Validation of a theory-based instrument measuring patient-reported psychosocial care by physicians using a multiple indicators and multiple causes model

2010 ◽  
Vol 80 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Oliver Ommen ◽  
Markus Wirtz ◽  
Christian Janssen ◽  
Melanie Neumann ◽  
Nicole Ernstmann ◽  
...  
JAMIA Open ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Renwen Zhang ◽  
Eleanor R Burgess ◽  
Madhu C Reddy ◽  
Nan E Rothrock ◽  
Surabhi Bhatt ◽  
...  

Abstract Objective Integrating patient-reported outcomes (PROs) into electronic health records (EHRs) can improve patient-provider communication and delivery of care. However, new system implementation in health-care institutions is often accompanied by a change in clinical workflow and organizational culture. This study examines how well an EHR-integrated PRO system fits clinical workflows and individual needs of different provider groups within 2 clinics. Materials and Methods Northwestern Medicine developed and implemented an EHR-integrated PRO system within the orthopedics and oncology departments. We conducted interviews with 11 providers who had interacted with the system. Through thematic analysis, we synthesized themes regarding provider perspectives on clinical workflow, individual needs, and system features. Results Our findings show that EHR-integrated PROs facilitate targeted conversation with patients and automated triage for psychosocial care. However, physicians, psychosocial providers, and medical assistants faced different challenges in their use of the PRO system. Barriers mainly stemmed from a lack of actionable data, workflow disruption, technical issues, and a lack of incentives. Discussion This study sheds light on the ecosystem around EHR-integrated PRO systems (such as user needs and organizational factors). We present recommendations to address challenges facing PRO implementation, such as optimizing data collection and auto-referral processes, improving data visualizations, designing effective educational materials, and prioritizing the primary user group. Conclusion PRO integration into routine care can be beneficial but also require effective technology design and workflow configuration to reach full potential use. This study provides insights into how patient-generated health data can be better integrated into clinical practice and care delivery processes.


2014 ◽  
Vol 33 (25) ◽  
pp. 4469-4481 ◽  
Author(s):  
Carmen D. Tekwe ◽  
Randy L. Carter ◽  
Harry M. Cullings ◽  
Raymond J. Carroll

2021 ◽  
Author(s):  
Musheer A. Aljaberi ◽  
Naser A. Alareqe ◽  
Mousa A. Qasem ◽  
Abdulsamad Alsalahi ◽  
Sarah Noman ◽  
...  

Abstract Background: Due to the limited research examining the psychological impact of coronavirus disease 2019 (COVID-19), our study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes and assess the differences between participants with and without post-traumatic stress disorder (PTSD) on the psychological outcomes as latent factors and items. Methods: An online survey was conducted on 999 participants. The Impact of Event Scale-Revised (IES-R) assessed the psychological impact, while outcomes were measured by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). A series of Confirmatory Factor Analysis (CFA), structural equation model (SEM), Multiple Indicators and Multiple Causes (MIMIC), and Differential Item Functioning (DIF) were conducted. Results: The IES-R has significant effects on the psychological outcomes. Participants with PTSD have a higher impact on latent factors (depression, anxiety, and insomnia) than those without PTSD. Among participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. For anxiety, 23.7% of respondents experienced moderate to severe anxiety symptoms, and 33.1% had mild symptoms of anxiety. For the ISI, 51.5% of participants experienced symptoms of insomnia. Conclusion: the IES-R for COVID-19 has a significant impact on depression, anxiety, and insomnia at the level of latent constructs and observed variables.


2007 ◽  
Vol 5 (2) ◽  
pp. 119
Author(s):  
L. Ambrosio Flores ◽  
L. Iglesias Martinez ◽  
C. Marin Ferrer ◽  
V. Pascual Gallego ◽  
A. Serrano Bermejo

2020 ◽  
Vol 5 (1) ◽  
pp. 17-32
Author(s):  
Paulo Reis Mourao

AbstractThe multiple indicators multiple causes (MIMIC) framework is used to analyze dimensions related to causation and indicators of tax haven status. Robust results were obtained that identify a country’s tax burden and area as causes of a country adopting policies usually observed in tax havens. The level of social security contributions as a proportion of public revenues and the ratio of indirect to direct taxes were found to be statistically significant indicators of tax havens. Data from 68 countries for more than twenty years were analyzed, enabling the results to contribute to a deepening of the current debate about tax havens and their socio-economic profiles.


2019 ◽  
Vol 19 (2) ◽  
pp. 100-117 ◽  
Author(s):  
Gabrielle Cécile Santos ◽  
Maria Liljeroos ◽  
Andrew A Dwyer ◽  
Cécile Jaques ◽  
Josepha Girard ◽  
...  

Background: Symptom perception in heart failure has been identified as crucial for effective self-care that is a modifiable factor related to decreased hospital readmission and improved survival. Aims: To review systematically the heart failure symptom perception literature and synthesise knowledge on definition, description, factors and instruments. Methods: We conducted a scoping review including studies reporting patient-reported symptom perception in adults with heart failure. Structured searches were conducted in Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, JBI and grey literature. Two authors independently reviewed references for eligibility. Data were charted in tables and results narratively summarised. Results: The search yielded 3057 references, of which 106 were included. The definition of heart failure symptom perception comprised body listening, monitoring signs, recognising, interpreting and labelling symptoms, and furthermore awareness of and assigning meaning to the change. Symptom monitoring, recognition and interpretation were identified as challenging. Symptom perception facilitators include prior heart failure hospitalisation, heart failure self-care maintenance, symptom perception confidence, illness uncertainty and social support. Barriers include knowledge deficits, symptom clusters and lack of tools/materials. Factors with inconsistent impact on symptom perception include age, sex, education, experiences of living with heart failure, comorbidities, cognitive impairment, depression and symptom progression. One instrument measuring all dimensions of heart failure symptom perception was identified. Conclusion: Heart failure symptom perception definition and description have been elucidated. Several factors facilitating or hampering symptom perception are known. Further research is needed to determine a risk profile for poor symptom perception – which can then be taken into consideration when supporting heart failure self-care.


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