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1.
Artigo em Alemão | MEDLINE | ID: mdl-34507381

RESUMO

Many surgical procedures are followed by postoperative pain. Acute pain should be treated optimally for medical and ethical reasons. Different psychological, physical, interventional and pharmacological methods are employed in a procedure specific and institution specific matter. For optimum patient care, implementation of acute pain management concepts in recommendations on quality management in German hospitals and outpatient clinics was enacted in September 2020 by Gemeinsamer Bundessausschuss (G-BA). Implementation of discharge management had already been enacted in 2017 for structured prescription of medication after hospital discharge, among other things. On the other hand, new national and international developments require a new weighting of pharmacotherapy in particular. Examples include debates on the safe use of metamizol and the opioid crisis in the US. To address these issues adjustments in informed consent and patient information and education are necessary. This includes also the information and education of caregivers. This article describes the legal framework, technical solutions and the impact of placebo and nocebo effects on doctor-patient communication.


Assuntos
Manejo da Dor , Alta do Paciente , Humanos , Consentimento Livre e Esclarecido , Dor Pós-Operatória/tratamento farmacológico , Relações Médico-Paciente
2.
JNMA J Nepal Med Assoc ; 59(236): 317-321, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-34508528

RESUMO

INTRODUCTION: Communication is an important aspect of the medical profession. Doctor-patient communication plays a significant role in health care delivery. This study aims to find outpatient department patient satisfaction in doctor-patient communication in a tertiary care hospital in Kathmandu, Nepal. METHODS: A descriptive cross-sectional study was conducted in the outpatient department of a tertiary care hospital in Kathmandu, Nepal in the month of August 2019. Validated questionnaire of Patient Satisfaction Questionnaire, consisting of 80 items, originally developed by Willis H. Ware and his colleagues were used and distributed to the patient in the outpatient department of the hospital. Their satisfaction level for doctor-patient communication was assessed on a five-point scale. The questionnaire was distributed randomly to the patient attending the hospital outpatient department during one month period. RESULTS: Out of the total participants, 420 (96%) at 95% CI (95.07±96.93) respondents reported that they were satisfied regarding communication with their doctors. Among the patients, 109 (24.0%) visited the department of medicine followed by obstetrics and gynaecology 85 (19.4%). CONCLUSIONS: The majority of participants were found to be satisfied with the doctor-patient communication. While this study has shown that the communication in the doctor-patient relationship was seen to be satisfactory, this might not show the generalized picture of the country. We should also think of ways to further improve the communication in our hospitals.


Assuntos
Satisfação do Paciente , Relações Médico-Paciente , Comunicação , Estudos Transversais , Humanos , Inquéritos e Questionários , Centros de Atenção Terciária
6.
BMC Health Serv Res ; 21(1): 865, 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429101

RESUMO

BACKGROUND: This study empirically evaluates the influence of medical information on patient trust at the physician level, the medical profession, hospitals, and with the payer. Restoring patient trust in a medical setting in Poland appears to be significantly affected due to the COVID-19 pandemic. Patient trust improves results from medical treatment, raises perception of healthcare performance, and smoothens the overall functionality of healthcare systems. METHODS: In order to study trust volatility, patients took part in a three-stage experiment designed via: (1) measured level of trust, (2) randomly dividing participants into two groups-control (i.e., re-examination of level of trust) and experimental (i.e., being exposed to a piece of certain manipulative information), and (3) checking whether observational changes were permanent. RESULTS: Results indicate that in the experimental group the increase of trust was noticed in the payer (27.7%, p < 0.001), hospitals (10.9%, p = 0.011), and physicians (decrease of 9.2%, p = 0.036). CONCLUSION: The study indicated that in Poland medical information is likely to influence patient trust in healthcare while interpersonal and social trust levels may be related to increases of trust in hospitals and in the payer versus decreases in physicians.


Assuntos
COVID-19 , Confiança , Humanos , Pandemias , Relações Médico-Paciente , Polônia/epidemiologia , SARS-CoV-2
7.
BMJ Open ; 11(8): e048552, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404708

RESUMO

OBJECTIVE: To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care. DESIGN: A qualitative phenomenological study was conducted. SETTING: A specialised headache unit at two university hospitals in Spain between February 2017 and December 2018. PARTICIPANTS: Patients diagnosed with NDPH according to the International Classification of Headache disorders (third beta edition). METHODS: Purposeful sampling was performed. Data were collected using unstructured and semistructured interviews, researchers' field notes and patients' drawings. An inductive thematic analysis was used to identify significant emerging themes from interviews, field notes and descriptions of patients' drawings. Also, Guillemin's proposal was used to analyse the contents of drawings. RESULTS: Nineteen patients with a mean age of 45.3 were recruited. Four main themes emerged: (1) Seeking a diagnosis, patients visit many doctors without receiving a clear answer and their diagnosis is delayed; (2) Self-medication-minimising pill intake, medication is ineffective, and therefore, some patients discontinue treatment, or are flexible with how they take medication; (3) Trying other non-pharmacological options, many patients turn to other therapies and complementary and/or alternative therapies as a second option, however these are ineffective and (4) Medical care, with two subthemes, referrals and lacking continuity of care, and building the doctor-patient relationship. Patients describe how the referral breaks the continuity of care, and how they identify the traits of a doctor who is approachable and which behaviours the doctor should avoid when caring for patients. CONCLUSIONS: An in-depth knowledge of the beliefs and expectations of patients with NDPH will allow the professional to establish a relationship of trust, which will improve the patients' knowledge of which therapies are the most appropriate, and to establish expectations based on the relationship with the doctor, and not only on patients' beliefs.


