaje , Grupo de Enfermería/organización & administración , Atención Dirigida al Paciente/organización & administración , Humanos , Modelos de Enfermería
2.
BMC Public Health ; 19(1): 1325, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640648

RESUMEN

BACKGROUND: Studies of the relationship between diverse populations, healthcare access and health outcomes have been dominated by approaches focusing on ethno-national groups or specific healthcare sectors. Healthcare bricolage conceptualises the processes by which individuals use multiple resources to address health concerns. It is relevant in superdiverse neighbourhoods with complex populations. This paper is original in its application of mixed methods to examine the extent to which, and the reasons why, individuals engage in healthcare bricolage. METHODS: The study utilized a parallel sequential methodology. Eight superdiverse neighbourhoods were selected, two in each of Bremen, Birmingham, Lisbon and Uppsala. Ethnographic research scoping the nature of each healthcare ecosystem was followed by 160 interviews (20 each neighbourhood) with a maximum variation sample of residents undertaken October 2015 to December 2016. Interviewees were asked to recall a health concern and describe actions taken to attempt resolution. Data was coded with a MAXQDA codebook checked for inter-coder reliability. Interview findings enabled identification of five types of bricolage, the nature of healthcare resources utilised and the factors which influenced residents' tactics. Results were used to design a household survey using new questions and validated epidemiological instruments implemented January to October 2017. Respondents were identified using random address files and interviewed in person or by telephone. Multinomal logistic regressions were used to estimate the effect of changing the values of determinants on the probability of observing an outcome. RESULTS: Age, gender, level of education, migration background and extent of functional limitation were associated with bricolage tactics. Individuals demonstrating high levels of agency were more likely than those with low levels to engage in bricolage. Residents with high levels of trust in physicians were less likely to bricolage than those with lower levels of trust. Levels of health literacy showed no significant effects. CONCLUSIONS: The nature and severity of health concern, trust in physicians and agency shaped residents' bricolage tactics. The concept of bricolage enabled us to make visible the actions and resources utilised around public healthcare systems that would otherwise remain outwith healthcare access research. Actions were frequently undertaken via networks offering insights into healthcare-seeking behaviour.


Asunto(s)
Centros Comunitarios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Disparidades en Atención de Salud/organización & administración , Características de la Residencia , Conducta Cooperativa , Ecosistema , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Dirigida al Paciente/organización & administración , Reproducibilidad de los Resultados
3.
J Nurs Adm ; 49(11): 543-548, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31651614

RESUMEN

Nursing leadership can play an essential role in the development of nursing informatics solutions by virtue of their broad understanding and oversight of nursing care. We describe a systems-level method for creating nursing informatics solutions with clearly defined structure and leadership from nursing executives. Based on the guiding principles of clear lines of responsibility, respect for expertise, and commitment to project aims, this allows nursing executive leadership to organize, set up, and own the development of nursing informatics solutions.


Asunto(s)
Liderazgo , Enfermeras Administradoras/normas , Rol de la Enfermera , Informática Aplicada a la Enfermería/organización & administración , Atención Dirigida al Paciente/organización & administración , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reino Unido , Estados Unidos
4.
Rev Infirm ; 68(254): 22-24, 2019 Oct.
Artículo en Francés | MEDLINE | ID: mdl-31587845

RESUMEN

To meet today's challenges and prepare for the future, our health system's "My Health 2022" strategic plan recommends development of prevention and health promotion and better access to quality care. This requires development of co-ordinated exercise between professionals and support structures and further development of digital and e-health.


Asunto(s)
Relaciones Interprofesionales , Enfermería/organización & administración , Atención Dirigida al Paciente/organización & administración , Humanos
5.
Urologiia ; (4 ()): 19-24, 2019 Sep.
Artículo en Ruso | MEDLINE | ID: mdl-31535793

RESUMEN

A multidisciplinary approach is currently a necessary and standard approach in treatment of cancer patients. The main goals of the multidisciplinary approach include coordinated highly effective interaction of medical specialists to timely identify, prescribe and conduct planned treatment, as well as prevention and correction of adverse events of treatment to achieve most lasting effect of treatment. The article discusses role of multidisciplinary team, including an oncologist, urologist, pathomorphologist, molecular genetics, radiologist, medical oncologist, radiation therapist, neurosurgeon, orthopedic surgeon, endovascular, thoracic and abdominal surgeons for effective treatment of oncourological patients. To solve existing problems, it is necessary to create common standards for the treatment of oncological diseases, develop and improve an oncological care system, improve logistics and improve skills of specialists or train specialists in the required profile.


