scholarly journals Exploring what patients with musculoskeletal conditions want from first point-of-contact health practitioners

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Jo Erwin ◽  
Kenneth Chance-Larsen ◽  
Michael Backhouse ◽  
Anthony D Woolf
Keyword(s):  
Focus Groups ◽  
Patient Perspective ◽  
Complementary Therapies ◽  
Health Practitioner ◽  
Shared Decision ◽  
Good Communication ◽  
Health Practitioners ◽  
Core Capabilities ◽  
First Contact ◽  
National Framework

Abstract Objectives This research was conducted to support the development of the Musculoskeletal (MSK) Health Capabilities Framework to ensure that the framework reflected patients’ priorities. The aim of this study was to explore what patients with MSK problems want from their initial consultation with a first contact health practitioner and, from the patient perspective, what characterizes a good first contact health practitioner. Methods Focus groups were held in four locations across England. Sixteen participants, aged 19–75 years and with a self-declared MSK condition, took part (11 female, five male). Participants discussed the questions they want answered when first going to see a health professional about an MSK problem and how they would describe a good first contact health provider. Results Participants wanted answers to questions about the nature of the problem, the management of the problem, where to get information and support to help themselves, what activities they can do and what the future holds. Values and behaviours they expect and value from first contact health practitioners include good communication skills, appreciation of impact, a willingness to discuss alternative and complementary therapies, shared decision-making and an awareness of their own limitations and when to refer. Conclusion The MSK core capabilities framework for first contact health practitioners aims to ensure a person-centred approach in the first stages of managing any MSK problem with which a person may present. The focus groups enabled the developers of the framework to achieve a greater understanding of patient priorities, expectations and needs and allowed the patient perspective to be included in this national framework.

scholarly journals Alea Ke Pau or Negotiated Evaluation: A Vital Concept in Pacific Health Promotion

2021 ◽  
Vol 8 (9) ◽  
pp. 200-206
Author(s):  
Malakai Ofanoa ◽  
Samuela Ofanoa ◽  
Stephen Buetow
Keyword(s):  
Health Promotion ◽  
Community Development ◽  
Focus Groups ◽  
Cultural Values ◽  
Power Relationships ◽  
Evaluation Approach ◽  
Health Funding ◽  
Funding Agencies ◽  
Health Practitioners ◽  
Pacific Health

For Pacific peoples, health promotion, community nursing and community development initiative over many years, has often been conducted within a framework of one-sided decision-making. There is always an imbalance between the power relationships of the community being studied and those of the researchers or health practitioners. As a result, there is lack of understanding on the part of the researchers and the health funding agencies of the need to negotiate processes with members of the community being studied or engaging with. All of this are within an overarching lack of understanding of, and respect for, Pacific cultural values, frameworks and Pacific ways of doing things. This paper seeks to explore an alternative concept whereby these values are acknowledged. This concept is metaphorically called “alea ke pau” (or, negotiated evaluation). This approach is forward-looking and one that respects a ‘bottom-up’ view rather than the traditional ‘top-down’ view of health work and funding agencies. However, using two Pacific research methodologies called Talanga and Kakala, to explore the concept of alea ke pau were held with five men’s focus groups operating within Kava Clubs in Auckland, New Zealand, and five focus groups in Tonga. The results from these discussions are presented demonstrating the development and application of the “alea ke pau” or “negotiated evaluation” approach. 

Communication skills and tips for Part 3 MRCOG Examination

2017 ◽  
Keyword(s):  
Decision Making ◽  
Communication Skills ◽  
Clinical Assessment ◽  
Clinical Skills ◽  
Real Life ◽  
Information Gathering ◽  
Shared Decision ◽  
Good Communication ◽  
Information Giving ◽  
Treatment Information

Good communication skills form a fundamental principle of the patient- centred clinical consultation. The new Part 3 of the MRCOG, assesses candidates based on their ability to apply the core clinical skills in the context of real- life scenarios. It assesses five core skills domains, with three relating to communication skills; i) Communicating with patients and their families, ii) Communicating with colleagues and iii) Information gathering. Communication skills in the Part 3 clinical assessment can be assessed in many forms: … ● Exploring patient symptoms or concerns (information gathering) ● Explaining a diagnosis, investigation or treatment (information giving) ● Involving the patient in a decision (shared decision making) ● Health promoting activities ● Obtaining informed consent for a procedure ● Breaking bad news ● Communicating with relatives ● Communicating with other members of the health care team … In order to provide patient- centred care, doctors must treat their patients as partners, involving them in the decision making regarding their care and instilling in them a sense of responsibility for their own health. When the patient feels that they are part of the team it increases their satisfaction with care, increases treatment adherence and improves clinical outcomes. It is these skills that are assessed in clinical assessment tasks involving communication. Clinical assessment candidates are often assessed in two communication domains; Process and Content. In order to do well in the information gathering stations, you must be aware of the differential diagnoses that may arise with various presentations and how to explore each one independently and as a collection. When it comes to information giving or shared decision marking, candidates need to be familiar with the most recent Royal College of Obstetrics and Gynaecology guidelines and know how to interpret their meaning to the patient and their families. The Calgary- Cambridge Model is one of the most recognized communication theories in medical education (Kurtz, 1996). This theory can be adapted to fit into most clinical scenarios. Using the Calgary- Cambridge Model, you should be able to obtain the majority of the points related to process.

