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Journal of Perioperative Practice Jun 2009The amount of surgery undertaken on the conscious patient is increasing. However, many patients are anxious and resistant to such surgery. Patients (n = 214) were...
The amount of surgery undertaken on the conscious patient is increasing. However, many patients are anxious and resistant to such surgery. Patients (n = 214) were surveyed to determine their related apprehensions. Being awake, feeling or seeing the body cut open and experiencing pain all increased anxiety. The potential for insufficient information provision was also a source of concern. Formal management of intraoperative apprehension may help limit anxiety and expel apparent misapprehensions.
Topics: Anxiety; Consciousness; Humans; Patients; Surgical Procedures, Operative
PubMed: 19591320
DOI: 10.1177/175045890901900601 -
Clinical Journal of Oncology Nursing Feb 2021Working in an outpatient setting for more than 10 years has presented its set of unique challenges. One of these challenges is how to appropriately staff in a fluid...
Working in an outpatient setting for more than 10 years has presented its set of unique challenges. One of these challenges is how to appropriately staff in a fluid environment. Many questions arise, including the following: Should an acuity system be used? If so, what does that look like? How is a patient's acuity assigned in an adequate time for nursing care? How are enough staff members scheduled to safely care for patients without overstaffing and blowing the budget? How do we maintain patient and nurse satisfaction?
Topics: Humans; Nursing Staff, Hospital; Outpatients; Personnel Staffing and Scheduling
PubMed: 33480872
DOI: 10.1188/21.CJON.104 -
Revista Espanola de Enfermedades... Jun 2023The 21st century has brough us a paradigm shift regarding patients care: the conventional physician-focused model of care has now changed into a patient-centered mode...
Relevance of patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) to assess disease status and quality of care in patients with inflammatory bowel disease.
The 21st century has brough us a paradigm shift regarding patients care: the conventional physician-focused model of care has now changed into a patient-centered mode that puts the patient at the center of his own healthcare. Establishing a non-prescriptive and collaborative therapeutic approach, empowering patients to make major decisions on their management, and strict respect to the patient's autonomy are the major drivers of this patient-centered care. Among other multiple collectives, this change has greatly impacted patients and physicians who deal with inflammatory bowel disease (IBD).
Topics: Humans; Patients; Delivery of Health Care; Patient Reported Outcome Measures; Inflammatory Bowel Diseases
PubMed: 36975153
DOI: 10.17235/reed.2023.9563/2022 -
Nursing & Health Sciences Dec 2022This retrospective, multicenter, descriptive study aimed to evaluate the conditions of inpatients in acute care hospitals using the Severity of a Patient's Condition and...
This retrospective, multicenter, descriptive study aimed to evaluate the conditions of inpatients in acute care hospitals using the Severity of a Patient's Condition and Extent of a Patient's Need for Medical/Nursing Care tool. The study included 4 234 253 patients admitted to acute care hospitals in Japan between April 2019 and March 2020. Electrocardiographic monitoring, provision of respiratory care, and administration of antiarrhythmic agent injections and treatment were performed in a sterile room for >20%, >10%, and <1% of patient-days, respectively. More than 40% of inpatients needed support with performing activities of daily living, such as dressing and undressing, turning over, and oral care. The proportion of patients requiring daily medical/nursing care was generally high at the beginning of hospitalization, gradually decreased, and subsequently increased. Patients in acute care hospitals in Japan were not hospitalized unnecessarily early or for inappropriately long periods, and the efficiency of medical care improved over time. The Severity of a Patient's Condition and Extent of a Patient's Need for Medical/Nursing Care tool is useful for evaluating patient conditions in acute care hospitals.
Topics: Humans; Retrospective Studies; Inpatients; Japan; Activities of Daily Living; Hospitalization
PubMed: 36053988
DOI: 10.1111/nhs.12980 -
AMIA ... Annual Symposium Proceedings.... 2022To address the needs of patient decision aid for refractive eye surgery, we developed a web-based tool, EyeChoose, which provides patient education, assists in selection...
To address the needs of patient decision aid for refractive eye surgery, we developed a web-based tool, EyeChoose, which provides patient education, assists in selection of a specific surgical modality, generates customized recommendations, and links patients to local surgeons, targeting specifically the population of college students. We conducted a focus group interview for needs assessment. We designed a scoring algorithm to provide customized recommendation of surgical modalities based on a patient's medical history and personal preferences. We completed a prototype implementation of the tool. Initial data from a validation study indicated that the system achieved 99.18% accuracy in its recommendation. A study to examine the usefulness and usability of EyeChoose is ongoing. Future research is required to implement the tool in naturalistic settings and to examine the generalizability of the findings to other populations.