Asunto(s)
Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración , Neoplasias Urológicas/terapia , Humanos , Grupo de Atención al Paciente/tendencias , Atención Dirigida al Paciente/tendencias , Médicos , Cirujanos , Resultado del Tratamiento
6.
Mayo Clin Proc ; 94(11): 2291-2301, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31563425

RESUMEN

Ensuring that the patient's voice is routinely incorporated in all aspects of health care in oncology is essential to provide quality care. Patient reported outcomes (PROs) are standardized measures that are used to obtain the patient's perspective and are increasingly used in all aspects of health care to ensure optimal delivery of patient-centered care. The US Food and Drug Administration encourages that PROs be used in studies for label indications. There are no uniform standardized methods to use PROs nor is there consensus on which PROs are best for regulatory approval, comparative effectiveness research, toxicity assessment, health-related quality of life, or symptom monitoring. For this review, we conducted a literature search using PubMed and Google Scholar, and herein summarize the evidence related to the use of PROs in clinic care and research. Using valid, reliable, and easily interpretable PROs developed in comparable populations will provide the most useful results. Various ways that PROs can be used successfully in oncology have been exemplified in this overview to provide clinicians and researchers practical guidance.


Asunto(s)
Medición de Resultados Informados por el Paciente , Satisfacción del Paciente/estadística & datos numéricos , Calidad de Vida , Humanos , Oncología Médica , Neoplasias , Atención Dirigida al Paciente/organización & administración
7.
Croat Med J ; 60(4): 316-324, 2019 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-31483117

RESUMEN

AIM: To assess the rates of specialist visits and visits to hospital emergency departments (ED) among patients in Austria with and without concurrent general practitioner (GP) consultation and among patients with and without chronic disease. METHODS: The cross-sectional questionnaire study was conducted in the context of the QUALICOPC project in 2012. Fieldworkers recruited 1596 consecutive patients in 184 GP offices across Austria. The 41-question survey addressed patients' experiences with regard to access to, coordination, and continuity of primary care, as well demographics and health status. Descriptive statistics as well as univariate and multivariate regression models were applied. RESULTS: More than 90% of patients identified a GP as a primary source of care. Among all patients, 85.5% reported having visited a specialist and 26.4% the ED at least once in the previous year. Having a usual GP did not change the rate of specialist visits. Additionally, patients with chronic disease had a higher likelihood of presenting to the ED despite having a GP as a usual source of care. CONCLUSION: Visiting specialists in Austria is quite common, and the simple presence of a GP as a usual source of care is insufficient to regulate pathways within the health care system. This can be particularly difficult for chronic care patients who often require care at different levels of the system and show higher frequency of ED presentations.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Control de Acceso/organización & administración , Médicos Generales/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Atención Dirigida al Paciente/organización & administración , Especialización/estadística & datos numéricos , Adolescente , Adulto , Anciano , Austria , Enfermedad Crónica , Estudios Transversales , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Derivación y Consulta , Encuestas y Cuestionarios , Adulto Joven
8.
Am J Occup Ther ; 73(5): 7305090010p1-7305090010p6, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31484018

RESUMEN

Passage of the Patient Protection and Affordable Care Act in 2010 mandated reform of the United States' existing primary care system. As part of this reform, advanced practice models, including the Patient-Centered Medical Home model, expanded, with the goal of increasing the use of interprofessional teams. Integrating occupational therapy was promoted as an opportunity to enhance the value of care provided in these redesigned primary care practices. However, occupational therapy's presence in primary care is still extremely limited.


