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1.
Age Ageing ; 53(5)2024 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-38783755

RESUMO

BACKGROUND: Patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and dementia are underrepresented in specialist palliative home care (SPHC). However, the complexity of their conditions requires collaboration between general practitioners (GPs) and SPHC teams and timely integration into SPHC to effectively meet their needs. OBJECTIVE: To facilitate joint palliative care planning and the timely transfer of patients with advanced chronic non-malignant conditions to SPHC. METHODS: A two-arm, unblinded, cluster-randomised controlled trial. 49 GP practices in northern Germany were randomised using web-based block randomisation. We included patients with advanced CHF, COPD and/or dementia. The KOPAL intervention consisted of a SPHC nurse-patient consultation followed by an interprofessional telephone case conference between SPHC team and GP. The primary outcome was the number of hospital admissions 48 weeks after baseline. Secondary analyses examined the effects on health-related quality of life and self-rated health status, as measured by the EuroQol 5D scale. RESULTS: A total of 172 patients were included in the analyses. 80.4% of GP practices had worked with SHPC before, most of them exclusively for cancer patients. At baseline, patients reported a mean EQ-VAS of 48.4, a mean quality of life index (EQ-5D-5L) of 0.63 and an average of 0.80 hospital admissions in the previous year. The intervention did not significantly reduce hospital admissions (incidence rate ratio = 0.79, 95%CI: [0.49, 1.26], P = 0.31) or the number of days spent in hospital (incidence rate ratio = 0.65, 95%CI: [0.28, 1.49], P = 0.29). There was also no significant effect on quality of life (∆ = -0.02, 95%CI: [-0.09, 0.05], P = 0.53) or self-rated health (∆ = -2.48, 95%CI: [-9.95, 4.99], P = 0.51). CONCLUSIONS: The study did not show the hypothesised effect on hospitalisations and health-related quality of life. Future research should focus on refining this approach, with particular emphasis on optimising the timing of case conferences and implementing discussed changes to treatment plans, to improve collaboration between GPs and SPHC teams.


Assuntos
Insuficiência Cardíaca , Cuidados Paliativos , Atenção Primária à Saúde , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Humanos , Cuidados Paliativos/métodos , Masculino , Feminino , Idoso , Alemanha , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/terapia , Insuficiência Cardíaca/diagnóstico , Demência/terapia , Doença Crônica , Serviços de Assistência Domiciliar , Equipe de Assistência ao Paciente , Fatores de Tempo , Comunicação Interdisciplinar , Prestação Integrada de Cuidados de Saúde/organização & administração
2.
Nervenarzt ; 94(12): 1081-1086, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-37870583

RESUMO

BACKGROUND: Nerve damage can be autoimmune inflammatory, metabolic or traumatic, among others, and can be difficult to differentiate. OBJECTIVE: What are the advantages of interdisciplinary networks and how do they work? MATERIAL AND METHOD: Field report with case presentation from the University Hospital Tübingen in cooperation with the BG Accident Clinic Tübingen. CONCLUSION: Interdisciplinary networks improve the care of our patients and also serve as regular multidisciplinary continuing education.


Assuntos
Equipe de Assistência ao Paciente , Nervos Periféricos , Humanos , Instituições de Assistência Ambulatorial
3.
Prax Kinderpsychol Kinderpsychiatr ; 72(3): 178-191, 2023 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-37057665

RESUMO

Case conference in a teamgroup in inpatient psychotherapy with children and adolescents are a tool to focus those aspects of treatment relations that can not (yet) be verbalized but present themselves in actions during the treatment. This paper gives a brief overview on the theory and methodology of case conferences and refers to an ongoing study. The presentation of a case conference leads to giving some general recommendations.


