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1.
Yakugaku Zasshi ; 140(10): 1295-1298, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32999207

RESUMO

Health professionals should adopt best practices that are cognizant of the communication skills of their patients. Pharmacists should be knowledgeable about hearing disabilities to effectively provide medication education to deaf and hard-of-hearing (HH) patients. The Act for Eliminating Discrimination against Persons with Disabilities requires pharmacists to take the appropriate actions to their patients. However, awareness about the appropriate actions for eliminate discrimination has not increased among medical professionals. This survey examined the knowledge about hearing disabilities, practice of appropriate actions and confidence in medication education to deaf and HH patients on 216 pharmacists in Yahata Pharmaceutical Association in November 2019. Pharmacists had poor awareness about hearing disabilities and about 30% of participants misunderstood appropriate actions in communication to deaf and HH patients. Practice of appropriate action in medication education were taken by only about half of the participants. In particular, placing Ear symbol had not be taken at all. Participants felt that they could provide medication education sufficiently by written materials in spite of poor understanding about the literacy of deaf individuals. On the other hand, they felt unconfident due to lack of understanding about hearing disabilities and how to communicate with their patients. This survey suggests that pharmacists need to learn about hearing disabilities for effective communication and practice of appropriate action in medication education to patients with hearing disabilities. Learning hearing disabilities may enable them to take the actions that are necessary to eliminate discrimination and enhance their confidence in providing medication education.


Assuntos
Comunicação , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Pessoas com Deficiência Auditiva , Farmacêuticos/psicologia , Autoimagem , Competência Clínica , Compreensão , Humanos , Educação de Pacientes como Assunto/métodos , Inquéritos e Questionários
2.
Lancet Oncol ; 21(8): e398-e404, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32758477

RESUMO

Immune checkpoint inhibitors (ICIs) have now been approved in numerous and diverse cancer types and combination regimens. Effective recognition and treatment of ICI toxicities, which might occur acutely, affect any organ system, and produce many distinct clinical syndromes, have emerged as essential goals of ICI management. Thus, developing robust diagnostic and management approaches for ICI toxicity across the health-care system is an urgent and unmet clinical need. In this Personal View, we describe barriers to high-quality care that have constrained the most effective management of patients with cancer receiving ICI treatment. We review education initiatives to enhance patient and physician awareness, which is necessary given the broad spectrum of ICI toxicities often experienced by patients, and assess various systems-based approaches that maximise the chances of appropriate management. In addition, we describe research pipelines that broaden evidence-based approaches and the pathobiology of these novel events. Developing effective, systematic approaches for the recognition and treatment of ICI toxicities will continue to grow in importance as these agents proliferate in cancer care.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Neoplasias/tratamento farmacológico , Humanos , Oncologia/educação , Assistência ao Paciente/métodos , Educação de Pacientes como Assunto/métodos
3.
J Natl Black Nurses Assoc ; 31(1): 41-45, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32853495

RESUMO

This quality improvement project aimed to answer the following clinical question: Among U.S. male veterans (N = 30) living with type 2 diabetes (T2D) receiving services from a Veterans Affairs (VA) endocrinology clinic, how does a diabetes toolkit influence knowledge and glycaemic control? All the study participants were male and from 31 to 91 years of age. A pre- and post-intervention diabetes knowledge test, body mass index (BMI), lipids, blood pressure, and lifestyle data were obtained as predictor variables. A1c levels were measured at baseline and fructosamine levels at 8-12 weeks post-intervention and converted to A1c levels. A diabetes toolkit was presented as an educational intervention to participating veterans. The pre- and post-intervention knowledge test measured an increase (p = 0.001) in diabetes knowledge. The pre- and post-intervention BMI, lipids, and blood pressure assessments measured changes in such variables associated with toolkit exposure. The regression model was marginally significant (p = 0.055) and the predictor variables explained 18.8% of variance in change of A1c. A multiple regression was conducted to determine the extent to which the following post-intervention outcome variables impacted glycemic control. Of four predictors, only one was significant: a patient's change in weight predicted (p = 0.016) a decrease in A1c.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Educação de Pacientes como Assunto/métodos , Veteranos/estatística & dados numéricos , Perda de Peso , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemoglobina A Glicada/metabolismo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade
4.
AIDS Educ Prev ; 32(3): 260-270, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32749877

