Perceived Barriers to the De-implementation of Routine Preoperative History & Physicals Preceding Low-risk Ambulatory Procedures: A Qualitative Study of Surgeon Perspectives

2022 ◽  
Vol 270 ◽  
pp. 359-368
Author(s):  
Alison S. Baskin ◽  
Alexandra I. Mansour ◽  
Abed Rahman Kawakibi ◽  
Porag Jeet Das ◽  
Anthony E. Rios ◽  
...  
2021 ◽  
Vol 3 (1) ◽  
pp. e000068
Author(s):  
Sonia Hur ◽  
Michael Tzeng ◽  
Eliza Cricco-Lizza ◽  
Spyridon Basourakos ◽  
Miko Yu ◽  
...  

ObjectivesPartial gland ablation (PGA) therapy is an emerging treatment modality that targets specific areas of biopsy-proven prostate cancer (PCa) to minimize treatment-related morbidity by sparing benign prostate. This qualitative study aims to explore and characterize perceptions and attitudes toward PGA in men with very-low-risk, low-risk, and favorable intermediate-risk PCa on active surveillance (AS).Design92 men diagnosed with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS were invited to participate in semistructured telephone interviews on PGA.SettingSingle tertiary care center located in New York City.Participants20 men with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS participated in the interviews.Main outcome measuresEmerging themes on perceptions and attitudes toward PGA were developed from transcripts inductively coded and analyzed under standardized methodology.ResultsFour themes were derived from 20 interviews that represent the primary considerations in treatment decision-making: (1) the feeling of psychological safety associated with low-risk disease; (2) preference for minimally invasive treatments; (3) the central role of the physician; (4) and the pursuit of treatment options that align with disease severity. Eleven men (55%) expressed interest in pursuing PGA only if their cancer were to progress, while nine men (45%) expressed interest at the current moment.ConclusionsAlthough an emerging treatment modality, patients were broadly accepting of PGA for PCa, with men primarily debating the risks versus benefits of proactively treating low-risk disease. Additional research on men’s preferences and attitudes toward PGA will further guide counseling and shared decision-making for PGA.


2013 ◽  
Vol 10 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Stasi Lubansky ◽  
Corrine Y. Jurgens ◽  
Carla Boutin-Foster

Introduction: Physicians in training must be able to counsel their patients on smoking cessation, however, little is known about the barriers that they face to counselling their patients.Aims: The study sought to identify barriers to smoking cessation counselling specific to physicians in training.Methods: Qualitative interviews in the form of focus groups were conducted with 30 medical residents. Focus groups were audio taped, transcribed verbatim and coded by two independent reviewers. Similar codes were grouped to form categories and then aggregated to form themes.Results: Seven themes emerged describing resident barriers to provision of smoking cessation counselling : (1) Lack of self-efficacy for providing counselling; (2) their perception that patients are not willing to change; (3) a lack of available resources/information for providers and patients; (4) differences in supervising physician's recommendations; (5) perceived lack of time; (6) a perception of lack of continuous care; and (7) a lack of practical skills in counselling.Conclusions: This study highlighted residents’ perceived barriers to providing smoking cessation counselling. These barriers are similar to those encountered by other providers. Additional barriers specific to residency exist and more training is necessary.Practice Implications: The barriers that physicians encounter to smoking cessation counselling must be addressed early on in residency training.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Indira S. E. van der Zande ◽  
Rieke van der Graaf ◽  
Martijn A. Oudijk ◽  
Elsbeth H. van Vliet-Lachotzki ◽  
Johannes J. M. van Delden

2020 ◽  
Vol 23 ◽  
pp. 100464
Author(s):  
Cecilie Skaarup Uldbjerg ◽  
Stine Schramm ◽  
Felix Ocaka Kaducu ◽  
Emilio Ovuga ◽  
Morten Sodemann

2019 ◽  
Vol 6 ◽  
pp. 233339281986701
Author(s):  
Rebekah Lemmons ◽  
Steve Zanskas

Objectives: The purpose of this qualitative inquiry was to understand the barriers related to effective self-care for master’s level residential counselors. Methods: Archival interview transcripts of 77 residential counselors were analyzed utilizing a social constructivist lens to identify perceived barriers to effective self-care. Themes related to levels of self-care influences including individual, supervisory, and organizational barriers to effective self-care emerged. Results: Results reflected those themes specifically by indicating that counselors can take steps to actively engage in wellness pursuits to promote self-care. Similarly, supervisors and organizations can enhance or impede a counselor’s ability to engage in self-care. Conclusions: Counselors should select work settings that have both supervisory and organizational supports for self-care. This includes encouraging a culture of wellness through support, development, coverage for time off, and other related areas. Implications show that practices and policies are needed to promote effective self-care across individual, supervisory, and agency domains.


2019 ◽  
Vol 34 (7) ◽  
pp. 1228-1235 ◽  
Author(s):  
Raquel C. Greer ◽  
◽  
Yang Liu ◽  
Kerri Cavanaugh ◽  
Clarissa Jonas Diamantidis ◽  
...  

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