Individualised care or anaesthetist preference: an uncomfortable question

2021 ◽  
Author(s):  
Iain Moppett
Keyword(s):  
Individualised Care

scholarly journals Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

2021 ◽  
pp. 026921632110198
Author(s):  
Catriona R Mayland ◽  
Rosemary Hughes ◽  
Steven Lane ◽  
Tamsin McGlinchey ◽  
Warren Donnellan ◽  
...  
Keyword(s):  
Public Health ◽  
Family Support ◽  
Online Survey ◽  
Free Text ◽  
Professional Networks ◽  
Dying Patients ◽  
The Face ◽  
Individualised Care ◽  
The Impact ◽  
Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

Individualised care in Flemish and Dutch hospitals: Comparing patients’ and nurses’ perceptions

2021 ◽  
Author(s):  
Sofie Theys ◽  
Elise Belle ◽  
Maud Heinen ◽  
Simon Malfait ◽  
Kristof Eeckloo ◽  
...  
Keyword(s):  
Individualised Care ◽  
Nurses Perceptions

scholarly journals Measuring Quality of Service in a Robotized Comprehensive Geriatric Assessment Scenario

2020 ◽  
Vol 10 (18) ◽  
pp. 6618
Author(s):  
Adrián Romero-Garcés ◽  
Jesús Martínez-Cruz ◽  
Juan F. Inglés-Romero ◽  
Cristina Vicente-Chicote ◽  
Rebeca Marfil ◽  
...  
Keyword(s):  
Quality Of Service ◽  
Functional Properties ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
User Preferences ◽  
Care Plans ◽  
Whole Process ◽  
Frail Elderly People ◽  
Individualised Care

Comprehensive Geriatric Assessment (CGA) is an integrated clinical process to evaluate frail elderly people in order to create therapy plans that improve their quality and quantity of life. The whole process includes the completion of standardized questionnaires or specific movements, which are performed by the patient and do not necessarily require the presence of a medical expert. With the aim of automatizing these parts of the CGA, we have designed and developed CLARC (smart CLinic Assistant Robot for CGA), a mobile robot able to help the physician to capture and manage data during the CGA procedures, mainly by autonomously conducting a set of predefined evaluation tests. Using CLARC to conduct geriatric tests will reduce the time medical professionals have to spend on purely mechanical tasks, giving them more time to develop individualised care plans for their patients. In fact, ideally, CLARC will perform these tests on its own. In parallel with the effort to correctly address the functional aspects, i.e., the development of the robot tasks, the design of CLARC must also deal with non-functional properties such as the degree of interaction or the performance. We argue that satisfying user preferences can be a good way to improve the acceptance of the robot by the patients. This paper describes the integration into the software architecture of the CLARC robot of the modules that allow these properties to be monitored at run-time, providing information on the quality of its service. Experimental evaluation illustrates that the defined quality of service metrics correctly capture the evolution of the aspects of the robot’s activity and its interaction with the patient covered by the non-functional properties that have been considered.

scholarly journals Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities

2018 ◽  
Vol 3 (5) ◽  
pp. e001018 ◽  
Author(s):  
Ramnath Subbaraman ◽  
Laura de Mondesert ◽  
Angella Musiimenta ◽  
Madhukar Pai ◽  
Kenneth H Mayer ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Healthcare Providers ◽  
Research Priorities ◽  
Directly Observed Therapy ◽  
Loss To Follow Up ◽  
Individualised Care ◽  
Health System Efficiency ◽  
Tuberculosis Therapy

Poor medication adherence may increase rates of loss to follow-up, disease relapse and drug resistance for individuals with active tuberculosis (TB). While TB programmes have historically used directly observed therapy (DOT) to address adherence, concerns have been raised about the patient burden, ethical limitations, effectiveness in improving treatment outcomes and long-term feasibility of DOT for health systems. Digital adherence technologies (DATs)—which include feature phone–based and smartphone-based technologies, digital pillboxes and ingestible sensors—may facilitate more patient-centric approaches for monitoring adherence, though available data are limited. Depending on the specific technology, DATs may help to remind patients to take their medications, facilitate digital observation of pill-taking, compile dosing histories and triage patients based on their level of adherence, which can facilitate provision of individualised care by TB programmes to patients with varied levels of risk. Research is needed to understand whether DATs are acceptable to patients and healthcare providers, accurate for measuring adherence, effective in improving treatment outcomes and impactful in improving health system efficiency. In this article, we describe the landscape of DATs that are being used in research or clinical practice by TB programmes and highlight priorities for research.

scholarly journals Considerations in Management for Trans and Gender Diverse Patients with Inherited Cancer Risk

2021 ◽  
Author(s):  
Beth Coad ◽  
Josephine Giblin ◽  
Reubs J. Walsh ◽  
Oliwia Kuczkowska ◽  
Alexander M. von Vaupel-Klein ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Best Practice ◽  
Cancer Genetics ◽  
National Guidelines ◽  
Inherited Cancer ◽  
Gender Diverse ◽  
Individualised Care ◽  
And Gender ◽  
The Impact ◽  
Risk Reducing