Assuntos
Pacientes Internados , Psicoterapia , Adolescente , Criança , Humanos , Psicoterapia/métodos , Inquéritos e Questionários
4.
BMC Geriatr ; 22(1): 578, 2022 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836238

RESUMO

BACKGROUND: Memory clinics (MCs) play a key role in accurate and timely diagnoses and treatment of dementia and mild cognitive impairment. However, within Australia, there are little data available on current practices in MCs, which hinder international comparisons for best practice, harmonisation efforts and national coordination. Here, we aimed to characterise current service profiles of Australian MCs. METHODS: The 'Australian Dementia Network Survey of Expert Opinion on Best Practice and the Current Clinical Landscape' was conducted between August-September 2020 as part of a larger-scale Delphi process deployed to develop national MC guidelines. In this study, we report on the subset of questions pertaining to current practice including wait-times and post-diagnostic care. RESULTS: Responses were received from 100 health professionals representing 60 separate clinics (45 public, 11 private, and 4 university/research clinics). The majority of participants were from clinics in metropolitan areas (79%) and in general were from high socioeconomic areas. While wait-times varied, only 28.3% of clinics were able to offer an appointment within 1-2 weeks for urgent referrals, with significantly more private clinics (58.3%) compared to public clinics (19.5%) being able to do so. Wait-times were less than 8 weeks for 34.5% of non-urgent referrals. Only 20.0 and 30.9% of clinics provided cognitive interventions or post-diagnostic support respectively, with 7.3% offering home-based reablement programs, and only 12.7% offering access to group-based education. Metropolitan clinics utilised neuropsychological assessments for a broader range of cases and were more likely to offer clinical trials and access to research opportunities. CONCLUSIONS: In comparison to similar countries with comprehensive government-funded public healthcare systems (i.e., United Kingdom, Ireland and Canada), wait-times for Australian MCs are long, and post-diagnostic support or evidence-based strategies targeting cognition are not common practice. The timely and important results of this study highlight a need for Australian MCs to adopt a more holistic service of multidisciplinary assessment and post-diagnostic support, as well as the need for the number of Australian MCs to be increased to match the rising number of dementia cases.


Assuntos
Demência , Encaminhamento e Consulta , Agendamento de Consultas , Austrália/epidemiologia , Demência/diagnóstico , Demência/epidemiologia , Demência/terapia , Humanos , Inquéritos e Questionários
5.
J Interprof Care ; 36(6): 810-819, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34979855

RESUMO

Digital Interprofessional Learning Client Documentation (D-IPL Client Docs) is an initiative designed to develop student interprofessional communication skills through electronic record writing and a virtual simulation (VS) or live virtual simulation (LVS) case conference. The aims of the study were to (a) identify whether D-IPL Client Docs supports student learning in the affective domain and (b) compare the learning outcomes for students participating in the VS versus the LVS case conference. Data were drawn from 83 Bachelor of Social Work students who had participated with other health professional students in the D-IPL Client Docs activities. The reflective journals submitted by this cohort of social work students were analyzed qualitatively and quantitatively using the Griffith University Affective Learning Scale. Qualitative analyses revealed that the activities enabled students in both groups to learn about themselves, their roles, and the roles of others, and the benefits of interprofessional collaboration in optimizing client outcomes. Quantitatively, the VS mode appeared to be more effective in supporting students to develop higher order affective learning; however, the effect size was small. Future studies should involve a larger sample size and include students from various professions to ascertain the transferability of findings.


Assuntos
Atitude do Pessoal de Saúde , Relações Interprofissionais , Humanos , Pessoal de Saúde , Estudantes , Documentação , Comportamento Cooperativo
6.
Ter Arkh ; 94(11): 1340-1344, 2022 Dec 26.
Artigo em Russo | MEDLINE | ID: mdl-37167175

RESUMO

A genesis of clinical case conference as a form of case discussion that integrates medical and educational functions is presented. The role of the following top figures of medicine in the development of clinical case conference is described: J.-M. Charcot, S.P. Botkin, G.A. Zakharin, V.N. Vinogradov, A.L. Myasnikov, E.M. Tareev, N.A. Mukhin. The article pays special attention to clinical case conference in Russian medical education. The role of clinical case conferences in shaping medical judgment in a clinician and a student is discussed.