Topics: Humans; Focus Groups; Students; Patients; Surgeons; Decision Support Techniques
PubMed: 37128460
DOI: No ID Found -
Social Science & Medicine (1982) Mar 2017Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient...
Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary. A tendency on the part of health professionals to judge patients' decisions to consult as appropriate or not is already described. What is less well explored is the patient's experience of such judgment. Drawing on data from 52 video-elicitation interviews conducted in the English primary care setting, the present paper examines how patients seek to legitimise their decision to consult, and their struggles in doing so. The concern over wasting the doctor's time is expressed repeatedly through patients' narratives. Referring to the sociological literature, the history of 'trivia' in defining the role of general practice is discussed, and current public discourses seeking to assist the patient in developing appropriate consulting behaviour are considered and problematised. Whilst the patient is expected to have sufficient insight to inform timely consulting behaviour, it becomes clear that any attempt on the part of doctor or patient to define legitimate help-seeking is in fact elusive. Despite this, a significant moral dimension to what is deemed appropriate consulting by doctors and patients remains. The notion of candidacy is suggested as a suitable framework and way forward for encompassing these struggles to negotiate eligibility for medical time.
Topics: Adult; Female; Humans; Interviews as Topic; Male; Middle Aged; Patient Acceptance of Health Care; Patients; Physician-Patient Relations; Primary Health Care; Qualitative Research; Surveys and Questionnaires; Time Factors; Video Recording
PubMed: 28135690
DOI: 10.1016/j.socscimed.2017.01.025 -
BMC Psychiatry Dec 2023Technology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients'...
BACKGROUND
Technology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients' perspectives on using passive remote monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders' perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation.
METHODS
Semi-structured interviews were conducted with staff and patients with experience of using Oxehealth technology face-to-face within a private room in Broadmoor Hospital. We applied thematic analysis to the data of each participant group separately. Themes and sub-themes were integrated, finalised, and presented in a thematic map. Design, management, and analysis was meaningfully informed by both staff and patients.
RESULTS
Twenty-four participants were interviewed (n = 12 staff, n = 12 patients). There were seven main themes: detecting deterioration and improving health and safety, "big brother syndrome", privacy and dignity, knowledge and understanding, acceptance, barriers to use and practice issues and future changes needed. Oxehealth technology was considered acceptable to both staff and patients if the technology was used to detect deterioration and improve patient's safety providing patient's privacy was not invaded. However, overall acceptance was lower when knowledge and understanding of the technology and its camera was limited. Most patients could not understand why both physical checks through bedroom windows, and Oxehealth was needed to monitor patients, whilst staff felt Oxehealth should not replace physical checks of patients as reassures staff on patient safety.
CONCLUSIONS
Oxehealth technology is considered viable and acceptable by most staff and patients but there is still some concern about its possible intrusive nature. However, more support and education for new patients and staff to better understand how Oxehealth works in the short- and long-term could be introduced to further improve acceptability. A feasibility study or pilot trial to compare the impact of Oxehealth with and without physical checks may be needed.
Topics: Humans; Hospitals, Psychiatric; Qualitative Research; Inpatients; Patient Safety; Technology
PubMed: 38098066
DOI: 10.1186/s12888-023-05437-w -
Revista Medica de Chile Jul 2020From a patient's point of view, an 'ideal' doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good...
BACKGROUND
From a patient's point of view, an 'ideal' doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good intentions. However, doctors' opinions about what it means to be a 'good' patient have not been systematically investigated.
AIM
To explore how patients define the characteristics of a 'good' and a 'bad' doctor, and how doctors define a 'good' and a 'bad' patient.
MATERIAL AND METHODS
We surveyed a cohort of 107 consecutive patients attending a community teaching hospital in February 2019, who were asked to define the desirable characteristics of a good/bad doctor. Additionally, a cohort of 115 physicians working at the same hospital was asked to define the desirable characteristics of a good/bad patient. Responses were subjected to content analysis. Simultaneously, an algorithm in Python was used to automatically categorize responses throughout text-mining.
RESULTS
The predominant patients' perspective alluded to desirable personal qualities more importantly than proficiency in knowledge and technical skills. Doctors would be satisfied if patients manifested positive personality characteristics, were prone to avoid decisional and personal conflicts, had a high adherence to treatment, and trusted the doctor. The text-mining algorithm was accurate to classify individuals' opinions.