Asunto(s)
Terapia Ocupacional , Humanos , Patient Protection and Affordable Care Act/legislación & jurisprudencia , Atención Dirigida al Paciente/organización & administración , Atención Primaria de Salud , Estados Unidos
9.
Bull World Health Organ ; 97(8): 563-569, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31384074

RESUMEN

In 2018, three independent reports were published, emphasizing the need for attention to, and improvements in, quality of care to achieve effective universal health coverage. A key aspect of high quality health care and health systems is that they are person-centred, a characteristic that is at the same time intrinsically important (all individuals have the right to be treated with dignity and respect) and instrumentally important (person-centred care is associated with improved health-care utilization and health outcomes). Following calls to make 2019 a year of action, we provide guidance to policy-makers, researchers and implementers on how they can take on the task of measuring person-centred care. Theoretically, measures of person-centred care allow quality improvement efforts to be evaluated and ensure that health systems are accountable to those they aim to serve. However, in practice, the utility of these measures is limited by lack of clarity and precision in designing and by using measures for different aspects of person-centeredness. We discuss the distinction between two broad categories of measures of patient-centred care: patient experience and patient satisfaction. We frame our discussion of these measures around three key questions: (i) how will the results of this measure be used?; (ii) how will patient subjectivity be accounted for?; and (iii) is this measure validated or tested? By addressing these issues during the design phase, researchers will increase the usability of their measures.


Asunto(s)
Satisfacción del Paciente , Atención Dirigida al Paciente/organización & administración , Indicadores de Calidad de la Atención de Salud/normas , Calidad de la Atención de Salud/organización & administración , Proyectos de Investigación , Humanos , Atención Dirigida al Paciente/normas , Mejoramiento de la Calidad , Calidad de la Atención de Salud/normas , Reproducibilidad de los Resultados
10.
J Athl Train ; 54(8): 858-868, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31386579

RESUMEN

CONTEXT: Determining meaningful aspects of health is crucial for outcome assessment; however, limited literature exists on the aspects of health that are deemed meaningful by the athletic patient population. OBJECTIVE: To identify experiences and meaningful outcomes after lower extremity (LE) musculoskeletal injury among collegiate athletes. DESIGN: Qualitative study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A purposive sample of 20 athletes (10 men, 10 women; age = 20.1 ± 1.83 years) from a National Collegiate Athletic Association Division I institution in the Midwest who had sustained an LE injury. DATA COLLECTION AND ANALYSIS: Semistructured face-to-face interviews and inductive data analysis were conducted. Trustworthiness of the data was established using member checks and peer debriefing. RESULTS: Four themes emerged from the data, revealing that physical changes, psychological changes, personal and lifestyle changes, and support were the most meaningful outcomes among athletes with an LE injury. The 4 themes were associated with 21 subthemes, indicating the complexity with which LE injury affects individuals. CONCLUSIONS: Our findings demonstrate the importance of caring for the whole person. Athletic trainers must broaden their focus to provide the best patient care and consider the person's activities and life demands outside of athletic participation. The themes identified in this study provide a basis for selecting appropriate health markers and outcome measures.


Asunto(s)
Atletas/psicología , Extremidad Inferior/lesiones , Sistema Musculoesquelético/lesiones , Calidad de Vida , Heridas y Traumatismos , Femenino , Humanos , Masculino , Atención Dirigida al Paciente/organización & administración , Investigación Cualitativa , Recuperación de la Función , Apoyo Social , Estudiantes/psicología , Universidades , Heridas y Traumatismos/etiología , Heridas y Traumatismos/psicología , Heridas y Traumatismos/rehabilitación , Adulto Joven
11.
BMC Health Serv Res ; 19(1): 564, 2019 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-31409347