scholarly journals From paper to program: Successfully translating an idea into a reality

2017 ◽  
Vol 24 (1) ◽  
pp. 50-56
Author(s):  
Marion Minis
Keyword(s):  
Good Practice ◽  
Shared Decision ◽  
Good Communication ◽  
Program Content ◽  
Extensive Program ◽  
Management Experience ◽  
Communication Practices ◽  
Practice Framework ◽  
Effective Design ◽  
Meaningful Communication

AbstractNo matter how excellent a framework for a new program is or how great it looks on paper, the challenge is how to ‘translate’ it into practice in such a way that it is an asset to the paid staff, volunteers and children involved. In this article, experiences of program development and delivery at Criss Cross Consultancy (CCC), where programs to empower vulnerable people are designed, are shared. With reference to the Good Practice Framework, the article draws on extensive program management experience to explore how good communication can support the effective design, implementation and delivery of programs. It illustrates the link between practice, meaningful communication and inclusion. Meaningful communication enables program content to be designed and adjusted to meet the needs of staff and children; shared decision-making to build co-ownership; recognition of expertise and matching people to roles; and effective top-down and bottom-up communication practices that engage with everyone. These communication outcomes are explored and examples are provided to illustrate how meaningful communication underpins the success of translating a program idea into a reality.

P002 IBD PARTNERSHIPS: UNDERSTANDING PATIENTS VS. CLINICIANS PERSPECTIVES OF IBD TREATMENT OPTIONS TO IMPROVE SHARED DECISION-MAKING

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Sandra Zelinsky ◽  
Catherine Finlayson
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Focus Groups ◽  
Shared Decision Making ◽  
Healthcare Providers ◽  
Treatment Decisions ◽  
Research Approach ◽  
Shared Decision ◽  
Rural And Urban

Abstract Background The patient is the only constant in the care journey, the person who experiences both processes and the outcomes of care. There is an international shift towards including patients as equal partners in research. Co-producing research with Inflammatory Bowel Disease (IBD) patients to understand their values, needs and priorities when making treatment decisions will potentially improve shared decision-making between IBD patients and their Healthcare Providers (HCPs). To facilitate this process patients and HCPs must have a common understanding of expected medication benefits, risks and the potential impact on quality of life. The information available to facilitate this conversation must be aligned and reflect the priorities that IBD Patients and Healthcare Providers consider when making treatment decisions. Both parties can then share information and work towards an agreement to what treatment plan should be implemented. Aims To understand what matters most to IBD patients when making treatment decisions by conducting a qualitative patient-led peer to peer study which will inform the development of an IBD patient and HCP survey. Methods IBD patients (≥ 18 years of age) were recruited through the IBD clinic at the University of Calgary and via social media. Focus groups were held in three separate provinces (British Columbia, Alberta and Ontario) in both rural and urban locations. The focus groups were facilitated by a Patient Engagement Researcher to alleviate any potential power dynamics and to create a safe space for IBD patients to share their perspectives. A participatory action research approach was used to encourage co-production with participants throughout the focus groups. The focus groups were audio recorded. Flip charts and sticky notes were used for brainstorming and prioritization exercises. All audio and written data were transcribed. Thematic analysis was used to identify emerging themes and patient priorities. Results A total of 21 participants attended the focus groups from both rural and urban locations. Participant diversity ranged in ethnicity and age. Most of the participants were female (18 females and 3 males) of which 4 were biologic naïve and 17 were biologic exposed. The Top 5 IBD Patient Priorities when making treatment decisions are 1) Risks(more serious/long term) 2) Education(Support/Evidence Based Information/Resources) 3) Side Effects(short term/less serious) 4) Efficacy 5) Impact(Quality of Life/ Lifestyle/Logistics). Conclusions Co-producing research ‘with’ and ‘by’ IBD patients helped to generate priorities that matter most to patients when making treatment decisions. The patient priorities will help in the development of an IBD Patient and HCP survey. The results from the two surveys will be compared to understand patient vs. HCP perspectives.

