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"Patient's lived experience" : New insights from the "scene" of deep-brain stimulation medical care.Medicine, Health Care, and Philosophy Sep 2019This editorial presents a special issue gathering four contributions about the patient's lived experience in the context of deep-brain stimulation. It aims at clarifying...
This editorial presents a special issue gathering four contributions about the patient's lived experience in the context of deep-brain stimulation. It aims at clarifying the meaning of such an experience and its scope for medical practice, the health system and its legal frame.
Topics: Deep Brain Stimulation; Humans; Patients
PubMed: 31175487
DOI: 10.1007/s11019-019-09896-5 -
Nurse Education Today Dec 2023Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing... (Review)
Review
BACKGROUND
Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing empathy and compassion from the perspective of researchers or clinicians. There has been limited attention to the perspectives of patients.
OBJECTIVE
The objective of this scoping review was to map the literature to identify patients' views of healthcare provider behaviours that exemplify empathic and compassionate interactions.
METHOD
This review used the Joanna Briggs Institute scoping review methodology. A comprehensive search of eight electronic databases was conducted with English language studies published in the last 10 years considered for inclusion.
RESULTS
Database searching resulted in 459 records for initial screening. After de-duplication and conducting a title and abstract review, 32 full-text articles were screened for eligibility. A total of 14 studies met the inclusion criteria and were critically reviewed using the Mixed Methods Appraisal Tool. The included papers profiled studies that had been conducted in clinical settings across seven countries. The healthcare encounters described in the papers were with a range of healthcare providers. Two overarching and interconnected categories of behaviours were identified as indicative of empathic/compassionate encounters: (1) communication skills such as listening, touch, body language, eye contact and positive demeanour; and (2) helping behaviours demonstrated by small acts of kindness that go beyond routine healthcare.
CONCLUSION
Given the breadth of studies describing the positive impact of empathy/compassion on people's physical and psychosocial wellbeing, the results from this review are valuable and shed new light on patients' views and experiences. The results provide a deeper understanding of healthcare provider behaviours that exemplify empathic and compassionate healthcare interactions and can be used to inform the education and training of healthcare providers from all disciplines.
Topics: Humans; Empathy; Delivery of Health Care; Health Personnel; Patients
PubMed: 37734368
DOI: 10.1016/j.nedt.2023.105957 -
The Journal of Knee Surgery Dec 2023Patient treatment decisions for knee osteoarthritis (OA) are driven largely by the patient's physical examination and radiograph findings. Because multiple treatment... (Review)
Review
Patient treatment decisions for knee osteoarthritis (OA) are driven largely by the patient's physical examination and radiograph findings. Because multiple treatment options may be medically appropriate, it is imperative that the patient's voice be considered to better facilitate patient-centered treatment decisions. Concordance between physicians and patients on optimal treatment can vary, with few studies identifying the factors important to patients when making treatment decisions for knee OA. The goal of this analysis is to identify and synthesize subjective factors in the literature found to influence patient decision-making in a presurgical knee OA population, such that physicians and health care teams can become better equipped to help patients realize their specific treatment goals. This review was registered with PROSPERO and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. A systematic search was completed in four databases for search terms related to knee OA and decision-making. Articles were eligible for inclusion when they discussed (1) patients' thoughts, feelings, goals, and perceptions that factored into treatment deliberation and decision-making; and (2) related to knee OA. Twenty-four articles were identified, 11 qualitative studies and 13 quantitative studies. Synthesis of the included articles revealed three main themes that drive patient treatment decisions: (1) individual catalysts to pursue treatment including pain and mobility limitations, (2) interpersonal factors including social networks and clinician trust, and (3) risks versus benefits assessment including patients' beliefs and expectations. Only a few studies looked at nonoperative treatment decisions, and no studies looked at cohorts considering knee preservation surgeries. This study was completed to synthesize literature related to patient treatment decisions for nonoperative and surgical management of knee OA, finding that patients consider multiple subjective factors when choosing whether to move forward with treatment. Understanding how patients' beliefs determine their preferences for treatment can improve shared decision-making.
Topics: Humans; Osteoarthritis, Knee; Pain; Patients
PubMed: 37072026
DOI: 10.1055/s-0043-56998 -
Intensive & Critical Care Nursing Dec 2023To examine the needs, perceptions and influencing factors according to former adult intensive care unit patients and relatives with regard to family participation in...
OBJECTIVES
To examine the needs, perceptions and influencing factors according to former adult intensive care unit patients and relatives with regard to family participation in essential care in the unit.
RESEARCH DESIGN
A qualitative interpretive descriptive study using inductive thematic analysis.
SETTING
Twelve pairs of former Dutch patients and their relatives were interviewed within two months after the patient's discharge from the unit between December 2017 and April 2018.
