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Journal of Genetic Counseling Jun 2022A personal or family medical history is inherently part of a genetic counselor's life story. Yet, the degree to which this history influences counselors' clinical...
A personal or family medical history is inherently part of a genetic counselor's life story. Yet, the degree to which this history influences counselors' clinical specialty choice and professional psychosocial practice is unexplored. A medical diagnosis may foster capacity for greater empathy, understanding, and rapport-building self-disclosure. Conversely, it could lead to disruptive countertransference, compassion fatigue, and eventually burnout. Research, however, has not specifically investigated this intersection. The aim of this study was to explore the impact of genetic counselors' personal and/or family medical history on choice of practice area and self-perceived impact on their psychosocial work within sessions. Members of the National Society of Genetic Counselors were recruited to complete an online screening survey. Of the 69 survey respondents that met inclusion criteria, 23 volunteered for and completed a telephone interview. Interview questions explored counselors' medical narratives and their consequent influence on specialty choice and clinical interaction with patients. Inductive analysis yielded nine domains within three major themes: Medical Story, Specialty Impact, and Psychosocial Influence. Participants were more likely to be attracted to a specialty possessing overlap with their medical history and attributed many of their psychosocial strengths to personal and/or family medical experiences, such as increased empathy or a more expansive scope in how they cared for patients. Many counselors, however, noted their medical history did not frequently influence their clinical practice, with most initially denying or downplaying use of self-disclosure about their history. Contradictory to their statements, the majority gave at least one example of self-disclosure, whether indirect, prompted, or direct. Importantly, almost all participants named or demonstrated countertransference. This study highlights that while medical history can be a valuable asset in providing care for patients, it requires a genetic counselor's diligent attentiveness and commitment to honest self-reflection.
Topics: Compassion Fatigue; Counselors; Countertransference; Empathy; Genetic Counseling; Humans
PubMed: 34826351
DOI: 10.1002/jgc4.1533 -
Bioethics Jul 2021Slippery slope-, taboo-breaking- or Nazi-analogy-arguments are common, but not uncontroversial examples of the complex relationship between bioethics and the various...
Slippery slope-, taboo-breaking- or Nazi-analogy-arguments are common, but not uncontroversial examples of the complex relationship between bioethics and the various ways of using historical arguments in these debates. In our analysis we examine first the relationship between bioethics and medical history both as separate disciplines and as argumentative practices. Secondly, we then analyse six common types of historical arguments in bioethics (slippery slope-, analogy-, continuity-, knockout/taboo-, ethical progress- and accomplice-arguments), some as arguments within the academic debate of bioethics, others as arguments within political and public debates over bioethical issues. We conclude by suggesting to bioethicists to better understand historical arguments as socially and culturally embedded practices of critical reflection of power, medical and government paternalism and possible future scenarios. More interdisciplinarity between ethicists and medical historians is needed to appropriately rationalize and understand the different legacies.
Topics: Bioethical Issues; Bioethics; Ethicists; Humans; Morals; Violence
PubMed: 33389764
DOI: 10.1111/bioe.12841 -
Air Medical Journal 2020
Topics: Air Ambulances; Emergency Medical Services; History, 20th Century; History, 21st Century; Humans; Inventions; Societies, Medical; Transportation of Patients; United States
PubMed: 32044069
DOI: 10.1016/j.amj.2019.11.004 -
BMJ (Clinical Research Ed.) Mar 2020
Topics: Humans; Medical History Taking; Ophthalmoscopy; Physical Examination; Vision Disorders; Vision Tests; Visual Acuity
PubMed: 32132015
DOI: 10.1136/bmj.m569 -
Medical History Jul 2023In contrast to the well-known stories of the embryotoxic drug, thalidomide, in countries where it was responsible for large numbers of birth defects, there is limited...