Abstract Purpose of Review To best support all patients with inherited cancer risk, we must broaden our scope of practice to consider the needs of the transgender and gender diverse (trans) community. We considered best practice for supporting trans patients including tailored risk assessments and management recommendations. Recent Findings There is limited literature considering trans patient care in cancer genetics. Small case studies have highlighted how medical transition and cancer risk–reducing options intersect with the need for individualised care. Studies have also shown that cancer genetics professionals do not feel prepared to support trans patients. Summary Patient-centred care for trans patients relies on a multidisciplinary team (MDT) engaged in shared decision-making. National guidelines are needed to standardise access to appropriate discussions around risk-reducing options and screening. International collaborative research is required to provide empiric data on the impact of gender-affirming treatments on cancer risk, and more experiential data is needed from trans patients accessing cancer genetics services. Finally, education and training in this area should be formally embedded for all cancer genetics professionals.

scholarly journals THE DEVELOPMENT OF THREE INDIVIDUALISED CARE PLANS TO GUIDE NURSING STAFF WHEN CARING FOR PATIENTS IN THE LAST MONTHS OF LIFE

2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A102.1-A102
Author(s):  
Elizabeth Rees ◽  
Amanda Henderson ◽  
Chris Stothard ◽  
Kathryn Gibson
Keyword(s):  
Nursing Staff ◽  
Care Plans ◽  
Individualised Care

The role of single pill combination therapy in the prevention of ischaemic stroke

2019 ◽  
Vol 64 (4) ◽  
pp. 126-132
Author(s):  
Wan Y Ho ◽  
Azmil H Abdul-Rahim ◽  
Jesse Dawson ◽  
Alan C Cameron
Keyword(s):  
Combination Therapy ◽  
Clinical Outcomes ◽  
Stroke Prevention ◽  
Healthcare Professionals ◽  
Evidence Base ◽  
Stroke Survivors ◽  
Perceived Benefit ◽  
Single Pill ◽  
Individualised Care

Background and aims The role of single pill combination therapy for stroke prevention remains to be established. We explored the perspectives of stroke survivors and healthcare professionals on single pill combination therapy for stroke prevention. Methods We conducted focus groups involving stroke survivors and healthcare professionals. Results We recruited six stroke survivors: four (67%) were female and mean age was 70 ± 12 years; and eight healthcare professionals (three Stroke Consultants, two Nurse Specialists, three General Practitioners). Improved adherence is the main perceived benefit of single pill combination therapy, although concerns exist surrounding less individualised care, unsuitability for use in the acute setting, reduced ability to titrate doses and difficulty identifying the cause of side effects. The clinical stability of patients, alongside single pill combination therapy efficacy, cost, side effect profile and evidence base for impact on risk factors and clinical outcomes are key factors influencing acceptability. Stroke survivors and healthcare professionals feel single pill combination therapy is most suitable for stable patients, although there is no evidence base for its use in this context. Conclusion Stroke healthcare professionals and stroke survivors are most amenable to using single pill combination therapy for stable patients, although its role in this context should be evaluated in studies with risk factor targets and clinical outcomes as endpoints.

scholarly journals Enabling individualised health in learning healthcare systems

2019 ◽  
Vol 25 (4) ◽  
pp. 125-129
Author(s):  
Shannon Wongvibulsin ◽  
Scott L. Zeger
Keyword(s):  
Healthcare Systems ◽  
Data Driven ◽  
Successful Implementation ◽  
Learning Approach ◽  
Evidence Based ◽  
Continuous Learning ◽  
Improved Outcomes ◽  
Effective Delivery ◽  
Individualised Care ◽  
Based Medicine

The rising burden of healthcare costs suggests that the healthcare system could benefit from novel methods that allow for continuous learning to provide more data-driven, individualised care at lower costs and with improved outcomes. Here, we present our synergistic Learning approach for Prediction, Interpretation/Inference and Communication (Learning PIC) framework to address the challenges hindering the successful implementation of learning healthcare systems and to enable the effective delivery of evidence-based medicine.

scholarly journals Patients’ perspectives on how to improve diabetes care and self-management: qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e032762
Author(s):  
Ruth Ndjaboue ◽  
Selma Chipenda Dansokho ◽  
Bianca Boudreault ◽  
Marie-Claude Tremblay ◽  
Maman Joyce Dogba ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Health Professionals ◽  
Research Network ◽  
Self Management ◽  
Framework Analysis ◽  
Convenience Sample ◽  
Individualised Care ◽  
The Impact ◽  
Expert Patients ◽  
Improve Diabetes Care

ObjectivePeople living with diabetes need and deserve high-quality, individualised care. However, providing such care remains a challenge in many countries, including Canada. Patients’ expertise, if acknowledged and adequately translated, could help foster patient-centred care. This study aimed to describe Expert Patients’ knowledge, wisdom and advice to others with diabetes and to health professionals to improve diabetes self-management and care.Design and methodsWe recruited a convenience sample of 21 men and women. Participants were people of diverse backgrounds who are Patient Partners in a national research network (hereafter Expert Patients). We interviewed and video-recorded their knowledge, wisdom and advice for health professionals and for others with diabetes. Three researchers independently analysed videos using inductive framework analysis, identifying themes through discussion and consensus. Expert Patients were involved in all aspects of study design, conduct, analysis and knowledge translation.ResultsAcknowledging and accepting the reality of diabetes, receiving support from family and care teams and not letting diabetes control one’s life are essential to live well with diabetes. To improve diabetes care, health professionals should understand and acknowledge the impact of diabetes on patients and their families, and communicate with patients openly, respectfully, with empathy and cultural competency.ConclusionExpert Patients pointed to a number of areas of improvement in diabetes care that may be actionable individually by patients or health professionals, and also collectively through intergroup collaboration. Improving the quality of care in diabetes is crucial for improving health outcomes for people with diabetes.

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