RESUMO

We implemented HPTN 062, an acceptability and feasibility study of a motivational-interviewing (MI) intervention to reduce HIV transmission among individuals with acute HIV infection (AHI) in Lilongwe, Malawi. Participants were randomly assigned to receive either brief education or the MI intervention over 24 weeks; all participants received the same messages about AHI. We used mixed methods to assess participants' understanding of the association between AHI and viral load, and its connection to sexual behavior at 8 weeks. While most participants understood key aspects of AHI, MI-intervention participants gave substantially more detailed descriptions of their understanding. Nearly all participants, regardless of study arm, understood that they were highly infectious and would be very likely to transmit HIV after unprotected sex during AHI. Our findings suggest that messages about AHI delivered during the period of AHI are likely beneficial for ensuring that those with AHI understand their level of infectiousness and its association with forward transmission.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Entrevista Motivacional , Educação de Pacientes como Assunto/métodos , Comportamento Sexual , Doença Aguda , Adulto , Estudos de Viabilidade , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Sexo sem Proteção , Carga Viral , Adulto Jovem
5.
PLoS One ; 15(8): e0237647, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804989

RESUMO

INTRODUCTION: Diabetes self-management education is a key aspect in the long-term management of type 2 diabetes. The patient and healthcare professional (HCP) perspective on the use of technology-assisted DSME has yet to be studied. Hence, the objective of this study was to better understand the factors that facilitate or hinder the adoptions of such education by adults with type 2 diabetes and their HCPs. METHODS: We systematically searched five databases (Medline, Embase, CINAHL, Web of Science Core Collection, and PsycINFO) until August 2019. The search included qualitative and mixed-method studies that reported the views of patients and HCPs regarding features, uses, and implementations of technology-assisted DSME. Data were synthesized through an inductive thematic analysis. RESULTS: A total of 13 articles were included, involving 242 patients, ranging from 18 to 81 years and included web-based, mobile application, digital versatile disc (DVD), virtual reality or telehealth interventions. Patients and HCPs had mixed views towards features of the technology-assisted interventions, with patients' personal qualities and HCPs' concerns affecting uses of the interventions. Patients generally preferred technologies that were easy to access, use, and apply and that had reliable information. Patients' ambitions motivated them, and personal attributes such as poor competence with technology, poor literacy, and language barriers acted as barriers. Patients especially liked the peer support that they received but did not like it when there was no regulation of advice on these platforms. HCPs believed that while the interventions were useful to patients, they faced difficulties with integration into their clinical workflows. CONCLUSION: This review explored the features of technology-assisted diabetes self-management education interventions that enhanced positive patient engagements and the negative aspects of both the platforms and the target groups. Technical support and training will be effective in managing these concerns and ensuring meaningful use of these platforms.


Assuntos
Tecnologia Educacional/métodos , Pessoal de Saúde/psicologia , Educação de Pacientes como Assunto/métodos , Autogestão/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
6.
Med Care ; 58 Suppl 2 9S: S94-S100, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32826778

RESUMO

BACKGROUND: Chronic pain and associated symptoms are debilitating for veterans. Medical costs of treatments are high and current treatment options, most notably with opioid medications, have been associated with significant risk. Mindfulness-based interventions appear promising for chronic pain, but require additional testing in veteran care settings. OBJECTIVE: This project was designed to test the feasibility of engaging and retaining veterans with chronic lower back pain in a new mindfulness protocol tailored for veterans, mindfulness-based care for chronic pain (MBCP). Clinical outcomes were also assessed. DESIGN: An open pilot trial of an 8-week MBCP course that included meditation, gentle yoga, and psychoeducation. SUBJECTS: Twenty-two veterans (mean age=49.77; 18% women) were recruited from a VA Medical Center in the Northeastern US. After screening for inclusion/exclusion criteria, 20 were eligible at baseline. MEASURES: Veterans were assessed at baseline and postintervention for functional impairment, pain intensity and bothersomeness, depression, and mindfulness. RESULTS: The average number of sessions completed was 5; only 4 (20%) attended all sessions. Eleven of the 20 participants (55%) attended 5 or more sessions and had complete preintervention and postintervention visits. Five of the 11 had a clinically meaningful decrease in pain intensity and in depressive symptoms, while 6 of 11 had a meaningful decrease in pain bothersomeness and functional impairment. CONCLUSIONS: It was challenging to enroll and retain participants in this study, even with our intervention designed for veterans. We discuss possible adaptations and refinements in MBCP for veterans with chronic pain to enhance feasibility and improve upon these interventions.