RESUMEN

BACKGROUND: Families play an important role meeting the care needs of individuals who require assistance due to illness and/or disability. Yet, without adequate support their own health and wellbeing can be compromised. The literature highlights the need for a move to family-centered care to improve the well-being of those with illness and/or disability and their family caregivers. The objective of this paper was to explore existing models of family-centered care to determine the key components of existing models and to identify gaps in the literature. METHODS: A scoping review guided by Arksey & O'Malley (2005) examined family-centered care models for diverse illness and age populations. We searched MEDLINE, PsycINFO, CINAHL and EMBASE for research published between 1990 to August 1, 2018. Articles describing the development of a family-centered model in any patient population and/or healthcare field or on the development and evaluation of a family-centered service delivery intervention were included. RESULTS: The search identified 14,393 papers of which 55 met our criteria and were included. Family-centered care models are most commonly available for pediatric patient populations (n = 40). Across all family-centered care models, the consistent goal is to develop and implement patient care plans within the context of families. Key components to facilitate family-centered care include: 1) collaboration between family members and health care providers, 2) consideration of family contexts, 3) policies and procedures, and 4) patient, family, and health care professional education. Some of these aspects are universal and some of these are illness specific. CONCLUSIONS: The review identified core aspects of family-centred care models (e.g., development of a care plan in the context of families) that can be applied to all populations and care contexts and some aspects that are illness specific (e.g., illness-specific education). This review identified areas in need of further research specifically related to the relationship between care plan decision making and privacy over medical records within models of family centred care. Few studies have evaluated the impact of the various models on patient, family, or health system outcomes. Findings can inform movement towards a universal model of family-centered care for all populations and care contexts.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Personal de Salud/organización & administración , Atención Dirigida al Paciente/organización & administración , Prestación de Atención de Salud/tendencias , Guías como Asunto , Personal de Salud/tendencias , Humanos
13.
BMC Health Serv Res ; 19(1): 575, 2019 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-31419980

RESUMEN

BACKGROUND: Recently, there has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM). Yet it remains unclear which patient characteristics should be determined to guide such an approach. Therefore, the opinions of healthcare providers (HCP) and people with T2DM about relevant patient characteristics for estimating healthcare needs of people with T2DM were assessed and compared. METHODS: Two separate online Delphi studies were conducted according to the RAND-UCLA Appropriateness Method: one with HCPs (n = 22) from Dutch primary and secondary care and one with people with T2DM treated in Dutch primary care (n = 46). The relevance of patient characteristics for estimating healthcare needs, defined as the number of yearly consultations, was assessed on a 5-point Likert scale. Characteristics with a median of 4 or 5 and an interquartile range ≤ 1.5 were considered relevant with consensus. Participants were also asked to select the top 5 of most relevant patient characteristics. To determine the overall top 5, the mean relative importance score of each characteristic was calculated. RESULTS: In two Delphi rounds, 28 and 15 patient characteristics were rated by HCPs and people with T2DM, respectively. Both HCPs and people with T2DM found health-related characteristics relevant for estimating healthcare needs of people with T2DM. However, HCPs preferred to estimate healthcare needs using person- and context-related characteristics. They ranked self-efficacy as the most relevant estimator. In contrast, people with T2DM were more in favor of health-related characteristics and ranked HbA1c as the most relevant estimator. CONCLUSIONS: The findings show that there is discrepancy in opinions on relevant patient characteristics for estimating healthcare needs between HCPs and people with T2DM. To achieve more tailored, patient-centered care, it is important that both groups agree on the topics to be discussed during patient consultations.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Personal de Salud/organización & administración , Evaluación de Necesidades/organización & administración , Atención Dirigida al Paciente/organización & administración , Anciano , Técnica Delfos , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino
14.
Prim Care ; 46(3): 287-302, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31375182

RESUMEN

Palliative care is a field of medicine that delivers patient-centered care for individuals and their families suffering from serious illness at all stages of the disease trajectory. It addresses the major priorities of relieving suffering, establishing goals of care, and managing physical symptoms while integrating the psychosocial, cultural, spiritual, and existential complexities of coping with chronic illness. This article discusses the role of palliative care in the health care system. It reviews the importance of prognostication, disease trajectory, and communication. The role of the primary care physician as part of a multidisciplinary team member delivering primary palliative care is emphasized.


Asunto(s)
Cuidados Paliativos al Final de la Vida/métodos , Cuidados Paliativos/métodos , Atención Primaria de Salud/organización & administración , Comunicación , Continuidad de la Atención al Paciente/organización & administración , Cuidados Paliativos al Final de la Vida/psicología , Humanos , Comunicación Interdisciplinaria , Cuidados Paliativos/psicología , Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración , Calidad de Vida , Revelación de la Verdad
15.
Prim Care ; 46(3): 303-317, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31375183

RESUMEN

Hospice is a model of care that offers significant benefits to patients at the end of their lives, their families, and also to the primary care physicians who have diligently cared for their patients. As comprehensive care physicians, primary care physicians can benefit from a strong understanding of hospice and the Medicare Hospice Benefit. This article describes the history of hospice, palliative care versus hospice care, clinical appropriateness of the hospice patient, the regulatory guidelines of the Medicare Hospice Benefit, hospice reimbursement, primary care reimbursement, and employment opportunities in hospice.