FINDINGS
Four themes emerged: the family's history, the patient's condition, supporting the patient and supporting the relative. The family's history, in particular the relationship with the patient and former experience with care, determined the level of participation in essential care. The level of participation was also influenced by the patient's condition, more specifically level of consciousness, stability of the patient's situation and length of the patient's stay. The third theme, supporting the patient, related to presence/being able to 'be there' for the patient and a mostly positive attitude towards family participation. The last theme was supporting the relative, with three subthemes associated with relatives' needs and perceptions: (dis)comfort with participation in essential care, need for invitation and support, and concern about the possible strain experienced by relatives.
CONCLUSION
Supporting the patient and supporting the relative are reflecting the needs and perceptions of patients and relatives regarding family participation in essential care. Both the family's history and the patient's condition influence the relative's level of participation. Intensive care unit nurses and other healthcare providers could take these themes into account when encouraging family participation in essential care.
IMPLICATIONS FOR CLINICAL PRACTICE
Patients' and relatives' needs and perceptions of family participation in essential care in the intensive care unit vary. Family participation in essential care is influenced by the family's history and the patient's condition. Healthcare providers could take these findings into account when implementing family participation in essential care.
Topics: Adult; Humans; Consciousness; Health Personnel; Intensive Care Units; Patient Discharge; Patients
PubMed: 37598505
DOI: 10.1016/j.iccn.2023.103525 -
Urogynecology (Philadelphia, Pa.) Dec 2023Limited studies focus on the integration of online portals, including telehealth services, in urogynecology while identifying promoters and deterrents of utilization,...
IMPORTANCE
Limited studies focus on the integration of online portals, including telehealth services, in urogynecology while identifying promoters and deterrents of utilization, especially for the older population.
OBJECTIVE
This study aimed to identify facilitators, concerns, technical or personal issues encountered, and the desired features of the online patient portals among older urogynecology patients.
STUDY DESIGN
This is a secondary analysis of a cross-sectional study of older patients (≥65 years). The survey was devised using 2 focus groups with questions addressing older patient practicality and comfort with virtual visits for menopause and urogynecology-specific conditions.
RESULTS
A total of 205 patients completed the study. Promoters of use included health care professional encouragement, enrollment on site with concurrent education, and clarification of relevance of the virtual care to one's care. Patients who were uncomfortable with portal use reported anxiety and technical issues as deterrents for using such technology. More than half of the patients were comfortable having online visits for preoperative (51.7%), postoperative (66.3%), and medical management (73.7%). Up to 60.5% of the patients believed that virtual visits were equally stressful as in-person visits, whereas 24.4% believed that the logistics of in-person visits were the cause of stress.
CONCLUSIONS
To improve access to care, augment the utilization of online patient portals, and combat ageism, enhancing the older urogynecologic patient's portal experience is vital. Investment in this population's needs includes education of patients, active enrollment, and engagement by health care systems, and addressing technical concerns.
Topics: Female; Humans; Patient Portals; Cross-Sectional Studies; Telemedicine; Delivery of Health Care; Patients
PubMed: 37097215
DOI: 10.1097/SPV.0000000000001359 -
JAMA Network Open Oct 2021Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite...
IMPORTANCE
Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures.
OBJECTIVE
To assess patients' knowledge about medical radiation and related risks.
DESIGN, SETTING, AND PARTICIPANTS
A survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020.
MAIN OUTCOMES AND MEASURES
Survey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues.
RESULTS
Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866). Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P = .03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P = .004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71; 95% CI, 1.43-2.03; P < .001) and having a higher educational level (intermediate vs low: OR, 1.48; 95% CI, 1.17-1.88; P < .001; high vs low: OR, 2.68; 95% CI, 2.09-3.43; P < .001).
CONCLUSIONS AND RELEVANCE
The results of this survey suggest that patients undergoing medical imaging procedures have overall limited knowledge about medical radiation. Intervention to achieve better patient awareness of radiation risks related to medical exposures may be beneficial.
Topics: Adult; Female; Health Knowledge, Attitudes, Practice; Humans; Italy; Male; Middle Aged; Patients; Perception; Radiation Exposure; Radiation, Ionizing; Surveys and Questionnaires
PubMed: 34643721
DOI: 10.1001/jamanetworkopen.2021.28561 -
Journal of Advanced Nursing Jan 2020To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
AIMS
To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
BACKGROUND
Patient and family engagement is increasingly emerging as a potential approach for improving patient safety.
DESIGN
Mixed method multilevel synthesis.
DATA SOURCES
PubMed, CINAHL, Embase, and Cochrance Library (January 2009-April 2018).
REVIEW METHODS
The review was conducted according to the principles recommended by the Cochrane Handbook for Systematic Review and in accordance with the PRISMA guidelines.
RESULTS
Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified.
CONCLUSION
Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility.
IMPACT
Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively.
