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BMC Medical Education Mar 2023Despite patient safety initiatives, medical errors remain common and devastating. Disclosing errors is not only ethical, but also promotes restoration of the...
PURPOSE
Despite patient safety initiatives, medical errors remain common and devastating. Disclosing errors is not only ethical, but also promotes restoration of the doctor-patient relationship. However, studies show active avoidance of error disclosure and the need for explicit training. In the South African setting, sparse information exists in terms of undergraduate medical training in error disclosure. To address this knowledge gap, the training of error disclosure in an undergraduate medical programme was examined, against the background of the available literature. The objective was to formulate a strategy to improve error disclosure teaching and practice, with the goal of improving patient care.
METHODS
Firstly, the literature was reviewed regarding the training of medical error disclosure. Secondly, the undergraduate medical training in error disclosure was probed, by looking at the pertinent findings from a broader study on undergraduate communication skills training. The design of the study was descriptive and cross-sectional. Anonymous questionnaires were distributed to all fourth- and fifth-year undergraduate medical students. Data were predominantly analysed quantitatively. Open-ended questions were analysed qualitatively using grounded theory coding.
RESULTS
Out of 132 fifth-year medical students, 106 participated (response rate 80.3%), while 65 out of 120 fourth-year students participated (response rate 54.2%). Of these participants, 48 fourth-year students (73.9%) and 64 fifth-year students (60.4%) reported infrequent teaching in the disclosure of medical errors. Almost half of the fourth-year students (49.2%) considered themselves novices in error disclosure, while 53.3% of fifth-year students rated their ability as average. According to 37/63 (58.7%) fourth-year students and 51/100 (51.0%) fifth-year students, senior doctors seldom or never modelled patient-centred care in the clinical training setting. These results resonated with the findings of other studies that showed lack of patient-centredness, as well as insufficient training in error disclosure, with resultant low confidence in this skill.
CONCLUSION
The study findings confirmed a dire need for more frequent experiential training in the disclosure of medical errors, in undergraduate medical education. Medical educators should view errors as learning opportunities to improve patient care and model error disclosure in the clinical learning environment.
Topics: Humans; Physician-Patient Relations; Cross-Sectional Studies; Students, Medical; Truth Disclosure; Medical Errors
PubMed: 36978065
DOI: 10.1186/s12909-023-04125-3 -
PloS One 2021This paper empirically examines whether there is an association between financial reporting disclosure quality and sustainability disclosure quality of the top 100...
This paper empirically examines whether there is an association between financial reporting disclosure quality and sustainability disclosure quality of the top 100 socially reputed Chinese listed firms. The paper computed financial disclosure quality by empirically combining earning qualities of accrual, persistence, predictability, and smoothness. Using content analysis and survey questionnaire research methods, it calculated sustainability quality by combining disclosure quantity (through quantitative weightings), disclosure type (through qualitative weightings), and disclosure item importance (through qualitative weightings) of economic, social, and environmental disclosures made in annual and sustainability reports, ascertained using the Global Reporting Initiative sustainability framework. The study finds that sustainability disclosure in the current period is sufficiently associated with financial disclosure quality of the current period and future period. Consistent with stakeholder theory, firms with a social reputation are perceived as trustworthy by stakeholders and shareholders. The findings lead to a cultural stakeholder theory where underlying values of societal culture create a condition supporting mutual stakeholder relationships between firm and various stakeholders. Demonstrating trustworthiness through disclosures can help boost consumer confidence and foreign trade relations for Chinese firms. The Chinese government can design innovative schemes to reward and promote trustworthiness in firms, such as regulating base-point reductions in interest rates on borrowing or raising funds.
Topics: China; Disclosure; Environmental Policy; Government; Humans; Income; Industry; Sustainable Development
PubMed: 34048431
DOI: 10.1371/journal.pone.0250884 -
European Journal of Oral Sciences Feb 2023We assessed adherence to five transparency practices-data sharing, code sharing, conflict of interest disclosure, funding disclosure, and protocol registration-in...
We assessed adherence to five transparency practices-data sharing, code sharing, conflict of interest disclosure, funding disclosure, and protocol registration-in articles in dental journals. We searched and exported the full text of all research articles from PubMed-indexed dental journals available in the Europe PubMed Central database until the end of 2021. We programmatically assessed their adherence to the five transparency practices using a validated and automated tool. Journal- and article-related information was retrieved from ScimagoJR and Journal Citation Reports. Of all 329,784 articles published in PubMed-indexed dental journals, 10,659 (3.2%) were available to download. Of those, 77% included a conflict of interest disclosure, and 62% included a funding disclosure. Seven percent of the articles had a registered protocol. Data sharing (2.0%) and code sharing (0.1%) were rarer. Sixteen percent of articles did not adhere to any of the five transparency practices, 29% adhered to one, 48% adhered to two, 7.0% adhered to three, 0.3% adhered to four, and no article adhered to all five practices. Adherence to transparency practices increased over time; however, data and code sharing especially remained rare. Coordinated efforts involving all stakeholders are needed to change current transparency practices in dental research.