Assuntos
Transtornos da Cefaleia , Relações Médico-Paciente , Cefaleia/diagnóstico , Cefaleia/terapia , Humanos , Assistência ao Paciente , Espanha
9.
Laryngorhinootologie ; 100(S 01): S1-S11, 2021 04.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-34352898

RESUMO

Rare diseases pose multiple challenges for patients, relatives, physicians, nursing staff, and therapists. Their rarity impedes research and treatments due to medical and economical reasons. Many diseases in the field otorhinolaryngology, head and neck surgery are rare diseases due to their low prevalence. The initiation of the right management processes requires knowledge about diagnostics, resources like centers, networks and registries, about specifics of the physician-patient relationship, follow-up care including communication with family doctors and the role of self-help groups. Of special interest for university hospitals and our scientific society are the specific aspects of research including European networks and research funding, information management, public relations, education, training, financing, and regulations like orphan drugs and clinical trials in small populations.


Assuntos
Otolaringologia , Médicos , Humanos , Relações Médico-Paciente , Doenças Raras/terapia , Sistema de Registros
10.
Ann Emerg Med ; 78(3): 453-454, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34420558
11.
J Assoc Physicians India ; 69(7): 11-12, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34431275

RESUMO

Traditional communication of medical literature using evidence-based terminologies are inadequate as the body of COVID-19 literature increases thereby requiring alternate methods of communication like podcasts, webinars, social media. A common theme in all these alternate forms of communication is the art of storytelling that allows physicians to make a connection with a patient by understanding their perspectives. Apart from few situations where story telling can be distracting in many situations where the patient's history is complex and require great listening skills and empathy.. Learning to be a good storyteller can help the physician help patients be a great change agent for them. Communicating with these patients can be done effectively using standard communication tools and using effective storytelling techniques can reinforce the patients trust in the provider and strengthen patient physician relationship. This could have a salutatory result both for the patient by increasing patient satisfaction and compliance with treatment and physician satisfaction by increasing to understand their patient's true concerns.


Assuntos
COVID-19 , Médicos , Comunicação , Humanos , Relações Médico-Paciente , SARS-CoV-2
12.
N Engl J Med ; 385(7): 581-583, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34358422
14.
BMC Med Educ ; 21(1): 460, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461865

RESUMO

PURPOSE: This study was conducted to assess the developmental factors of empathy among medical students of Tehran University of Medical Sciences (TUMS). METHODS: To assess the empathy levels, 42 first-year and an equal number of last-year medical students were randomly selected. They answered a questionnaire including the medical student version of the Jefferson Scale, demographic, and some related variables. Statistical analyses were performed using the Chi-square test, T-test, univariate, and multivariate regressions. RESULT: The study population consisted of 51 (60.7 %) men and 33 (39.3 %) women with a mean (SD) age of 22.24 (4.10) years. The Jefferson score was 110.19 ± 13.61 and 103.52 ± 20.00 in first- and last-year medical students, respectively. Moreover, medical students who completely passed at least one of the considered empathy courses of the TUMS curriculum had higher empathy scores compared to their counterparts (109.83 ± 15.54 vs. 103.68 ± 19.02). There was no significant association between empathy and gender, self-experience of illness, marital status, family history of chronic disease, and parents' education (all P-values > 0.05). After adjusting for the effects of confounders, the empathy scores were significantly associated with the academic year level (p = 0.04), level of interest in medicine (p = 0.001), and passing the empathy courses (p = 0.04). CONCLUSIONS: The data provided from a top Iranian medical school indicated that the academic year level, level of interest in medicine, and passing the empathy courses were significantly associated with the empathy level. Further studies are recommended.


Assuntos
Estudantes de Medicina , Adulto , Estudos Transversais , Empatia , Feminino , Humanos , Irã (Geográfico) , Masculino , Relações Médico-Paciente , Fatores Sexuais , Adulto Jovem
15.
N Engl J Med ; 385(9): 774-775, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34415688
16.
AMA J Ethics ; 23(7): E524-529, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34351261

RESUMO

Following a case in which a patient's self-report contradicts imaging data, this commentary considers how patient-clinician communication, including an assessment of and accommodations for maximizing health literacy and shared decision making, can elucidate a patient's values and preferences. Patients' perceptions of how much input they have in making their health decisions influences the patient-clinician therapeutic alliance and outcomes and can support patients' physical and emotional well-being.