Topics: Family; Female; Humans; Male; Patient Safety; Patients
PubMed: 31588602
DOI: 10.1111/jan.14227 -
Physiotherapy Jun 2020Routine imaging for non-specific low back pain is advised against in guidelines yet imaging continues to occur. Patient and public beliefs regarding imaging may be a... (Review)
Review
BACKGROUND OR CONTEXT
Routine imaging for non-specific low back pain is advised against in guidelines yet imaging continues to occur. Patient and public beliefs regarding imaging may be a driving factor contributing to this.
OBJECTIVES
To review the current evidence in relation to patient and public beliefs regarding imaging for low back pain.
DATA SOURCES
A systematic scoping review was conducted in databases Medline, Embase, Cinahl, Psyc info (inception - Jan 2018).
STUDY SELECTION
Any method of study including beliefs of adults about imaging for non-specific low back pain.
DATA EXTRACTION AND DATA SYNTHESIS
Descriptive data was extracted and patient and public beliefs about imaging for low back pain was analysed using conventional qualitative content analysis.
RESULTS
12 studies from an initial search finding of 1135 were analysed. 3 main themes emerged; (1) The Desire for imaging; (2) Influences on patient desire for imaging including (a) clinical presentation, (b) past experience and (c)relationships with care professionals and (3) Negative consequences of imaging.
LIMITATIONS
Few qualitative studies were found, all studies were in English language, the majority of studies were older than 2003.
CONCLUSION AND IMPLICATIONS OF KEY FINDINGS
There is little available evidence on patient and public beliefs about imaging but what evidence there is suggests that imaging is seen as positive in the management of low back pain and patient desire for a diagnosis is a big driver of this. There is also a suggestion that these beliefs may still be being influenced by health care professionals.
Topics: Health Knowledge, Attitudes, Practice; Humans; Low Back Pain; Patients; Public Opinion
PubMed: 32026824
DOI: 10.1016/j.physio.2019.08.014 -
Nursing Research 2020Public and patient involvement in healthcare research is increasing, but the effect of involvement on individuals, service delivery, and health outcomes-particularly in...
BACKGROUND
Public and patient involvement in healthcare research is increasing, but the effect of involvement on individuals, service delivery, and health outcomes-particularly in specialist population groups like critical care-remains unclear, as does the best way to involve people who have experienced critical illness.
OBJECTIVES
The aim of the study was to explore former patients' and family members' views and experiences of involvement in critical care research and/or quality improvement.
METHODS
Using a qualitative methodology, semistructured telephone interviews were conducted with seven former intensive care unit patients and three close family members across England. Data were analyzed using a standard process of inductive thematic analysis.
RESULTS
Four key themes were identified: making it happen, overcoming hurdles, it helps, and respect and value. Findings center on the need for flexibility, inclusivity, and transparency. They further highlight the particular challenges faced by critical illness survivors and their family members in relation to research involvement, the importance of individualized support and training, and the vital role that project leads have in making people feel valued and equal partners in the process.
DISCUSSION
This is the first study to explore patients' experiences of involvement in critical care research. Despite the small, homogenous sample, the study provides valuable and important data to guide future practice. It highlights the need to enable and support people to make informed choices at a time when they are ready to do so. It further highlights the importance of gatekeepers to avoid vulnerable people contributing before they are ready-a practice that could negatively affect their health status.
Topics: Critical Care; Family; Humans; Patients; Program Evaluation; Qualitative Research; Quality Improvement; Research Subjects; Social Support
PubMed: 32496396
DOI: 10.1097/NNR.0000000000000443 -
The Lancet. Digital Health Sep 2021Artificial intelligence (AI) promises to change health care, with some studies showing proof of concept of a provider-level performance in various medical specialties....
Artificial intelligence (AI) promises to change health care, with some studies showing proof of concept of a provider-level performance in various medical specialties. However, there are many barriers to implementing AI, including patient acceptance and understanding of AI. Patients' attitudes toward AI are not well understood. We systematically reviewed the literature on patient and general public attitudes toward clinical AI (either hypothetical or realised), including quantitative, qualitative, and mixed methods original research articles. We searched biomedical and computational databases from Jan 1, 2000, to Sept 28, 2020, and screened 2590 articles, 23 of which met our inclusion criteria. Studies were heterogeneous regarding the study population, study design, and the field and type of AI under study. Six (26%) studies assessed currently available or soon-to-be available AI tools, whereas 17 (74%) assessed hypothetical or broadly defined AI. The quality of the methods of these studies was mixed, with a frequent issue of selection bias. Overall, patients and the general public conveyed positive attitudes toward AI but had many reservations and preferred human supervision. We summarise our findings in six themes: AI concept, AI acceptability, AI relationship with humans, AI development and implementation, AI strengths and benefits, and AI weaknesses and risks. We suggest guidance for future studies, with the goal of supporting the safe, equitable, and patient-centred implementation of clinical AI.
Topics: Artificial Intelligence; Attitude to Computers; Attitude to Health; Humans; Patients; Public Opinion
PubMed: 34446266
DOI: 10.1016/S2589-7500(21)00132-1