Assuntos
Educação Médica , Humanos , Federação Russa , Educação Médica/métodos
7.
BMC Med Educ ; 21(1): 574, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34772406

RESUMO

BACKGROUND: Effective social and behavioral sciences teaching in medical education requires integration with clinical experience, as well as collaboration between social and behavioral sciences experts and clinical faculty. However, teaching models for achieving this integration have not been adequately established, nor has the collaboration process been described. This study aims to propose a collaborative clinical case conference model to integrate social and behavioral sciences and clinical experience. Additionally, we describe how social and behavioral science experts and clinical faculty collaborate during the development of the teaching method. METHODS: A team of medical teachers and medical anthropologists planned for the development of a case conference based on action research methodology. The initial model was planned for a 3-h session, similar to a Clinicopathological Conference (CPC) structure. We evaluated each session based on field notes taken by medical anthropologists and post-session questionnaires that surveyed participants' reactions and points of improvement. Based on the evaluation, a reflective meeting was held to discuss revisions for the next trial. We incorporated the development process into undergraduate medical curricula in clinical years and in a postgraduate and continuous professional development session for residents and certified family physicians in Japan. We repeated the plan-act-observe-reflection process more than 15 times between 2015 and 2018. RESULTS: The development of the collaborative clinical case conference model is summarized in three phases: Quasi-CPC, Interactive, and Co-constructive with unique structures and underlying paradigms. The model successfully contributed to promoting the participants' recognition of the clinical significance of social and behavioral sciences. The case preparation entailed unique and significant learning of how social and behavioral sciences inform clinical practice. The model development process promoted the mutual understanding between clinical faculty and anthropologists, which might function as faculty development for teachers involved in social and behavioral sciences teaching in medical education. CONCLUSIONS: The application of appropriate conference models and awareness of their underlying paradigms according to educational situations promotes the integration of social and behavioral sciences with clinical medicine education. Faculty development regarding social and behavioral sciences in medical education should focus on collaboration with scholars with different paradigmatic orientations.


Assuntos
Ciências do Comportamento , Educação Médica , Currículo , Docentes , Docentes de Medicina , Pesquisa sobre Serviços de Saúde , Humanos , Ensino
8.
BMC Med Educ ; 21(1): 392, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34294060

RESUMO

BACKGROUND: Despite its long-established importance, diagnostic reasoning (DR) education has suffered uneven implementation in medical education. The Clinical Problem Solvers (CPSolvers) podcast has emerged as a novel strategy to help teach DR through case conferences with expert diagnosticians and trainees. CPSolvers has 25,000 listeners in 147 countries. The aim of this study was to evaluate the podcast by eliciting the developers' goals of the podcast, then determining to what extent they aligned with the listeners' actual usage habits, features they valued, and perceptions of the podcast. METHODS: We conducted semi-structured interviews with 3 developers and 8 listeners from April-May 2020, followed by qualitative thematic analysis. RESULTS: Three major developer goals with sub-goals resulted: 1. To teach diagnostic reasoning in a case-based format by (1a) teaching schemas, (1b) modeling expert diagnostic reasoning, (1c) teaching clinical knowledge, and (1d) teaching diagnostic reasoning terminology. 2. To change the culture of medicine by (2a) promoting diversity, (2b) modeling humility and promoting psychological safety, and (2c) creating a fun, casual way to learn. 3. To democratize the teaching of diagnostic reasoning by leveraging technology. Listeners' usage habits, valued features, and perceptions overall strongly aligned with all these aspects, except for (1c) clinical knowledge, and (1d) diagnostic reasoning terminology. Listeners identified (1a) schemas, and (2c) promotion of psychological safety as the most valuable features of the podcast. CONCLUSION: CPSolvers has been perceived as a highly effective and novel way to disseminate DR education in the form of case conferences, serving as an alternative to traditional in-person case conferences suspended during COVID-19. CPSolvers combines many known benefits of in-person case conferences with a compassionate and entertaining teaching style, plus advantages of the podcasting medium - democratizing morning report for listeners around the world.