Corrigendum to: Approaches to management of complaints and notifications about health practitioners in Australia

2016 ◽  
Vol 40 (3) ◽  
pp. 353
Author(s):  
Claudette S. Satchell ◽  
Merrilyn Walton ◽  
Patrick J. Kelly ◽  
Elizabeth M. Chiarella ◽  
Suzanne M. Pierce ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Health Practitioner ◽  
Handling System ◽  
National Accreditation ◽  
Australian Health ◽  
Complaint Handling ◽  
Health Practitioners ◽  
Productivity Commission ◽  
Similarities And Differences

In 2005, the Australian Productivity Commission made a recommendation that a national health registration regimen and a consolidated national accreditation regimen be established. On 1 July 2010, the National Registration and Accreditation Scheme (NRAS) for health practitioners came into effect and the Australian Health Practitioner Regulation Agency (AHPRA) became the single national oversight agency for health professional regulation. It is governed by the Health Practitioner Regulation National Law Act (the National Law). While all states and territories joined NRAS for registration and accreditation, NSW did not join the scheme for the handling of complaints, but retained its existing co-regulatory complaint-handling system. All other states and territories joined the national notification (complaints) scheme prescribed in the National Law. Because the introduction of NRAS brings with it new processes and governance around the management of complaints that apply to all regulated health professionals in all states and territories except NSW, where complaints management remains largely unchanged, there is a need for comparative analysis of these differing national and NSW approaches to the management of complaints/notifications about health professionals, not only to allow transparency for consumers, but also to assess consistency of decision making around complaints/notifications across jurisdictions. This paper describes the similarities and differences for complaints/notifications handling between the NRAS and NSW schemes and briefly discusses subsequent and potential changes in other jurisdictions.

scholarly journals Recommendations for Treating Males: An Ethical Rationale for the Inclusion of Testicular Self-Examination (TSE) in a Standard of Care

2015 ◽  
Vol 12 (3) ◽  
pp. 539-545 ◽  
Author(s):  
Michael J. Rovito ◽  
Janna Manjelievskaia ◽  
James E. Leone ◽  
Michael Lutz ◽  
Chase T. Cavayero ◽  
...  
Keyword(s):  
Task Force ◽  
Clinical Care ◽  
Significant Risk ◽  
Standard Of Care ◽  
Health Practitioner ◽  
Ethical Implications ◽  
Legal Term ◽  
Health Practitioners ◽  
Care Guidelines ◽  
Self Examination

The phrase “standard of care” is primarily a legal term representing what procedure a reasonable person (i.e., health practitioner) would administer to patients across similar circumstances. One major concern for health practitioners is delivering and advocating for treatments not defined as a standard of care. While providing such treatments may meet certain ethical imperatives, doing so may unwittingly trigger medical malpractice litigation fears from practitioners. Apprehension to deviate, even slightly, from the standard of care may (seem to) put the practitioner at significant risk for litigation, which, in turn, may limit options for treatment and preventive measures recommended by the practitioner. Specific to testicular treatment, certain guidelines exist for cancer, torsion, vasectomy, and scrotal masses, among others. As it relates to screening, practitioner examination is expected for patients presenting with testicular abnormalities. Testicular self-examination (TSE) advocacy, however, is discouraged by the U.S. Preventive Services Task Force, which may prompt a general unwillingness among health practitioners to promote the behavior. Considering the benefits TSE has beyond cancer detection, and the historical support it has received among health practitioners, it is paramount to consider the ethical implications of its official “exclusion” from preventive health and clinical care recommendations (i.e., standard of care). Since good ethics should lead practitioner patient care guidelines, not fear of increased malpractice risks, we recommend the development of a standard of care for counseling males to perform TSE.

Extent of depressive symptomatology among patients seeking care in prepaid group practice

1983 ◽  
Vol 13 (1) ◽  
pp. 121-129 ◽  
Author(s):  
Janet R. Hankin ◽  
Ben Z. Locke
Keyword(s):  
Internal Medicine ◽  
Mental Health ◽  
Depressive Symptoms ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Adult Patients ◽  
Group Practice ◽  
Health Practitioner ◽  
Health Practitioners

SynopsisA total of 1921 consecutive adult patients seen in the Departments of Internal Medicine and Obstetrics–Gynaecology at a prepaid group practice completed a self-administered depressive symptomatology questionnaire, the Centre for Epidemiologic Studies Depression Scale (CES-D). New health practitioners and physicians, who were not mental health specialists, blindly judged the presence or absence of depressive symptomatology. Twenty-one per cent of the patients suffered from depressive symptoms according to the CES-D, but only 15% of these were judged to be depressed by their physician or new health practitioner. The variables which predict the recognition of depressive symptomatology are discussed.

