The Engaged Patient: The Relevance of Patient–Physician Communication for Twenty-First-Century Health

2020 ◽  
Vol 61 (3) ◽  
pp. 259-273 ◽  
Author(s):  
Stefan Timmermans

The patient–doctor interaction has changed profoundly in the past decades. In reaction to paternalistic communication patterns, health policy makers have advocated for patient-centered care and shared decision-making. Although these models of medical communication remain still aspirational, patients have become more engaged in advocating for their own health in encounters with physicians. I argue that the engaged patient is a more accurate conceptualization of the changing role of the patient than patient consumerism, the empowered, or expert patient. I examine how the emergence of engaged patients influences the autonomy of health professionals, relates to the rise of the internet as an alternative source of medical information, centers the role of the patient–doctor interaction in public health epidemics, and contributes to health inequities.

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.


Author(s):  
Salma Shickh ◽  
◽  
Sara A. Rafferty ◽  
Marc Clausen ◽  
Rita Kodida ◽  
...  

2021 ◽  
pp. 112972982110069
Author(s):  
Rui Pinto ◽  
Clemente Sousa ◽  
Anabela Salgueiro ◽  
Isabel Fernandes

The cannulation of an arteriovenous fistula (AVF) by the hemodialysis (HD) nurse is challenging. Despite it being the focus of extensive research, it is still one of the majors causes of damage making it prone to failure. A considerable number of Clinical Practice Guidelines (CPGs) for the management of vascular access (VA) have been published worldwide over the past two decades. This review aimed to assess all information available in the selected CPG regarding AVF cannulation for HD providing a comprehensive analysis in order to interpret possible future cannulation approaches. A total of seven CPGs were described in a coding table separated in seven subthemes: Initiation of cannulation, preparation, technique, needle selection, surveillance, pain, and education. Our analysis outlines current CPGs for HD VA cannulation with lack of good evidence support for the majority of the recommendations, showing that, there is an urgent need for international collaboration and coordination to ensure relevant and high-quality evidence. Future CPGs must consider recommendations with better grading of evidence aiming patient-centered care and nurse decision models that can potentially represent better AVF cannulation outcomes.


2014 ◽  
Vol 28 (4) ◽  
pp. 271-280 ◽  
Author(s):  
Dina Williams ◽  
Alexey Kluev

This paper examines the evolution of the entrepreneurial function of Russia's leading universities: the study is based on a conceptualization of a university's entrepreneurial development pathway developed by the OECD in 2009. The data on entrepreneurship development were collected in 2012 through a survey of technology transfer and innovation development managers of 18 National Research Universities. The primary data were complemented by desktop analysis of the strategy development documents of the universities surveyed. The results suggest that in the period studied, 2008–2012, a new type of university, the entrepreneurial university, has emerged in Russia. However, these entrepreneurial universities are facing serious challenges in the implementation of an entrepreneurial, innovation-oriented mission due to the lack of managerial competencies and inadequate infrastructure development. The paper has significant theoretical and practical implications in shedding light on the development of the entrepreneurial university in Russia, where the process is still in its infancy. The authors depict a trajectory of entrepreneurial transformation in and barriers to this process that, it is argued, university executives and policy makers should take into consideration.


2011 ◽  
Vol 17 (4) ◽  
pp. 211-218 ◽  
Author(s):  
Claire F. Snyder ◽  
Albert W. Wu ◽  
Robert S. Miller ◽  
Roxanne E. Jensen ◽  
Elissa T. Bantug ◽  
...  

2009 ◽  
Vol 3 (1) ◽  
pp. 63-77 ◽  
Author(s):  
Peter Coleman

AbstractThe nature and experience of human ageing is changing as people come to live longer lives both as active 'young-old' and dependent 'old-old'. Europe is in the forefront of population ageing and stands in great need of a creative response at many levels, including from religious bodies. There needs to be recognition that older Europeans benefit less than in the past from the elder's traditional religious role of witnessing and transmitting faith. Indeed in some European countries older people can be greatly troubled in their own faith yet pastorally unsupported as Christian churches focus on evangelizing the reluctant young. Pastoral theology needs to be developed to encourage creative responses to the older person's isolation, which can be cultural and spiritual as well as physical. Possibly the greatest challenge is to respond effectively to the rising numbers entering the fourth age in a state of dementia. In this respect western Christianity has much to learn from the Eastern Orthodox tradition, which lays less emphasis on rationality as the criterion for human and moral status, and more on the person in relationship. Even if we forget who we are, we can and should be remembered by others, and in the last analysis are remembered by God.


Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Heidi D. Klepin

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.


Author(s):  
Michelle Krawczyk

People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.


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