CONCLUSIONS
Ideally, fusing the skills of the scientist to the reflective capabilities of the medical humanist will fulfill the archetype of what patients consider to be a 'good' doctor. Doctors' preferences reveal a "paternalistic" style, and his/her opinions should be managed carefully to avoid stigmatizing certain patients' behaviors.
Topics: Attitude of Health Personnel; Attitude to Health; Chile; Cohort Studies; Hospitals, Community; Hospitals, Teaching; Humans; Patients; Physician-Patient Relations; Physicians; Surveys and Questionnaires
PubMed: 33399677
DOI: 10.4067/S0034-98872020000700930 -
International Journal of Qualitative... Dec 2023To describe the patient's experience of participation in their care when admitted for elective surgical procedures.
PURPOSE
To describe the patient's experience of participation in their care when admitted for elective surgical procedures.
MATERIALS AND METHODS
A purposive sample of 14 patients who had undergone elective surgery was included in semi-structured individual interviews at a university hospital. The data was analysed using qualitative content analysis.
RESULTS
One theme was identified: Creating a meaningful relationship to enable participation in the care, based on three categories; Abilities, willingness, and a lack of experience affect participation, A professional approach with an open communication and individualized information, and The importance of structural factors.
CONCLUSIONS
To meet the patient's individual needs and wishes regarding participation, meaningful relationships need to be created between patient and healthcare personnel. The results also indicate that the patients have insufficient knowledge about their role regarding participation. To improve patient participation, its meaning needs to be clarified individually to the patient, emphasizing the importance to be active involved in his or her own care.
Topics: Male; Female; Humans; Patients; Patient Participation; Hospitalization; Communication; Qualitative Research
PubMed: 36617889
DOI: 10.1080/17482631.2022.2163958 -
Farmacia Hospitalaria : Organo Oficial... 2023The Pharmacotherapeutic follow-up program (PFU) carried out by the clinical pharmacist can be categorized within 3 fundamental activities; identification, resolution and...
OBJECTIVES
The Pharmacotherapeutic follow-up program (PFU) carried out by the clinical pharmacist can be categorized within 3 fundamental activities; identification, resolution and prevention of adverse drug events. These must be adjusted to the requirements and resources of each institution, developing procedures to increase PFU efficiency and to guarantee patient safety. The clinical pharmacists of UC-CHRISTUS Healthcare Network developed a Standardized Pharmacotherapeutic Evaluation Process (SPEP). The main goal of our study is to evaluate the impact of this tool through the pharmacist evaluation number and pharmacist interventions number. Secondarily to determine the potential and direct cost savings associated with the pharmacist interventions in an Intensive care unit (ICU).
METHODS
A quasi-experimental study evaluated the frequency and type of pharmacist evaluation and pharmacist interventions performed by clinical pharmacists in adult patients units of UC-CHRISTUS Healthcare Network, before and after the implementation of SPEP. The distribution of variables was evaluated using the Shapiro-Wilk test and the association between the use of SPEP and the pharmacist evaluation and pharmacist interventions number was performed using the Chi-square test. The cost evaluation associated with pharmacist interventions in the ICU was carried out using methodology proposed by Hammond et al. RESULTS: A total number of 1,781 patients was evaluated before and 2,129 after the SPEP. The pharmacist evaluation and pharmacist interventions number in the before-SPEP period were 5,209 and 2,246. In the after-SPEP period were 6,105 and 2,641, respectively. The increase in both the pharmacist evaluation and pharmacist interventions number was significant only in critical care patients. The potential cost saving in after-SPEP period in the ICU was USD 492,805. Major adverse drug events prevention was the intervention that generated the most savings with a reduction of 60.2%. The total direct savings for sequential therapy was USD 8,072 in the study period.
CONCLUSIONS
This study shows a clinical pharmacist developed tool called SPEP that increased the pharmacist evaluation and pharmacist interventions number in multiple clinical scenarios. These were significant only in critical care patients. Future investigations should make effort to evaluate the quality and clinical impact of these interventions.
Topics: Adult; Humans; Inpatients; Outpatients; Pharmacists; Patient Safety; Drug-Related Side Effects and Adverse Reactions; Pharmacy Service, Hospital
PubMed: 37198085
DOI: 10.1016/j.farma.2023.04.004