Validation of the extended ICF core set for stroke from the patient perspective using focus groups

2011 ◽  
Vol 34 (2) ◽  
pp. 157-166 ◽  
Author(s):  
Andrea Glässel ◽  
Michaela Coenen ◽  
Barbara Kollerits ◽  
Alarcos Cieza
Keyword(s):  
Focus Groups ◽  
Patient Perspective ◽  
Icf Core Set ◽  
Core Set

Deploying and using volunteer health practitioners in response to emergencies: Proposed uniform state legislation provides liability protections and workers’ compensation coverage

2008 ◽  
Vol 3 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Michealle Carpenter, JD ◽  
James G. Hodge, Jr, JD, LLM ◽  
Raymond P. Pepe, AB, JD
Keyword(s):  
Public Health ◽  
Disaster Response ◽  
Healthcare Delivery ◽  
Health Practitioner ◽  
Workers Compensation ◽  
Public Health Services ◽  
Public Health Emergencies ◽  
Uniform State ◽  
Essential Public Health Services ◽  
Health Practitioners

To respond effectively to natural disasters and other public health emergencies, government resources must be augmented with the resources of volunteer organizations. Governmental actors are prepared to utilize volunteer health practitioners (VHPs) to meet patient surge capacity and provide essential public health services. However, difficult legal challenges arise regarding licensure, the scope of practice of volunteers, the relationship of volunteers to local healthcare delivery systems, disciplinary enforcement, the extent of exposure to civil liability, and how to provide compensation for volunteers injured or killed during disaster response activities. The Uniform Emergency Volunteer Health Practitioner Act (UEVHPA) seeks to address these problems and provide a better legal environment that facilitates VHPs efforts.This article discusses two important provisions of the UEVHPA, Section 11 which provides immunity against claims for negligence, under certain circumstances, for volunteers and organizations engaged in the deployment and use of volunteers, and Section 12 which provides workers’ compensation benefits to VHPs when other sources of coverage are not available. Disaster relief organizations and healthcare provider organizations have consistently identified uncertainty and a lack of uniformity with respect to these issues as a major source of concern to volunteer practitioners and as a potential deterrent to their effective recruitment and utilization. Uniform state enactment of the UEVHPA would resolve many inconsistencies and gaps in the regulation and protection of VHPs across states.

scholarly journals Understanding shared decision-making experience among vulnerable population: Focus group with food bank clients

2020 ◽  
pp. 1-8
Author(s):  
Young Ji Lee ◽  
Tiffany Brazile ◽  
Francesca Galbiati ◽  
Megan Hamm ◽  
Cindy Bryce ◽  
...  
Keyword(s):  
Decision Making ◽  
Focus Groups ◽  
Shared Decision Making ◽  
Vulnerable Populations ◽  
Clinical Decision Making ◽  
Decision Aids ◽  
Clinical Decision ◽  
Therapeutic Options ◽  
Shared Decision ◽  
Food Bank

Abstract Introduction: Shared decision-making (SDM) is a critical component of delivering patient-centered care. Members of vulnerable populations may play a passive role in clinical decision-making; therefore, understanding their prior decision-making experiences is a key step to engaging them in SDM. Objective: To understand the previous healthcare experiences and current expectations of vulnerable populations on clinical decision-making regarding therapeutic options. Methods: Clients of a local food bank were recruited to participate in focus groups. Participants were asked to share prior health decision experiences, explain difficulties they faced when making a therapeutic decision, describe features of previous satisfactory decision-making processes, share factors under consideration when choosing between treatment options, and suggest tools that would help them to communicate with healthcare providers. We used the inductive content analysis to interpret data gathered from the focus groups. Results: Twenty-six food bank clients participated in four focus groups. All participants lived in areas of socioeconomic disadvantage. Four themes emerged: prior negative clinical decision-making experience with providers, patients preparing to engage in SDM, challenges encountered during the decision-making process, and patients’ expectations of decision aids. Participants also reported they were unable to discuss therapeutic options at the time of decision-making. They also expressed financial concerns and the need for sufficiently detailed information to evaluate risks. Conclusion: Our findings suggest the necessity of developing decision aids that would improve the engagement of vulnerable populations in the SDM process, including consideration of affordability, use of patient-friendly language, and incorporation of drug–drug and drug–food interactions information.

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