Assuntos
COVID-19 , Educação Médica , Visitas de Preceptoria , Humanos , Aprendizagem , SARS-CoV-2
9.
Nervenarzt ; 92(9): 935-940, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34046725

RESUMO

BACKGROUND: In many cases the placement of people with mental disorders in closed residential homes is an expression of the lack of alternative care options. In the area of tension between the need for security in the case of chronically self-endangering behavior, recurrent acute psychiatric crisis interventions and a lack of perspective to establish a permanent therapy, in many places a placement in a closed facility approved under care law is carried out. OBJECTIVE: What alternatives are there to closed institutional care in the psychiatric care system in Germany? METHODS: A trialogical discussion process was carried out in an expert panel taking the relevant literature into consideration and with the participation of organizations of those affected and their relatives. RESULTS: The community psychiatric care system in Germany is extremely heterogeneous. The fragmented sociolegal and financing systems makes cross-sectoral and continuous care planning and service provision difficult. Precisely tailored and individualized services that could prevent the persons concerned from being placed in a closed home exist in Germany only at a few locations and in the form of individual model projects. CONCLUSION: The structural and sociolegal deficits addressed require a reform of the institutional framework and a redirection of all actors involved, including the clinics. Alternative approaches to the care of people with severe mental disorders are outlined. These include the Wedding model, binding community psychiatric structures, the basic functional model and assistance services under the German Social Code IX following the revision of the Federal Participation Act.


Assuntos
Transtornos Mentais , Saúde Mental , Alemanha , Humanos , Transtornos Mentais/terapia
10.
BMC Nurs ; 19: 14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32095116

RESUMO

BACKGROUND: The implementation of clearly structured dementia-specific case conferences could be an important tool to enable nursing staff to properly analyse and manage challenging behaviour in nursing home residents with dementia. A process evaluation of the responses of nursing homes to the implementation of WELCOME-IdA (Wittener model of case conferences for people with dementia - the Innovative dementia-oriented Assessment tool) was carried out to gain insight into which key elements of the intervention were adopted by the nursing homes and which elements were adapted. METHODS: This study was part of a larger process evaluation using a qualitative design. Thirty-four semi-structured telephone interviews and 15 focus group interviews were conducted in four nursing homes. The interviews were analysed using deductive content analysis, although inductive categories have been developed. RESULTS: Nursing home staff adopted the roles of moderator, case reporter, keeper of the minutes and reflection partner in WELCOME-IdA, but the selection of the staff members who filled these roles differed across nursing homes. The recommended group size of 5-8 participants per case conference was sometimes adopted. The key element of having core nursing teams who participated continuously in all case conferences was not adopted at all. Instead, there was a high level of rotation among staff members. The pre-defined process structure of WELCOME-IdA was adapted in such a way that the assessment of the residents' behaviour and the selection of the relevant domain for the behaviour analysis were conducted in advance of the case conference. The evaluation of the interventions was also organized differently. CONCLUSION: The scope of the response implies that WELCOME-IdA requires further adaptation to the requirements of nursing processes in nursing homes. The results provide important information on the selection of role keepers and offer insights into a) how knowledge of the structured training was circulated and transformed into self-organized case conferences and b) how knowledge was circulated throughout the entire processing of one case. Thus, these results can be used to optimize intervention and implementation. Overall, the intervention should allow more possibilities for tailored adaptation than it currently does.