Topics: Dental Research; Disclosure; Europe
PubMed: 36482006
DOI: 10.1111/eos.12908 -
Developmental Psychology Apr 2021Disclosing a sexual minority (e.g., lesbian, gay, or bisexual) identity to others is an ongoing process throughout life. Research shows that disclosure is stressful, and...
Disclosing a sexual minority (e.g., lesbian, gay, or bisexual) identity to others is an ongoing process throughout life. Research shows that disclosure is stressful, and this stress is related to poorer mental health for sexual minority youth. However, there are few theoretically grounded studies examining disclosure stress and its prospective association with mental health. The current study utilizes two conceptualizations of sexual identity development-stage models and milestone models-to contextualize how changes in disclosure-related stress are associated with depression symptoms from adolescence into young adulthood. Data come from a sample of lesbian, gay, and bisexual youth between ages 15-24 surveyed over three years (N=555; 82% youth of color; 40% bisexual; 63% free and reduced lunch; and 49% assigned female at birth). We estimated (1) parallel process models and (2) growth curve models with disclosure stress as a time-varying covariate, which were respectively informed by stage and milestone conceptualizations of sexual identity development. Results indicated that depression symptoms declined while disclosure stress increased. In the parallel process model, higher baseline disclosure stress correlated with higher baseline levels and steeper declines in depression symptoms. When disclosure stress was modeled as a time-varying covariate, it was most strongly associated with higher depression symptoms at earlier ages. Disclosure is a developmental process that confers differential risk for depression symptoms earlier in the life course, which can hinder the typical decline of depression symptoms in young adulthood. Supporting sexual minority youth when they disclose their sexual identity throughout adolescence can have long-term benefits for mental health.
Topics: Adolescent; Adult; Bisexuality; Depression; Disclosure; Female; Homosexuality, Female; Humans; Sexual and Gender Minorities; Young Adult
PubMed: 34711995
DOI: 10.1037/dev0001168 -
JAMA Network Open Apr 2022
Topics: Communication; Disclosure; Humans
PubMed: 35385094
DOI: 10.1001/jamanetworkopen.2022.9747 -
PloS One 2023We aimed to assess the adherence to five transparency practices (data availability, code availability, protocol registration and conflicts of interest (COI), and funding...
BACKGROUND
We aimed to assess the adherence to five transparency practices (data availability, code availability, protocol registration and conflicts of interest (COI), and funding disclosures) from open access Coronavirus disease 2019 (COVID-19) related articles.
METHODS
We searched and exported all open access COVID-19-related articles from PubMed-indexed journals in the Europe PubMed Central database published from January 2020 to June 9, 2022. With a validated and automated tool, we detected transparent practices of three paper types: research articles, randomized controlled trials (RCTs), and reviews. Basic journal- and article-related information were retrieved from the database. We used R for the descriptive analyses.
RESULTS
The total number of articles was 258,678, of which we were able to retrieve full texts of 186,157 (72%) articles from the database Over half of the papers (55.7%, n = 103,732) were research articles, 10.9% (n = 20,229) were review articles, and less than one percent (n = 1,202) were RCTs. Approximately nine-tenths of articles (in all three paper types) had a statement to disclose COI. Funding disclosure (83.9%, confidence interval (CI): 81.7-85.8 95%) and protocol registration (53.5%, 95% CI: 50.7-56.3) were more frequent in RCTs than in reviews or research articles. Reviews shared data (2.5%, 95% CI: 2.3-2.8) and code (0.4%, 95% CI: 0.4-0.5) less frequently than RCTs or research articles. Articles published in 2022 had the highest adherence to all five transparency practices. Most of the reviews (62%) and research articles (58%) adhered to two transparency practices, whereas almost half of the RCTs (47%) adhered to three practices. There were journal- and publisher-related differences in all five practices, and articles that did not adhere to transparency practices were more likely published in lowest impact journals and were less likely cited.
CONCLUSION
While most articles were freely available and had a COI disclosure, adherence to other transparent practices was far from acceptable. A much stronger commitment to open science practices, particularly to protocol registration, data and code sharing, is needed from all stakeholders.
