Background: Multiple studies in the primary care field have indicated the benefits of using a patient centered approach in communication with the patient;such interviewing methods have been shown to improve patient sa...Background: Multiple studies in the primary care field have indicated the benefits of using a patient centered approach in communication with the patient;such interviewing methods have been shown to improve patient satisfaction and adherence. There is a scarcity of anesthetic literature regarding communication skills in the perioperative period. The goal is to analyze to what extent empathic patient-centered communication methods are being used by anesthesia providers. Communication scores will be compared among providers, as well as to providers across several different subspecialties. Methods: This study is an observational descriptive study at a large tertiary care center, University Hospital in Newark, NJ. The observer observes and grades patient interviews, scoring against established criteria using an adapted version of the Kalamazoo grading tool. The researcher observes and grades the preoperative interview using the adapted Kalamazoo scale. At the end of the observed encounter, the anesthesia providers are asked to fill out a brief form detailing their demographic history, details regarding the providers’ length and type of clinical education and training, undergraduate education, previous communication training, number of years of practice, primary language, gender, and age will be obtained. Results: Anesthesia providers included in the study were physician anesthesiologists, residents, and nurse anesthetists. The average Kalamazoo score was 28.7 amongst all providers. There was no significant effect of provider level on the score at the p Conclusions: The data revealed anesthesia providers provide patient-centered encounters with a mean score of 28.7, which is higher than the average for providers from multiple different specialties observed in Joyce, et al. study (mean score of 25.25). The subcategories “Understanding patient’s perspective” and “reaches agreement” scored 3.86, and 3.83, respectively. This may indicate that anesthesia providers can improve on allowing the patient to communicate their understanding of anesthesia, as well as collecting information from the patient that can affect their anesthesia (i.e., severe nausea following previous anesthesia).展开更多
Background: The opinion of physicians clearly counts in prioritizing health care, but there is little information on the rationales underlying treatment decisions and whether these rationales are accepted by patients....Background: The opinion of physicians clearly counts in prioritizing health care, but there is little information on the rationales underlying treatment decisions and whether these rationales are accepted by patients. Objective: To compare physicians and patients regarding their understanding and use of therapeutic benefit and treatment costs as criteria for prioritizing health care. Methods: Seven physicians and twelve patients were purposefully selected to yield a heterogeneous sample. Participants were interviewed face-to-face, following a semi-structured topic guide comprising three scenarios that focused on interventions with low or unproven therapeutic benefit and high costs, respectively. For data analysis we used qualitative content analysis. Results: We found that patients and physicians differed in their understanding of therapeutic benefit, their expectations of what medicine can do and their use of costs as criteria for prioritizing health care. Physicians were less likely to assess a certain intervention as effec tive, and they less often accepted upper funding limits in health care. Unlike the physicians, patients raised non-medical aspects in decision making such as the patient’s consent and social inequalities. Conclusions: The revealed differences point toward the necessity to strengthen the doctor-patient communication, to improve information for patients about the possibilities and limits of health care and to gain a deeper understanding of their attitudes, wishes and concerns to reach an agreement by physicians and patients on the treatment to be implemented.展开更多
<strong>Aims and Objectives: </strong>To understand the lived experience and needs of patients with sickle cell disease during and two weeks after their crisis and identify the obstacles faced by patients ...<strong>Aims and Objectives: </strong>To understand the lived experience and needs of patients with sickle cell disease during and two weeks after their crisis and identify the obstacles faced by patients while they are in the hospital. <strong>Background:</strong> Although there is no specific data of a number of affected individuals with sickle cell disease in Oman based on their age, the majority of the Omani population are youth. This category of the population is either in their high school or working in the governmental or private sector in the country. When the most productive category of the population are getting frequently absent due to sickle cell crisis and complication of sickle cell crisis from their work, this leads to huge financial and human resource burden. <strong>Design:</strong> Phenomenology. <strong>Method:</strong> This qualitative descriptive research was conducted using face-to-face interviews based on an interview protocol. The interview protocol was developed by the authors based on a framework called domains of well-being. Twenty adult patients have been recruited for the interview after meeting inclusion criteria and were asked about their well-being and lived experience during sickle cell crisis. Authors used SRQR checklist in reporting the study. <strong>Results:</strong> Thirteen themes were identified related to patients’ lived experience and their well-being during sickle cell crisis. Patients reported physical, emotional, social, and spiritual alteration. Major themes that emerged are communication, medical team interpretation of genuine pain, Emotional disturbance during the crisis, What does this study contribute to the wider global clinical community? Nurses and doctors should use therapeutic communication when dealing with sickle cell patients. Nurses