11.
Aging Ment Health ; 23(8): 966-975, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-29669442

RESUMO

Background/Aims: Neuropsychiatric symptoms (NPS) in dementia pose great challenges for residents and staff in nursing homes. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) has recently in a randomized controlled trial demonstrated reductions in NPS. We explored the participating staff's experiences with the model and how it meets the challenges when dealing with the complexity of NPS. Methods: Three to six months after the end of the intervention, we interviewed 32 of the caregivers, leaders, and physicians participating in the trial, in five focus groups. We used thematic content analysis. Results: The analysis yielded two main themes: (1) a systematic reflection method enhanced learning at work; (2) the structure of the approach helped staff to cope with NPS in residents with dementia. Conclusion: TIME shifts the way of learning for the staff from a traditional to a more innovative and reflection-based learning through a process of learning how to learn at work. The staff's experienced increased coping in their approach to complex problems. Our results emphasise the importance of a structured and biopsychosocial approach to NPS in clinical practice. Future research should explore models for integrating situated learning in daily routines in nursing homes.


Assuntos
Atitude do Pessoal de Saúde , Sintomas Comportamentais , Demência , Pessoal de Saúde , Aprendizagem , Casas de Saúde , Agitação Psicomotora , Adulto , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/etiologia , Sintomas Comportamentais/terapia , Demência/complicações , Demência/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/etiologia , Agitação Psicomotora/terapia , Pesquisa Qualitativa , Adulto Jovem
12.
Nervenarzt ; 90(8): 796-803, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31243508

RESUMO

The German Academy for Rare Neurological Diseases (DASNE) founded in 2017 on the Wartburg in Eisenach, aims to pave the way for an optimized personalized management of patients in all age groups with rare neurological diseases. By bringing rare neurological disease experts together and through forming a dynamic national network the DASNE, initiated by the Centers for Rare Diseases in Lübeck and Tübingen, will continuously foster mutual exchange. Members of the DASNE are renowned experts covering the whole spectrum of rare neurological disorders including pediatric neurology. Through case presentations and multidisciplinary discussion both at yearly meetings and on an internet platform, the main aims of DASNE are to establish a German expertise and reference network for rare neurological disorders. Further main aims are to provide continuous medical education for younger academics in the field of rare neurological disorders and facilitate translation.


Assuntos
Técnicas de Apoio para a Decisão , Doenças do Sistema Nervoso , Neurologia , Academias e Institutos , Alemanha , Humanos , Doenças do Sistema Nervoso/terapia , Neurologia/métodos , Neurologia/tendências
13.
Z Gerontol Geriatr ; 51(1): 48-53, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27599818

RESUMO

BACKGROUND: Up to 90 % of nursing home residents with dementia suffer from urinary incontinence with adverse effects on the quality of life. Nurses are often insufficiently prepared for incontinence management and their knowledge is incomplete. Urinary incontinence management for people with dementia is complex due to the multifactorial nature of the disease and cognitive impairment. OBJECTIVE: This study explored the effects of an educational program and subsequent nursing case conferences on urinary incontinence and quality of life of nursing home residents with dementia. METHODS: The stepped-wedge trial design was used and seven nursing homes were included. In total 140 people were included in the study. The intervention consisted of an educational program and six case conferences at each ward. Urinary incontinence and quality of life were measured at baseline, after 2 and 6 months as well as at the end of the study. Univariate analysis of variance (ANOVA), repeated measures ANOVA and linear regression were used to compare the groups and the results at different times of measurement. The responsible ethics committees approved the study. RESULTS: After 6 months urinary incontinence decreased or was approximately equal to the initial measurement. At the end of the study urinary incontinence was slightly but not significantly higher. In the whole sample the quality of life increased in seven out of nine categories up to the end of the study. CONCLUSION: Urinary incontinence management for people with dementia is complex and an educational program and case conferences during 6 months proved to be effective in reducing urinary incontinence and improve the quality of life in nursing home residents with dementia.