Assuntos
Dor Lombar/terapia , Terapias Mente-Corpo/métodos , Adulto , Idoso , Doença Crônica , Protocolos Clínicos , Depressão/epidemiologia , Depressão/terapia , Avaliação da Deficiência , Feminino , Nível de Saúde , Humanos , Dor Lombar/epidemiologia , Masculino , Meditação/métodos , Pessoa de Meia-Idade , Atenção Plena/métodos , Medição da Dor , Educação de Pacientes como Assunto/métodos , Desempenho Físico Funcional , Projetos Piloto , Índice de Gravidade de Doença , Fatores Socioeconômicos , Veteranos , Saúde dos Veteranos , Ioga
7.
PLoS One ; 15(8): e0236750, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745145

RESUMO

INTRODUCTION: Treatment adherence has been evaluated as a major predictor of long-term outcome, and education has been suggested to improve adherence. Considering the characteristics of adult learners, it is necessary to implement educational programs that meet the needs of transplant patients. Multimedia education may be well-suited for this. This study aims to develop video education materials in accordance with transplant patients' self-care needs. METHODS: This study includes a literature review and patient interviews aimed at developing video education materials for the self-care needs of patients who underwent renal transplant surgery at a university hospital in Seoul. Ten patients were interviewed about the desired educational content, accessibility, and other preferences. After verifying the validity of the data, the video scenarios were produced and satisfaction surveys were conducted. RESULTS: Eleven self-care education items were identified through interviews with 10 kidney transplant patients. The expert validation of video-based educational content result was high (mean CVI = 0.94). The mean score of the patients' satisfaction evaluation of the completed 7-minute video instructional materials was also high (4.55 on a 5-point Likert scale). CONCLUSION: Findings indicate that the video education materials will meet the needs of adult learners and mitigate the limitations of the existing education programs by increasing interest and motivation and may contribute to increased treatment adherence and ultimately, positively effect self-care for new transplant patients.


Assuntos
Transplante de Rim/educação , Educação de Pacientes como Assunto/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Multimídia , Inquéritos e Questionários , Materiais de Ensino
8.
Dermatol Online J ; 26(3)2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32609441

RESUMO

The expanding role of social media in medical care has resulted in dermatology patients seeking support online regarding personal experience with diagnosis and treatment of skin cancer. Owing to increased privacy settings in closed Facebook groups, the current study analyzed themes of keratinocyte carcinoma patients' posts within a relatively private social media network. Although the majority of messages included sharing personal experience and provided psychosocial support (50%), there were a significant number of posts offering medical advice (35%), with the majority of such replies being unsupported by evidence-based medicine (87%). The level of medical misinformation and potential harm to patients seeking advice online is important for medical practitioners treating skin cancer and provides impetus for possible further research into online support and education groups that are moderated for misinformation.


Assuntos
Informação de Saúde ao Consumidor , Disseminação de Informação/métodos , Educação de Pacientes como Assunto/métodos , Grupos de Autoajuda , Neoplasias Cutâneas , Mídias Sociais , Comunicação , Medicina Baseada em Evidências , Humanos , Apoio Social
9.
Prev Chronic Dis ; 17: E63, 2020 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-32678061

RESUMO

Data suggest that more men than women are dying of coronavirus disease 2019 (COVID-19) worldwide, but it is unclear why. A biopsychosocial approach is critical for understanding the disproportionate death rate among men. Biological, psychological, behavioral, and social factors may put men at disproportionate risk of death. We propose a stepwise approach to clinical, public health, and policy interventions to reduce COVID-19-associated morbidity and mortality among men. We also review what health professionals and policy makers can do, and are doing, to address the unique COVID-19-associated needs of men.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/psicologia , Política de Saúde , Pneumonia Viral/mortalidade , Pneumonia Viral/psicologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Feminino , Promoção da Saúde , Humanos , Masculino , Pandemias , Educação de Pacientes como Assunto/métodos , Peptidil Dipeptidase A/sangue , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Medicina Preventiva , Saúde Pública , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia
10.
Am J Public Health ; 110(S2): S215-S218, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32663077

RESUMO

A health care system and a Medicaid payer partnered to develop an educational intervention and payment redesign program to improve timely postpartum visits for low-income, high-risk mothers in New York City between April 2015 and October 2016. The timely postpartum visit rate was higher for 363 mothers continuously enrolled in the program than for a control group matched by propensity score (67% [243/363] and 56% [407/726], respectively; P < .001). An innovative partnership between a health care system and Medicaid payer improved access to health care services and community resources for high-risk mothers.