should establish rapport and trust with patients. In each health care setting, there should be a social worker to deal with patients with chronic illness social relationships between the patient, family and friends, post-discharge status, spiritual and Islamic activities, and physical abilities. <strong>Conclusion:</strong> Participants’ physical and psychological statuses were mostly affected. Moreover, participants experienced extreme emotional disturbance during a painful crisis. However, it was not well understood why participants experienced post sickle cell crisis symptoms which need to be further investigated. <strong>Relevance to Clinical Practice:</strong> Understanding the lived experience of sickle cell patients may help improve nursing and medical care provided to them and enhance better outcomes for patients. These findings made the nurses and physicians plan a strategy of treating sickle cell patients using a holistic approach.展开更多
Background and aim: People suffering from mental illness and their experiences of attitudes towards them are rarely investigated from the perspective of the individual. The aim was to gain an understanding of how a gr...Background and aim: People suffering from mental illness and their experiences of attitudes towards them are rarely investigated from the perspective of the individual. The aim was to gain an understanding of how a group of mental health patients experienced social relationships in personal settings as well as in society. Method: Open interviews with twenty-five mental health patients were conducted and analysed with a qualitative content analysis. Result: The essence of the result was that mental health patients’ experiences are still not taken enough into account, neither by mental health professionals nor by their social networks. This was underpinned by four core categories: Patients’ experience of deteriorated and reduced social contacts due to various degrees of acceptance and knowledge of people in general;service users reported on difficulties with social contacts in general, with family relationships, relationships with friends and workmates and with employers;reduced life opportunities were expressed, including violated self-image and poor coping competence and, ambivalent experiences of contact with the mental health services were reported. Conclusion and clinical implication: The present study contributes to the understanding of mental health patients’ experiences of professional services and of their social networks. This knowledge may strengthen the implications of patient-centred care essential for the outcome of the care.展开更多
Objective: To ascertain a method for building good nurse-patient relations from the narratives of veteran nurses who have accumulated profound nursing experience, and to show these phenomena in model form. Methods: Se...Objective: To ascertain a method for building good nurse-patient relations from the narratives of veteran nurses who have accumulated profound nursing experience, and to show these phenomena in model form. Methods: Semi-structured interviews were conducted, verbatim records of the contents of the interviews produced, and qualitative analysis undertaken. Results of analysis and concepts considered important were shown in model form. Results: Veteran nurses, utilizing their nursing specialization, showed “Concern as humans,” transcending their professional specialty. This was expressed as “spreading the wings of imagination” in order to know what is important to patients, and “protecting souls” in order to defend, together with patients, what is most important to the latter. “Spreading the wings of imagination to protect patients’ souls” became the key to build good nurse-patient relations. Conclusion: Nurses with deep experience expressed building good nurse-patient relations as “spreading the wings of imagination and protecting patients’ souls.” We were able to ascertain that in nursing practice, using the sensitivity of veteran nurses, is one way of manifesting nursing conduct.展开更多
文摘Background: Multiple studies in the primary care field have indicated the benefits of using a patient centered approach in communication with the patient;such interviewing methods have been shown to improve patient satisfaction and adherence. There is a scarcity of anesthetic literature regarding communication skills in the perioperative period. The goal is to analyze to what extent empathic patient-centered communication methods are being used by anesthesia providers. Communication scores will be compared among providers, as well as to providers across several different subspecialties. Methods: This study is an observational descriptive study at a large tertiary care center, University Hospital in Newark, NJ. The observer observes and grades patient interviews, scoring against established criteria using an adapted version of the Kalamazoo grading tool. The researcher observes and grades the preoperative interview using the adapted Kalamazoo scale. At the end of the observed encounter, the anesthesia providers are asked to fill out a brief form detailing their demographic history, details regarding the providers’ length and type of clinical education and training, undergraduate education, previous communication training, number of years of practice, primary language, gender, and age will be obtained. Results: Anesthesia providers included in the study were physician anesthesiologists, residents, and nurse anesthetists. The average Kalamazoo score was 28.7 amongst all providers. There was no significant effect of provider level on the score at the p Conclusions: The data revealed anesthesia providers provide patient-centered encounters with a mean score of 28.7, which is higher than the average for providers from multiple different specialties observed in Joyce, et al. study (mean score of 25.25). The subcategories “Understanding patient’s perspective” and “reaches agreement” scored 3.86, and 3.83, respectively. This may indicate that anesthesia providers can improve on allowing the patient to communicate their understanding of anesthesia, as well as collecting information from the patient that can affect their anesthesia (i.e., severe nausea following previous anesthesia).