Assuntos
Doença de Alzheimer/enfermagem , Enfermagem Geriátrica/educação , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Capacitação em Serviço , Casas de Saúde/estatística & dados numéricos , Incontinência Urinária/enfermagem , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Administração de Caso , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Qualidade de Vida/psicologia , Suíça , Incontinência Urinária/epidemiologia , Incontinência Urinária/psicologia
14.
Nihon Koshu Eisei Zasshi ; 64(9): 556-566, 2017.
Artigo em Japonês | MEDLINE | ID: mdl-28993553

RESUMO

Objective Floor plan sketches (FPSs) are schematic representations of floors in a home. FPSs display information gathered from observations and interviews on people's way of dwelling. To elucidate the effects of utilizing FPSs in case reviews assuming a community care meeting attended by multidisciplinary professionals, we conducted reviews of hypothetical cases created for experimental purposes.Methods Two hypothetical cases (Cases 1 and 2) were developed, and each case was reviewed with and without FPSs. Two groups (Groups A and B) were created, each consisting of five health care and welfare professionals involved in actual case reviews. Group A reviewed Case 1 without FPSs followed by Case 2 with FPSs, while Group B reviewed Case 2 without FPSs followed by Case 1 with FPSs. Case conferences and group interviews conducted after the completion of these reviews. Based on the verbatim transcripts of the reviews and interviews, we investigated differences between case reviews with and without FPSs with regard to the time required for the review and the number and contents of participants' comments.Results Review content could largely be divided into two categories: (1) the living conditions and support for the case subjects and their families, and (2) their homes and their way of dwelling at home. These categories were common to case reviews both with and without FPSs. In discussions about the homes and ways of dwelling, however, confirmation of the locations of rooms consumed a large amount of time in case reviews without FPSs. In case reviews with FPSs, discussions were more specific and included details such as room usage and paths by which residents move. The mean time required for a review was 41 minutes per case (range: 36 to 44 minutes), which did not greatly differ based on whether or not FPSs were used. Participants made more comments and seemed to interact more actively with each other when they had the FPSs than when they did not. The impressions of participants were that FPSs allowed the visualization of the case subjects and their families in their homes and fostered a greater feeling of familiarity with the case.Conclusion The use of FPSs in case reviews reduces the time spent on information sharing and allows more detailed review contents. Furthermore, FPSs enhance the ability to imagine the daily lives of case subjects and their families, thereby potentially broadening assessments in case reviews.


Assuntos
Habitação , Redes Comunitárias , Feminino , Habitação/estatística & dados numéricos , Habitação/provisão & distribuição , Humanos , Masculino , Pessoa de Meia-Idade
15.
BMC Psychiatry ; 16: 233, 2016 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-27406242

RESUMO

BACKGROUND: Nearly all persons with dementia will experience neuropsychiatric symptoms (NPS) during the course of their disease. Clinicians and researchers emphasize the need for an evidence-informed standardized approach to managing NPS that integrates pharmacological and nonpharmacological treatments for real-world implementation. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) represents such an approach and is a multicomponent intervention based on the theoretical framework of cognitive behavioural therapy. METHODS/DESIGN: The trial is a 3-month cluster randomized trial conducted in 30 nursing homes including 168 participants with dementia and a high level of agitation. Each nursing home defined as a cluster will be randomized to receive either the TIME intervention (the intervention group) or a brief education-only intervention regarding dementia and NPS (the control group). TIME is a manual-based, multicomponent programme that includes a rigorous assessment, one or more case conferences and the treatment and evaluation of NPS. Patient-level measurements are taken at baseline (prior to randomization) and 8 and 12 weeks later. The primary outcome measure is the change in agitation, as defined by the Neuropsychiatric Inventory-Nursing Home Version, at 8 weeks from baseline. Secondary outcome measures include change in agitation at 12 weeks from baseline, and change from baseline at 8 and 12 weeks in other NPS, quality of life, and the use of psychotropic and analgesic medications. Mixed methods will be used to follow, measure and explore the implementation process and the effect of the intervention at the individual staff level and the organization level. Combining measurements of clinical effectiveness and implementation outcomes define this trial as an effectiveness-implementation hybrid trial. DISCUSSION: Measuring the implementation and effect of complex interventions aimed at reducing NPS in nursing homes is challenging. In this study protocol, we describe a multicomponent program, TIME, and discuss how an effectiveness-implementation cluster randomized hybrid trial can meet these challenges. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02655003 . Registered 6 January 2016.