In contrast to the well-known stories of the embryotoxic drug, thalidomide, in countries where it was responsible for large numbers of birth defects, there is limited information on its history in India. Its presence before 2002, when the country issued the first marketing licence for a thalidomide-containing preparation, is assumed to be negligible. This article challenges this view by showing that the drug entered the Indian subcontinent through the former Portuguese territory of Goa around 1960. We examine the subsequent development of its distribution, use and regulation in India from the mid-1960s up to the present situation. Colonial legacies are a crucial explanation for the early appearance of thalidomide on the Indian subcontinent. They also influenced its re-emergence as drug for treating leprosy reactions in India after 1965. We identify key actors in this process: the original German producer that delivered thalidomide free of charge, European doctors who worked for international non-governmental organizations, the World Health Organization (WHO), which supported clinical trials and later discouraged the use of the drug, and finally the Indian state institutions that limited its distribution and later quickly opened the way for the private sector to produce and market thalidomide and its analogues. Finally, we discuss the risk of thalidomide-induced birth defects by casting a critical look on the present state of regulatory provisions and the monitoring of birth defects in India.
Topics: Humans; Thalidomide; India; Physicians; World Health Organization
PubMed: 37668377
DOI: 10.1017/mdh.2023.27 -
Medical History Apr 2020This special issue uses Catholicism as a thread to bring together five contributions to the transnational history of contraception. The articles, which cover examples...
This special issue uses Catholicism as a thread to bring together five contributions to the transnational history of contraception. The articles, which cover examples from Western and East-Central Europe, East Africa and Latin America, all explore the complex interplay between users and providers of birth control in contexts marked by prevalence of the Catholic religion and/or strong political position of the Catholic Church. In the countries examined here, Brazil, Belgium, Poland, Ireland and Rwanda, Catholicism was the majority religion during the different moments of the long twentieth century the authors of this special issue focus on. Using transnationalism as a perspective to examine the social history of the entanglements between Catholicism and contraception, this special issue seeks to underscore the ways in which individuals and organisations used, adapted and contested local and transnational ideas and debate around family planning. It also examines the role of experts and activist groups in the promotion of family planning, while paying attention to national nuances in Catholic understandings of birth control. The contributions shed light on the motivations behind involvement in birth control activism and expertise, its modus operandi, networking strategies and interactions with men and women demanding contraceptive information and technology. Moreover, through the use of oral history, as well as other print sources such as women's magazines, this collection of articles seeks to illustrate 'ordinary' men and women's practices in the realm of reproductive health.
Topics: Catholicism; Contraception; History, 20th Century; Humans; Religion and Medicine
PubMed: 32284632
DOI: 10.1017/mdh.2020.1 -
Artificial Organs Dec 2020
Topics: Artificial Organs; History, 20th Century; History, 21st Century; Humans; International Cooperation; Publishing; Societies, Medical
PubMed: 33264422
DOI: 10.1111/aor.13849 -
Studies in Health Technology and... May 2021Physicians spend a lot of time in routine tasks, i.e. repetitive and time consuming tasks that are essential for the diagnostic and treatment process. One of these tasks...
BACKGROUND
Physicians spend a lot of time in routine tasks, i.e. repetitive and time consuming tasks that are essential for the diagnostic and treatment process. One of these tasks is to collect information on the patient's medical history.
OBJECTIVES
We aim at developing a prototype for an intelligent interviewer that collects the medical history of a patient before the patient-doctor encounter. From this and our previous experiences in developing similar systems, we derive recommendations for developing intelligent interviewers for concrete medical domains and tasks.
METHODS
The intelligent interviewer was implemented as chatbot using IBM Watson assistant in close cooperation with a family doctor.
RESULTS
AnCha is a rule-based chatbot realized as decision tree with 75 nodes. It asks a maximum of 44 questions on the medical history, current complaints and collects additional information on the patient, social details, and prevention.
CONCLUSION
When developing an intelligent digital interviewer it is essential to define its concrete purpose, specify information to be collected, design the user interface, consider data security and conduct a practice-oriented evaluation.