Assuntos
Custo Compartilhado de Seguro/métodos , Medicaid/economia , Cuidado Pós-Natal/estatística & dados numéricos , Adulto , Feminino , Humanos , Programas de Assistência Gerenciada , Motivação , Cidade de Nova Iorque , Educação de Pacientes como Assunto/métodos , Cuidado Pós-Natal/economia , Pobreza , Gravidez , Gravidez de Alto Risco , Centros de Atenção Terciária , Estados Unidos
11.
PLoS One ; 15(7): e0235625, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645036

RESUMO

INTRODUCTION: The risk of emergence and spread of antibiotic resistance is high in Southeast Asian countries and various strategies are being used to raise awareness about appropriate antibiotic use and antibiotic resistance within communities. Public engagement in science has not been widely practised in Myanmar. We describe the use of a forum theatre to engage with the community about antibiotic use. METHODS: The engagement activities took place in a peri-urban township in Yangon, Myanmar. Five preliminary story gathering workshops with the community were carried out to develop scripts and songs for the forum theatre. After that, we organised forum theatre plays between September and October 2018. Following each play we provided four simple key messages based on WHO's world antibiotic awareness week advocacy materials; 1) Antibiotics are medicines used to treat bacterial infections 2) Antibiotics are not useful for coughs and colds 3) Never use leftover antibiotics or share antibiotics with others 4) Prevent infections by regularly washing hands, preparing food hygienically, avoiding close contact with sick people, and keeping vaccinations up to date. We evaluated the engagement activities by conducting focus group discussions (FGD) with audience members. RESULTS: Ten forum theatre plays were performed on two topics; "Fever and antibiotics" and "Mixed medicines", reaching 1175 community members. Four themes emerged from our thematic analysis: 1) Knowledge dissemination, 2) Enjoyment and fun, 3) Willingness to support and recommendations for future engagement activities and 4) Preference over traditional methods of health education. We found improvement of antibiotic related knowledge and enjoyment among audience who were also willing to support future engagement activities and preferred forum theatre approach over formal health talks. CONCLUSIONS: We conclude that forum theatre is an effective innovative approach to engage and disseminate knowledge on appropriate use of antibiotics with the community in a participatory way.


Assuntos
Anti-Infecciosos/administração & dosagem , Educação de Pacientes como Assunto/métodos , Conhecimento do Paciente sobre a Medicação/métodos , Participação do Paciente/métodos , Humanos , Adesão à Medicação , Mianmar , Jogos e Brinquedos
12.
Drug Discov Ther ; 14(3): 151-152, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32669524

RESUMO

Community-acquired pneumonia (CAP) is the third leading contributor to lost disability-adjusted life years worldwide, and this is especially true in the elderly population. In order to reduce the burden of disease, effective management of CAP is crucial to public health in terms of maintaining and promoting the health of the elderly and involves safe drug use, vaccinations, early treatment in the ICU, and health education. Since the long-term mortality of CAP is particularly high in the elderly, biomarkers and a predictive diagnostic model of CAP should be developed in future research.


Assuntos
Antibacterianos/administração & dosagem , Infecções Comunitárias Adquiridas/prevenção & controle , Gerenciamento Clínico , Vacinas Pneumocócicas/administração & dosagem , Pneumonia/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Atenção , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Humanos , Educação de Pacientes como Assunto/métodos , Pneumonia/tratamento farmacológico , Pneumonia/epidemiologia
13.
Recenti Prog Med ; 111(7): 398-401, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-32658877

RESUMO

The SARS-CoV-2 pandemic has lifted the veil about how medical knowledge is produced and disseminated. Action Bias, together with economic, academic and media-related interests, has concurred to generate and spread low-value and even unreliable information about some hypothetical therapeutic interventions for CoViD-19. Not only this "infodemic" has weakened people's ability to make informed health choices, but it also has influenced the process of new evidence generation through the violation of the equipoise principle. The CoViD-19 infodemic has further highlighted the need for reliable health information and for people to enter the process of understanding and promoting valuable research. Through a randomized controlled trial, the Informed Health Choices project has shown that it is not impossible neither quixotic to better orient people about health choices since primary school. Similar competencies should be disseminated to everyone through sources that are selected and validated for their capability of reporting evidence based health information about the effects of treatments.