Topics: Humans; COVID-19; Publications; Conflict of Interest; Disclosure; Europe
PubMed: 37494359
DOI: 10.1371/journal.pone.0288406 -
Annals of Plastic Surgery Apr 2023Little information is available regarding how to review a plastic surgery manuscript. This vital responsibility ensures that publications meet an acceptable scientific... (Observational Study)
Observational Study
Little information is available regarding how to review a plastic surgery manuscript. This vital responsibility ensures that publications meet an acceptable scientific standard. Thoughtful and thorough reviews are essential to protect patients and surgeons from unscientific practices and products. This discussion provides information for the reviewer, gained from the author's experience, including examples of a thorough review, likely to be useful to the editor, and a cursory one that is unhelpful.The first consideration is relevance. Prerequisites for publication include institutional review board approval, disclosure of financial conflicts, and discussion of the regulatory status of devices. Particular attention is needed to check for conflicts of interest, which are endemic in plastic surgery today. In view of the common practice of using computer-generated imaging, reviewers need to be especially vigilant for inauthentic "photoshopped" photographs. Examples of published images that have been digitally altered are provided.If data are available, it may be possible to check the statistical tests. Reviewers need to be aware of the practice of p-hacking. A quick literature search can identify relevant but unreferenced publications. The manuscript needs to be properly organized into sections. Minor points may be made regarding style. The study design and methodology need to be evaluated to be sure that the conclusions are well supported by data. Randomized studies are rarely feasible. Fortunately, well-done prospective observational studies in consecutive patients can be just as useful. Realistic complication rates are expected. Meta-analyses in plastic surgery are often subject to confounding variables. Comments should be available to the authors; confidential comments hidden from authors are discouraged. Like honesty, transparency is the best policy. Manuscripts should be evaluated solely for merit, not the identity of the author or institution. Timeliness of submission of the review is appreciated by authors.Evidence-based medicine is concerned solely with the facts. The 2 basic criteria are a solid scientific basis and reliable evidence of efficacy. Reviewers need to keep an open mind. Studies that challenge the status quo are often the most valuable ones and are needed for the advancement of the specialty.
Topics: Humans; Surgery, Plastic; Peer Review; Plastic Surgery Procedures; Disclosure; Research Design
PubMed: 37093767
DOI: 10.1097/SAP.0000000000003502 -
Frontiers in Public Health 2023
Topics: Humans; Disclosure; HIV Infections
PubMed: 38264248
DOI: 10.3389/fpubh.2023.1357915 -
Health & Social Care in the Community May 2021Domestic violence victims are in frequent contact with the healthcare service yet rarely disclose. Therefore, it is critical to understand victims' experiences and... (Review)
Review
Domestic violence victims are in frequent contact with the healthcare service yet rarely disclose. Therefore, it is critical to understand victims' experiences and perceptions regarding disclosure in healthcare settings. The goal of this review is to provide an updated synthesis of qualitative research identifying barriers and facilitators, advice, and positive and negative outcomes of adult victims' disclosure of domestic violence to healthcare professionals (HCPs). A systematic search of PsychINFO, CINAHL and Web of Science was conducted in January 2018. Thirty-four eligible studies were identified, including 783 domestic violence victims (781 females). Formal quality assessment indicated variable study quality. Barriers of disclosure included negative HCPs attitudes, victims' perceptions of safety and concerns about the consequences of disclosing. Facilitators of disclosing included a positive relationship with the HCP, HCPs directly asking victims about abuse, and HCPs ensuring that the environment is safe and disclosure is confidential. Victims advised increased awareness of HCPs reactions to disclosure and avoiding mirroring their perpetrators minimization. HCPs were encouraged to engage in direct questioning and maintain a supportive and secure environment. Positive and negative outcomes of abuse were identified, such as being able to leave the abuser or, on the other hand, the victims' situation not changing. Our results indicate that barriers for disclosure of domestic violence in healthcare settings persist despite the widespread implementation of policies and guidelines to counter them. Based on these findings, we provide recommendations for clinical practice and future research to help improve disclosure in healthcare settings.
Topics: Adult; Attitude of Health Personnel; Disclosure; Domestic Violence; Female; Humans; Motivation; Qualitative Research
PubMed: 33440034
DOI: 10.1111/hsc.13282 -
Palliative Medicine Jul 2021Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in... (Review)
Review
BACKGROUND
Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics.
AIM
To derive a greater understanding of the characteristics of potentially effective emotional disclosure-based interventions in palliative care by:(1) Developing a taxonomy of emotional disclosure-based interventions tested in people with advanced disease and(2) Mapping and linking objectives, outcomes, underlying mechanisms, and implementation factors.
DESIGN
A scoping review drawing on Intervention Component Analysis to combine evidence from studies' methods, results, and discussion sections.
DATA SOURCES
Six databases were searched to May 2020 including CINAHL, PsycINFO, and MEDLINE. Studies of emotional disclosure in adults with advanced disease were included. Study quality was appraised using an established tool.
RESULTS
Seven thousand seven hundred ninety-two unique records were screened, of which 25 primary studies were included. Intervention characteristics were grouped into classes within three domains: topic of disclosure, format, and dose. Evidence was not available to determine which, if any, of the characteristics is most effective. Thematic synthesis of evidence from methods and discussion sections identified factors to consider in tailoring an emotional disclosure-based intervention to this setting, including: population characteristics (e.g. time since diagnosis), providing a safe environment, and flexibility in format.
CONCLUSIONS
This review approach facilitated a clearer understanding of factors that may be key in developing emotional disclosure-based interventions for palliative populations. Intervention Component Analysis has potential for application elsewhere to help develop evidence-based interventions.
Topics: Adult; Delivery of Health Care; Disclosure; Emotions; Hospice and Palliative Care Nursing; Humans; Palliative Care
PubMed: 34053341
DOI: 10.1177/02692163211013248