Topics: Humans; Intelligence; Physician-Patient Relations
PubMed: 33965913
DOI: 10.3233/SHTI210083 -
Ui Sahak Aug 2023Currently, the education of the history of medicine in South Korea has established a solid foundation. Since Kim Du-jong (1896-1988) began giving medical history...
Currently, the education of the history of medicine in South Korea has established a solid foundation. Since Kim Du-jong (1896-1988) began giving medical history lectures at Severance Medical College in 1946, a total of 22 universities-over half of the 40 total universities-have implemented medical history education in the curriculum as of 2023. Furthermore, several textbooks and translations summarizing Western and Korean medical history have been published. However, despite this expansion, there has been little discussion on how to implement medical history education for students. To address this gap, this study examines the period and structure of medical history education, as well as various teaching methods, while considering their respective advantages and disadvantages. Firstly, there are two main approaches to implementing medical history education. One approach integrates medical history throughout the entire educational process, while the other concentrates on specific stages of education. Both approaches extend beyond undergraduate education and encompass medical education after graduation. The former emphasizes integration with basic medical and clinical education, while the latter focuses on ensuring educational coherence. Secondly, the structure of medical history courses can be broadly categorized as chronological or thematic. Within the chronological approach, there are two subcategories: general and periodic. The general method is traditionally used in history education but may be rigid in structure and fail to engage students' interest. On the other hand, the period method conveys multidimensional and comprehensive understanding of different periods but may make it challenging to grasp the overall flow of history, resulting in fragmentation of the course. Thematic structure can be further divided into topic-centered and field-specific methods. Both approaches allow for adjusting the content and arrangement of courses based on student interests and teaching conditions, but they present challenges in maintaining the coherence of the entire course. Lastly, the teaching methods in medical history education can be categorized into traditional lectures, small-group discussions, and individual research guidance. Most medical history courses adopt a lecture-based teaching method, which effectively provides diverse knowledge to medical students who may be unfamiliar with historical research and methodology. However, due to the one-directional nature of the instruction and the passive role of the learners, it can be challenging to stimulate learners' motivation or assess their understanding. Consequently, recent changes try to incorporate active learning through small-group discussions and individual research guidance.
Topics: History of Medicine; Humans; Schools, Medical; Medicine; Educational Status; Education, Medical; Students, Medical
PubMed: 37718563
DOI: 10.13081/kjmh.2023.32.595 -
Journal of the American Medical... Jun 2022A participant's medical history is important in clinical research and can be captured from electronic health records (EHRs) and self-reported surveys. Both can be...
OBJECTIVE
A participant's medical history is important in clinical research and can be captured from electronic health records (EHRs) and self-reported surveys. Both can be incomplete, EHR due to documentation gaps or lack of interoperability and surveys due to recall bias or limited health literacy. This analysis compares medical history collected in the All of Us Research Program through both surveys and EHRs.
MATERIALS AND METHODS
The All of Us medical history survey includes self-report questionnaire that asks about diagnoses to over 150 medical conditions organized into 12 disease categories. In each category, we identified the 3 most and least frequent self-reported diagnoses and retrieved their analogues from EHRs. We calculated agreement scores and extracted participant demographic characteristics for each comparison set.
RESULTS
The 4th All of Us dataset release includes data from 314 994 participants; 28.3% of whom completed medical history surveys, and 65.5% of whom had EHR data. Hearing and vision category within the survey had the highest number of responses, but the second lowest positive agreement with the EHR (0.21). The Infectious disease category had the lowest positive agreement (0.12). Cancer conditions had the highest positive agreement (0.45) between the 2 data sources.
DISCUSSION AND CONCLUSION
Our study quantified the agreement of medical history between 2 sources-EHRs and self-reported surveys. Conditions that are usually undocumented in EHRs had low agreement scores, demonstrating that survey data can supplement EHR data. Disagreement between EHR and survey can help identify possible missing records and guide researchers to adjust for biases.
Topics: Documentation; Electronic Health Records; Humans; Information Storage and Retrieval; Population Health; Surveys and Questionnaires
PubMed: 35396991
DOI: 10.1093/jamia/ocac046