Assuntos
Demência/diagnóstico , Demência/terapia , Modelos Psicológicos , Casas de Saúde , Analgésicos/efeitos adversos , Analgésicos/uso terapêutico , Análise por Conglomerados , Demência/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Noruega/epidemiologia , Casas de Saúde/tendências , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/epidemiologia , Agitação Psicomotora/terapia , Psicotrópicos/efeitos adversos , Psicotrópicos/uso terapêutico , Qualidade de Vida/psicologia , Resultado do Tratamento
16.
Acad Psychiatry ; 40(3): 494-7, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27001311

RESUMO

Objective An innovative course was developed for fellows enrolled in the Yale School of Medicine Addiction Psychiatry program to educate them in key principles of adult learning, apply these principles in a case conference presentation, and to improve skills in providing and receiving feedback. Methods An initial training module on educational skills was followed by individual mentorship to prepare a case presentation. A feedback module provided space to learn and practice skills in feedback delivery. Results The program showed positive results and improved confidence levels of the participants in presenting and providing/receiving feedback. Conclusions Implementing a course designed to improve teaching and feedback skills is feasible in a 1-year Addiction Psychiatry fellowship.


Assuntos
Currículo , Docentes de Medicina/educação , Bolsas de Estudo , Psiquiatria/educação , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Capacitação de Professores/métodos , Humanos , Especialização
17.
J Adolesc Young Adult Oncol ; 13(3): 514-522, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38569162

RESUMO

Purpose: This study addresses the critical issue of fertility preservation among young patients with cancer in Japan, recognizing the brief decision-making window and the need for comprehensive support. Pharmacists, well-versed in the side effects of anticancer drugs, can play a vital role in this support process. However, the extent of pharmacists' involvement in fertility preservation remains unclear. We aimed to investigate pharmacists' roles in addressing cancer treatment-induced fertility concerns and their collaboration with physicians, offering insights into enhancing pharmacist participation in fertility preservation. Methods: A survey conducted between April and July 2022 targeted doctors and pharmacists at cancer treatment hospitals, along with pharmacists affiliated with the Japanese Society of Pharmaceutical Health Care and Sciences. Results: Our findings indicated that although pharmacists had limited knowledge about gonadotoxicity and fertility, they expressed readiness to conduct research and provide information when consulted. Approximately 10%-20% of the pharmacists participated in explaining the primary disease at diagnosis. Pharmacists played a more prominent role after establishing chemotherapy regimens, with less involvement in its formulation. Notably, treatment decision case conferences emerged as crucial forums for gathering patient data, confirming treatment plans, and identifying those in need for fertility preservation information. Roughly half of the pharmacists attended these conferences, suggesting a need for increased participation. Conclusion: Enhancing physician-pharmacist collaboration could be pivotal for effective fertility preservation. This requires augmenting the knowledge and awareness of both professions and encouraging greater participation in case conferences to create a conducive environment for addressing this critical aspect of cancer care.


Assuntos
Preservação da Fertilidade , Farmacêuticos , Médicos , Humanos , Preservação da Fertilidade/métodos , Feminino , Médicos/psicologia , Masculino , Adulto , Inquéritos e Questionários , Neoplasias/tratamento farmacológico , Adulto Jovem
18.
J Endocr Soc ; 7(4): bvad023, 2023 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-36860907