Assuntos
Betacoronavirus , Disseminação de Informação , Pandemias , Antivirais/uso terapêutico , Betacoronavirus/imunologia , Comunicação , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Tomada de Decisões , Reposicionamento de Medicamentos , Medicina Baseada em Evidências , Necessidades e Demandas de Serviços de Saúde , Humanos , Comportamento de Busca de Informação , Uso Off-Label , Pandemias/prevenção & controle , Educação de Pacientes como Assunto/métodos , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto/ética , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Equipolência Terapêutica , Vacinas Virais
14.
PLoS One ; 15(7): e0236180, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697801

RESUMO

INTRODUCTION: Sexual and reproductive health are significant aspects of quality of life. Healthcare often fails to provide adequate support for young cancer survivors in this area, hence the need to develop more effective interventions. The present study aimed to describe experiences of participating in a web-based psycho-educational intervention focusing on sexual dysfunction and fertility distress after cancer, and to explore these experiences within the theoretical frame of the basic psychological needs for competence, relatedness and autonomy according to self-determination theory. METHODS: Individual semi-structured interviews with 24 women and 4 men, age 19-40, were abductively analyzed using the Framework approach for qualitative content analysis. RESULTS: Participant experiences corresponded well with the three main deductive themes competence, relatedness and autonomy, divided into a total of nine subthemes illustrating varying degrees of basic need satisfaction with considerable nuance but not without ambiguity. While satisfaction of the need for competence could be linked to the amount of information in relation to participants' cognitive capacity, satisfaction of the need for relatedness seemed to be of special importance for these young adults with cancer experience. Invitation to the program meant a chance at alleviating loneliness and normalizing problems, symptoms and concerns. Participants' descriptions of perceived autonomy support were more challenging and ambiguous, because of the many contradictions in participants' responses to their variable situations. CONCLUSION: Basic psychological needs were confirmed as flexible positions along a continuum rather than discrete and mutually exclusive qualities. Understanding the variety of basic need satisfaction may enhance the design of future web-based interventions to be even more inclusive, tailorable and autonomy-supportive. Further research is warranted to determine the role of basic need satisfaction as a possible mediator for web-based psychoeducational interventions in cancer survivorship care.


Assuntos
Sobreviventes de Câncer/psicologia , Fertilidade , Neoplasias/complicações , Educação de Pacientes como Assunto/métodos , Angústia Psicológica , Disfunções Sexuais Fisiológicas/reabilitação , Adulto , Feminino , Humanos , Intervenção Baseada em Internet , Masculino , Neoplasias/psicologia , Autonomia Pessoal , Satisfação Pessoal , Pesquisa Qualitativa , Qualidade de Vida , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Adulto Jovem
15.
J Am Acad Orthop Surg ; 28(14): 597-605, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32692097

RESUMO

INTRODUCTION: The purpose of this study is to assess the impact of Trauma Recovery Services (TRS), a program facilitating engagement and recovery on satisfaction after orthopaedic trauma. METHODS: Two hundred ninety-four patients with surgically managed extremity fractures were prospectively surveyed. Satisfaction was assessed after 12 months using a 13-question telephone survey, rated on a Likert scale from 1 to 5 (with five being excellent). TRS resource utilization during and after hospitalization was recorded. Eighty-eight patients (30%) used TRS. RESULTS: Overall satisfaction was high with a mean score of 4.32. Although no differences were observed between the control group and patients with TRS utilization in age, sex, race, insurance, smoking history, or employment status, TRS patients sustained more high-energy mechanisms (81% versus 56%) and had more associated psychiatric illness (33% versus 17%), both P < 0.01. Multivariable regression indicated general exposure to TRS to be an independent predictor of higher overall care ratings (B = 1.31; P = 0.03). DISCUSSION: Utilization of TRS was the greatest predictor of better overall care ratings. This study builds on existing evidence demonstrating the positive impact of Trauma Survivor Network programming. We conclude that a hospital-wide program supporting patient education and engagement can effectively increase patient satisfaction after traumatic injury. LEVEL OF EVIDENCE: Prognostic Level II.