Asunto(s)
Cuidados Paliativos al Final de la Vida/métodos , Médicos de Atención Primaria , Atención Primaria de Salud/organización & administración , Comunicación , Continuidad de la Atención al Paciente/organización & administración , Cuidados Paliativos al Final de la Vida/psicología , Humanos , Reembolso de Seguro de Salud , Comunicación Interdisciplinaria , Cuidados Paliativos/métodos , Cuidados Paliativos/psicología , Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración , Pronóstico , Calidad de Vida , Derivación y Consulta/organización & administración , Derivación y Consulta/estadística & datos numéricos , Factores de Tiempo , Revelación de la Verdad
16.
Int J Equity Health ; 18(1): 107, 2019 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-31272466

RESUMEN

PURPOSE: Chronic disease is a global concern. While ample research has aimed to identify the epidemiology of multimorbidity and patient complexity using administrative data, little attention has been paid to the processes of care that treating complex patients entail. Consequently, the concept of patient complexity itself does not directly speak to how challenging it may be to care for a given patient. The purpose of this study was to investigate how primary care providers define, encounter, and manage complex patients, especially those with chronic pain. To our knowledge, this is the first study to move beyond general narrative descriptions of complexity towards an interrogation that is grounded in the work practices of caring for these patients. METHODS: We undertook an institutional ethnography (IE) in Ontario, Canada. IE uses people's everyday work problems as the starting point for an exploration of the often-invisible social relations that orient experiences. Grounded in the everyday experience of primary care providers, we draw here on 51 interviews that were collected as part of our larger IE study, to interrogate the utility of definitions of patient complexity as medical multimorbidity. FINDINGS: Care providers consider patients challenging due to their socio-economic status more so than their medical problems alone. Our data shows that patients' issues are often bound up with poverty, trauma, and mental health concerns, and are challenging for health care providers in part because the interventions needed exceed the scope of their medical expertise, while social issues render the treatment of potentially straightforward medical problems complicated. This was especially so for patients with chronic pain. CONCLUSION: Defining patient complexity as morbidity alone is inadequate; such models neglect syndromes and conditions that are not included in formal disease classifications. Chronic pain should be included among the chronic conditions that are considered to constitute multimorbidity. In order to provide effective patient-centered care, discussions of patient complexity must also attend to the complex social and economic circumstances in which many patients live and include broader issues of inequity and social justice. This approach would enable policies to better support primary care providers who struggle to manage their patients with complex needs across domains of physiological health, mental health, and the quality of their living conditions, and in so doing improve the care that patients receive.


Asunto(s)
Enfermedad Crónica/terapia , Manejo de la Enfermedad , Necesidades y Demandas de Servicios de Salud/organización & administración , Femenino , Personal de Salud/organización & administración , Humanos , Narración , Ontario , Atención Dirigida al Paciente/organización & administración , Atención Primaria de Salud/organización & administración
17.
Cien Saude Colet ; 24(6): 2279-2292, 2019 Jun 27.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31269185

RESUMEN

The profile of pediatric care has gone through changes in Brazil and in the world. This process becomes more visible in surveys that deal with hospital admission or specialized outpatient care data. This fact leads us to the idea that it is in such spaces that these children and subjects who care for them are more visible and negotiate decisions. We aim to perform a state of the art literature review on decision making discussions and definitions, analyzing the current research in light of the theoretical Mol perspectives on the actors' logics of chronic diseases care; And the perspective of care goods exchanges in the dialogue between Martins and Moreira, triggering the Theory of Gift. The synthesis of the literature shows that decision making may be understood as a care planning process in which family, patients and health professionals are involved, and is linked to the family-centered care model. In terms of difficulties, we point out the prevalence of a dynamic that favors a criticizable choice because of the risks of inequality, such as the lack of discussion on the options and the actuation of the family mostly in times of difficult decisions.