RESUMO

Context: The COVID-19 pandemic challenged undertaking gradual educational activities for residency and fellowship trainees. However, recent technological advances have enabled broadening active learning opportunities through international online conferences. Objective: The format of our international online endocrine case conference, launched during the pandemic, is introduced. The objective impact of this program on trainees is described. Methods: Four academic facilities developed a semiannual international collaborative endocrinology case conference. Experts were invited as commentators to facilitate in-depth discussion. Six conferences were held between 2020 and 2022. After the fourth and sixth conferences, anonymous multiple-choice online surveys were administered to all attendees. Results: Participants included trainees and faculty. At each conference, 3 to 5 cases of rare endocrine diseases from up to 4 institutions were presented, mainly by trainees. Sixty-two percent of attendees reported 4 facilities as the appropriate size for the collaboration to maintain active learning in case conferences. Eighty-two percent of attendees preferred a semiannual conference. The survey also revealed the positive impact on trainees' learning regarding diversity of medical practice, academic career development, and confidence in honing of presentation skills. Conclusion: We present an example of our successful virtual global case conference to enhance learning about rare endocrine cases. For the success of the collaborative case conference, we suggest smaller cross-country institutional collaborations. Preferably, they would be international, semiannually based, and with recognized experts as commentators. Since our conference has engendered multiple positive effects on trainees and faculty, continuation of virtual education should be considered even after the pandemic era.

19.
Curr Pharm Teach Learn ; 13(12): 1646-1653, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34895674

RESUMO

INTRODUCTION: Safe and effective care transitions require interprofessional collaboration, but there is limited literature on interprofessional strategies to teach care transitions. The objective was to evaluate student pharmacist and nurse readiness for change towards interprofessional collaborative practice during care transitions. METHODS: Interprofessional teams were instructed to collaborate and provide care for their patient throughout multiple healthcare transitions. Students were asked to complete the Interprofessional Socialization and Valuing Scale (ISVS) 9A/9B, the nine-item set version, prior to implementation of the case conference series and after the activity debrief. RESULTS: There was an increase across six items from the ISVS scale for pharmacy students and eight of nine for nursing students. There were significant changes in two of nine items for the pharmacy groups and three of nine in the nursing group. CONCLUSIONS: An interprofessional case conference series demonstrated a significant increase in student pharmacist and student nurse awareness of the importance of working within a team during care transitions, as well as an appreciation towards their role within the interprofessional team.


Assuntos
Farmácia , Transição para Assistência do Adulto , Currículo , Humanos , Relações Interprofissionais , Transferência de Pacientes
20.
Curr Pharm Teach Learn ; 13(9): 1252-1258, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34330406

RESUMO

BACKGROUND: The establishment of interprofessional education (IPE) as an effective method for training future health care providers, the subsequent establishment of IPE requirements in accreditation standards, and the challenges to integrating IPE into professional-centric curricula have created an environment that encourages opportunity for innovation and collaboration in curriculum design. INTERPROFESSIONAL EDUCATION ACTIVITY: Interprofessional Education Collaborative (IPEC) Core Competencies were integrated into an Interprofessional Case Conference (ICC) model that included six annual case conferences involving students from eight health professions across multiple campuses. Students worked in groups of eight with no more than two students from each profession per group. Interprofessional teams facilitated live progressive cases consisting of iterative guided student discussion alternating with group problem solving, followed by "talk-show style" reports. A retrospective pre-post study design using the validated IPEC Competency Self-Assessment V3 and Student Perspective of Interprofessional Clinical Education tools assessed student perspectives of the ICC model. The online survey was sent to participants who attended at least one ICC in 2015-2016 and 2016-2017. DISCUSSION: Pre-/post-data was available from 94 students. Results revealed modest, but significant, score changes across both instruments, confirming the value of IPE and the ICC training model. IMPLICATIONS: The ICC formula allowed flexibility in applying IPE, resolved scheduling and resources challenges, complemented other IPE programming, and assisted in meeting pharmacy accreditation requirements and the diverse IPE needs of health professions education. The model is flexible, inexpensive, and could be readily replicated at other institutions.


Assuntos
Relações Interprofissionais , Farmácia , Currículo , Pessoal de Saúde/educação , Humanos , Estudos Retrospectivos
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