Assuntos
Fraturas Ósseas/psicologia , Fraturas Ósseas/cirurgia , Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/estatística & dados numéricos , Satisfação do Paciente , Serviços Preventivos de Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Eficiência Organizacional , Feminino , Previsões , Fraturas Ósseas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recuperação de Função Fisiológica , Inquéritos e Questionários , Adulto Jovem
17.
PLoS One ; 15(6): e0234926, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559237

RESUMO

BACKGROUND: Communication and shared decision-making (SDM) are essential to patient-centered care. Hospital-based palliative care with patients with limited health literacy (LHL) poses particular demands on communication. In this context, patients' emotions and vulnerable condition impact their skills to obtain, understand, process and apply information about health and healthcare even more. If healthcare providers (HCPs) meet these demands, it could enhance communication. In this study, HCPs were interviewed and asked for their strategies, barriers and suggestions for improvement regarding communication and SDM with LHL patients in hospital-based palliative care. METHODS: A qualitative interview study was conducted in 2018 in four Dutch hospitals with 17 HCPs-11 physicians and 6 nurses. Transcripts were analyzed using thematic analysis. RESULTS: In general HCPs recognized limited literacy as a concept, however, they did not recognize limited health literacy. Regarding SDM some HCPs were strong advocates, others did not believe in SDM as a concept and perceived it as unfeasible. Furthermore, five themes, acting as either strategies, barriers or suggestions for improvement emerged from the interviews: 1) time management; 2) HCPs' communication skills; 3) information tailoring; 4) characteristics of patients and significant others; 5) the content of the medical information. CONCLUSIONS: According to HCPs, more time to communicate with their patients could resolve the most prominent barriers emerged from this study. Further research should investigate the organizational possibilities for this and the actual effectiveness of additional time on effective communication and SDM. Additionally, more awareness for the concept of LHL is needed as a precondition for recognizing LHL. Furthermore, future research should be directed towards opportunities for tailoring communication, and the extent to which limited knowledge and complex information affect communication and SDM. This study provides first insights into perspectives of HCPs, indicating directions for research on communication, SDM and LHL in hospital-based palliative care.


Assuntos
Tomada de Decisão Clínica/métodos , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/métodos , Cuidados Paliativos/psicologia , Feminino , Letramento em Saúde/normas , Humanos , Masculino , Relações Enfermeiro-Paciente , Enfermeiras e Enfermeiros/psicologia , Cuidados Paliativos/métodos , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/normas , Relações Médico-Paciente , Médicos/psicologia , Melhoria de Qualidade
19.
Breast Cancer Res Treat ; 183(1): 213-216, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32594281

RESUMO

PURPOSE: The outbreak of the coronavirus disease 2019 (COVID-19) has led to interruption or delay in treatment of breast cancer patient. This commentary aims to standardize the management procedures and ensure complete or relatively complete treatment for breast cancer patients during the outbreak of COVID-19. METHODS: Provide detailed online diagnosis, online treatment recommendations, and face-to-face consultation suggestions. RESULTS: Breast cancer patients who are at high risk of COVID-19 are advised to consult online first. For patients who have undergone online consultation and need face-to-face consultation, try to go to the clinic alone and take necessary precautions. Medical staff should be provided with necessary training about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing and knowledge of standard precautions and personal protective equipment. CONCLUSIONS: This commentary focused on breast cancer patients and provided suggestions to avoid the spread of COVID-19. Some of these suggestions are also suitable for cancer patients in other lesions. We hope our suggestions are useful to oncologists in other countries and help them to overcome this challenge.


Assuntos
Betacoronavirus , Neoplasias da Mama/terapia , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Assistência ao Paciente/normas , Educação de Pacientes como Assunto/métodos , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto/normas , Telemedicina/métodos , Betacoronavirus/isolamento & purificação , Neoplasias da Mama/virologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Surtos de Doenças , Feminino , Humanos , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
20.
Med Clin North Am ; 104(4): 695-708, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32505261

RESUMO

The diagnosis of opioid use disorder (OUD) is often overlooked or inadequately managed during the inpatient admission. When recognized, a common strategy is opioid detoxification, an approach that is often ineffective and can be potentially dangerous because of loss of tolerance and subsequent risk for overdose. Medication for addiction treatment (MAT), including methadone and buprenorphine, is effective and can be dispensed in the hospital for both opioid withdrawal and initiation of maintenance treatment. Hospitalists should be knowledgeable about diagnosing and managing patients with OUD, including how to manage acute pain or MAT during the perioperative setting.


Assuntos
Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Transtornos Relacionados ao Uso de Opioides/terapia , Educação de Pacientes como Assunto/métodos , Analgésicos Opioides/uso terapêutico , Buprenorfina/uso terapêutico , Redução do Dano , Hospitalização , Humanos , Metadona/uso terapêutico , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Tratamento de Substituição de Opiáceos/psicologia
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