Assuntos
Comunicação , Letramento em Saúde , Tomada de Decisões , Tomada de Decisão Compartilhada , Emoções , Humanos , Participação do Paciente , Relações Médico-Paciente , Autorrelato
17.
PLoS One ; 16(8): e0249872, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347779

RESUMO

This paper analyzes the application of various telemedicine services in Gansu Province, China during the COVID-19 epidemic, and summarizes the experiences with these services. In addition, the satisfaction levels of patients and doctors with the application of telemedicine in COVID-19 were investigated, the deficiencies of telemedicine in Gansu were determined, and recommendations for modification were proposed. Coronavirus Disease 2019 (COVID-19) has broken out in China, and Gansu Province in Northwest of China has not been spared. To date, there are 91 local COVID-19 cases and 42 imported cases. 109 hospitals were selected as designated hospitals during the COVID-19 outbreak, and most of them were secondary hospitals. However, it was unsatisfactory that the ability of medical services is relatively low in most of secondary hospitals and primary hospitals. Therefore, we helped the secondary hospitals cope with COVID-19 by means of remote consultation, long-distance education, telemedicine question and answer (Q&A). Our practical experience shows that telemedicine can be widely used during the COVID-19 epidemic, especially in developing countries and areas with lagging medical standards.


Assuntos
COVID-19/epidemiologia , COVID-19/terapia , Telemedicina/organização & administração , China/epidemiologia , Surtos de Doenças , Educação à Distância/organização & administração , Educação à Distância/estatística & dados numéricos , Educação Médica Continuada/métodos , Educação Médica Continuada/organização & administração , Educação Médica Continuada/estatística & dados numéricos , Educação Continuada em Enfermagem/métodos , Educação Continuada em Enfermagem/organização & administração , Educação Continuada em Enfermagem/estatística & dados numéricos , Epidemias , Geografia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Relações Médico-Paciente , Consulta Remota/instrumentação , Consulta Remota/métodos , Consulta Remota/organização & administração , Consulta Remota/estatística & dados numéricos , SARS-CoV-2/fisiologia , Software , Telemedicina/instrumentação , Telemedicina/métodos
18.
Fertil Steril ; 116(2): 279-280, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34353569

RESUMO

The goal of this Views and Reviews is to let colleagues and leaders well versed in the African American experience in reproductive medicine address the problems of racism affecting our trainees and patients and, more significantly, propose solutions. The areas in reproductive medicine that will be explored from the African American perspective include the pipeline of providers, health disparities, and access to infertility treatment.


Assuntos
Afro-Americanos , Disparidades em Assistência à Saúde , Racismo , Medicina Reprodutiva , Afro-Americanos/etnologia , Afro-Americanos/história , Educação de Pós-Graduação em Medicina/ética , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/organização & administração , Educação de Pós-Graduação em Medicina/tendências , Escravização/ética , Escravização/história , Feminino , Acesso aos Serviços de Saúde/ética , Acesso aos Serviços de Saúde/história , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/história , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Infertilidade/etnologia , Infertilidade/história , Infertilidade/terapia , Masculino , Relações Médico-Paciente/ética , Racismo/ética , Racismo/história , Racismo/prevenção & controle , Medicina Reprodutiva/educação , Medicina Reprodutiva/ética , Medicina Reprodutiva/história , Medicina Reprodutiva/tendências , Fatores Socioeconômicos
20.
Ann Emerg Med ; 78(3): 388-396, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34304916

RESUMO

STUDY OBJECTIVE: Patient experience metrics have become increasingly important in evaluations of health care organizations and physician performance. Although such measures have been touted as a way to make objective comparisons of performance, they are subject to many of the same biases as other survey instruments, including gender bias. METHODS: A total of 320 surveys were conducted between February and October 2020. Surveys included vignettes describing different scenarios, and respondents were asked to rate the vignette physician in each scenario on 1 of 3 themes: listening, time, or courtesy. Three vignettes per theme were used. Half of the surveys used a male physician and half used a female physician. Using tests of difference, we compared the ratings of male and female vignette physicians. We also used a statistical technique known as anchoring vignettes to show how respondents' ratings of vignette physicians related to their ratings of their own physicians. RESULTS: In all 9 vignette scenarios, the male vignette physician was rated more highly than the female vignette physician. These differences were statistically significant in 2 of 9 scenarios. Male vignette physicians were given more top-box ratings than female vignette physicians. Anchoring vignettes showed a statistically nonsignificant association between vignette ratings and ratings of respondents' own physicians. CONCLUSION: Our findings revealed a pattern of higher ratings of male vignette physicians when compared to female vignette physicians, which may translate to ratings of patients' own physicians. These findings suggest that current methods to evaluate patients' experiences with their own physicians may disadvantage female physicians.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Sexismo/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Médicas
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