文摘Background: The opinion of physicians clearly counts in prioritizing health care, but there is little information on the rationales underlying treatment decisions and whether these rationales are accepted by patients. Objective: To compare physicians and patients regarding their understanding and use of therapeutic benefit and treatment costs as criteria for prioritizing health care. Methods: Seven physicians and twelve patients were purposefully selected to yield a heterogeneous sample. Participants were interviewed face-to-face, following a semi-structured topic guide comprising three scenarios that focused on interventions with low or unproven therapeutic benefit and high costs, respectively. For data analysis we used qualitative content analysis. Results: We found that patients and physicians differed in their understanding of therapeutic benefit, their expectations of what medicine can do and their use of costs as criteria for prioritizing health care. Physicians were less likely to assess a certain intervention as effec tive, and they less often accepted upper funding limits in health care. Unlike the physicians, patients raised non-medical aspects in decision making such as the patient’s consent and social inequalities. Conclusions: The revealed differences point toward the necessity to strengthen the doctor-patient communication, to improve information for patients about the possibilities and limits of health care and to gain a deeper understanding of their attitudes, wishes and concerns to reach an agreement by physicians and patients on the treatment to be implemented.
文摘<strong>Aims and Objectives: </strong>To understand the lived experience and needs of patients with sickle cell disease during and two weeks after their crisis and identify the obstacles faced by patients while they are in the hospital. <strong>Background:</strong> Although there is no specific data of a number of affected individuals with sickle cell disease in Oman based on their age, the majority of the Omani population are youth. This category of the population is either in their high school or working in the governmental or private sector in the country. When the most productive category of the population are getting frequently absent due to sickle cell crisis and complication of sickle cell crisis from their work, this leads to huge financial and human resource burden. <strong>Design:</strong> Phenomenology. <strong>Method:</strong> This qualitative descriptive research was conducted using face-to-face interviews based on an interview protocol. The interview protocol was developed by the authors based on a framework called domains of well-being. Twenty adult patients have been recruited for the interview after meeting inclusion criteria and were asked about their well-being and lived experience during sickle cell crisis. Authors used SRQR checklist in reporting the study. <strong>Results:</strong> Thirteen themes were identified related to patients’ lived experience and their well-being during sickle cell crisis. Patients reported physical, emotional, social, and spiritual alteration. Major themes that emerged are communication, medical team interpretation of genuine pain, Emotional disturbance during the crisis, What does this study contribute to the wider global clinical community? Nurses and doctors should use therapeutic communication when dealing with sickle cell patients. Nurses should establish rapport and trust with patients. In each health care setting, there should be a social worker to deal with patients with chronic illness social relationships between the patient, family and friends, post-discharge status, spiritual and Islamic activities, and physical abilities. <strong>Conclusion:</strong> Participants’ physical and psychological statuses were mostly affected. Moreover, participants experienced extreme emotional disturbance during a painful crisis. However, it was not well understood why participants experienced post sickle cell crisis symptoms which need to be further investigated. <strong>Relevance to Clinical Practice:</strong> Understanding the lived experience of sickle cell patients may help improve nursing and medical care provided to them and enhance better outcomes for patients. These findings made the nurses and physicians plan a strategy of treating sickle cell patients using a holistic approach.
文摘Background and aim: People suffering from mental illness and their experiences of attitudes towards them are rarely investigated from the perspective of the individual. The aim was to gain an understanding of how a group of mental health patients experienced social relationships in personal settings as well as in society. Method: Open interviews with twenty-five mental health patients were conducted and analysed with a qualitative content analysis. Result: The essence of the result was that mental health patients’ experiences are still not taken enough into account, neither by mental health professionals nor by their social networks. This was underpinned by four core categories: Patients’ experience of deteriorated and reduced social contacts due to various degrees of acceptance and knowledge of people in general;service users reported on difficulties with social contacts in general, with family relationships, relationships with friends and workmates and with employers;reduced life opportunities were expressed, including violated self-image and poor coping competence and, ambivalent experiences of contact with the mental health services were reported. Conclusion and clinical implication: The present study contributes to the understanding of mental health patients’ experiences of professional services and of their social networks. This knowledge may strengthen the implications of patient-centred care essential for the outcome of the care.
文摘Objective: To ascertain a method for building good nurse-patient relations from the narratives of veteran nurses who have accumulated profound nursing experience, and to show these phenomena in model form. Methods: Semi-structured interviews were conducted, verbatim records of the contents of the interviews produced, and qualitative analysis undertaken. Results of analysis and concepts considered important were shown in model form. Results: Veteran nurses, utilizing their nursing specialization, showed “Concern as humans,” transcending their professional specialty. This was expressed as “spreading the wings of imagination” in order to know what is important to patients, and “protecting souls” in order to defend, together with patients, what is most important to the latter. “Spreading the wings of imagination to protect patients’ souls” became the key to build good nurse-patient relations. Conclusion: Nurses with deep experience expressed building good nurse-patient relations as “spreading the wings of imagination and protecting patients’ souls.” We were able to ascertain that in nursing practice, using the sensitivity of veteran nurses, is one way of manifesting nursing conduct.