Asunto(s)
Servicios de Salud del Adolescente/organización & administración , Servicios de Salud del Niño/organización & administración , Toma de Decisiones , Adolescente , Brasil , Niño , Enfermedad Crónica/terapia , Prestación de Atención de Salud/organización & administración , Salud de la Familia , Humanos , Atención Dirigida al Paciente/organización & administración
18.
J Med Libr Assoc ; 107(3): 314-322, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31258437

RESUMEN

Objective: The goal of this scoping review was to collect data on patient- and family-centered care (PFCC) programs and initiatives that have included the direct involvement of librarians and information professionals to determine how librarians are involved in PFCC and highlight opportunities for librarians to support PFCC programs. Methods: Systematic literature searches were conducted in seven scholarly databases in the information, medical, and social sciences. Studies were included if they (1) described initiatives presented explicitly as PFCC programs and (2) involved an information professional or librarian in the PFCC initiative or program. Based on the definition of PFCC provided by the Institute for Patient- and Family-Centered Care, the authors developed a custom code sheet to organize data elements into PFCC categories or initiatives and outcomes. Other extracted data elements included how the information professional became involved in the program and a narrative description of the initiatives or programs. Results: All included studies (n=12) identified patient education or information-sharing as an integral component of their PFCC initiatives. Librarians were noted to contribute to shared decision-making through direct patient consultation, provision of health literacy education, and information delivery to both provider and patient with the goal of fostering collaborative communication. Conclusions: The synthesis of available evidence to date suggests that librarians and information professionals should focus on patient education and information-sharing to support both patients or caregivers and clinical staff. The burgeoning efforts in participatory care and inclusion of patients in the decision-making process pose a unique opportunity for librarians and information professionals to offer more personalized information services.


Asunto(s)
Enfermería de la Familia/organización & administración , Colaboración Intersectorial , Bibliotecólogos/psicología , Atención Dirigida al Paciente/organización & administración , Rol Profesional , Humanos
19.
Br J Hosp Med (Lond) ; 80(7): 377-379, 2019 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-31283399

RESUMEN

Radiologists play a pivotal role in patient management in modern hospital medicine and more so with regard to breast imaging. The diagnosis of breast pathology hinges predominantly on mammography and ultrasound imaging. With reduced clinician confidence in clinical examination alone, virtually all patients with breast symptoms are being referred for imaging. The traditional 'one-stop' clinics are victims of their own success and demand outstrips availability. This article makes a case for imaging-led breast clinics to increase efficiency, reduce duplication of work and cost, and increase throughput of patients.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Biopsia , Enfermedades de la Mama/diagnóstico por imagen , Enfermedades de la Mama/patología , Eficiencia Organizacional , Humanos , Satisfacción del Paciente , Atención Dirigida al Paciente/organización & administración , Derivación y Consulta
20.
J Allied Health ; 48(2): 127-133, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31167015

RESUMEN

PURPOSE: The scope of hospice or palliative care has expanded since its inception, which has significant ramifications for the AH workforce. This study sought to elicit allied health (AH) clinicians' understanding and views about palliative care and its relevance to their clinical practice and to identify their educational needs. Results from analysis of free text survey responses to a single open-ended question from a larger survey are presented. METHODS: An online survey was distributed to AH clinicians via email lists for the CareSearch Allied Health Hub, Allied Health Professions Australia, and other groups. Descriptive statistics and content analysis of free text responses were used to analyse the data. RESULTS: A total of 217 AH clinicians responded to an email survey and 187 useable responses were analysed. Four themes were identified: 1) palliative care employs a client-centred model of care, 2) acknowledgement of living whilst dying, 3) interdisciplinary palliative care interventions provide active care in a range of domains, and 4) characteristics of palliative care teams and settings. CONCLUSION: AH clinicians plan an active role in physical, social, and psycho-spiritual care of palliative care patients and caregivers. Burgeoning numbers of palliative care patients in nonspecialist palliative care settings require AH clinicians to develop skills and competencies to work with people who have advanced disease.


Asunto(s)
Técnicos Medios en Salud/psicología , Cuidados Paliativos/organización & administración , Rol Profesional , Adulto , Australia , Cuidadores/psicología , Estudios Transversales , Humanos , Comunicación Interdisciplinaria , Masculino , Cuidados Paliativos/psicología , Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración
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