scholarly journals Health Care Trajectories for Children With ADHD in France: Results From the QUEST Survey

2016 ◽  
Vol 24 (1) ◽  
pp. 52-65 ◽  
Author(s):  
Hervé Caci ◽  
David Cohen ◽  
Olivier Bonnot ◽  
Bernard Kabuth ◽  
Jean-Phillipe Raynaud ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
National Sample ◽  
Adhd Diagnosis ◽  
Delay In Diagnosis ◽  
The Core ◽  
Initial Onset ◽  
Improvement Method ◽  
Core Symptoms ◽  
Improve Patient

Objective: The objective of this study is to retrospectively describe the pathway toward ADHD diagnosis and treatment, and identify potential areas for improvement. Method: Parent-reported questionnaires were collected by a national sample of ADHD specialists. Results: In total, 473 complete questionnaires were analyzed. Initial onset of ADHD symptoms was reported at a mean age of 4.45 years. Mean age at diagnosis was 8.07 years, and half of the families had seen at least three health care professionals previously. Psychiatrists were most commonly consulted. A “combined” (89% boys) and inattentive (49% boys) profile was identified. Diagnosis was made 1 year later for the latter group. Two thirds of patients received pharmacological treatment. The delay in diagnosis was identified as the main source of concern for caregivers. Conclusion: The 4-year delay in diagnosis may represent a loss of opportunity. Training health care professionals in the core symptoms of ADHD may help reduce disparities and improve patient trajectory.

Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence

2021 ◽  
pp. 016327872110408
Author(s):  
Hosung (Joel) Kang ◽  
Cecilia Flores-Sandoval ◽  
Benson Law ◽  
Shannon Sibbald
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Assessment Tools ◽  
Team Members ◽  
Team Assessment ◽  
Health Care Evaluation ◽  
Team Functioning ◽  
Interdisciplinary Health Care ◽  
Psychometric Evidence ◽  
Improve Patient

Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practice. More research is required to develop surveys that better reflect the current reality of teamwork in our evolving health system, including a greater consideration for patient as team members. Additionally, more research is needed to encompass an increasing development of team assessment tools.

Primer on Medical Professionalism

2004 ◽  
Vol 94 (2) ◽  
pp. 206-209 ◽  
Author(s):  
Joseph A. Diaz ◽  
Michael J. Stamp
Keyword(s):  
Health Care ◽  
Social Contract ◽  
Health Care Professionals ◽  
Hippocratic Oath ◽  
Medical Professionals ◽  
Medical Professionalism ◽  
Medical Providers ◽  
The Public ◽  
The Core

Medicine as a profession depends on a unique social contract between the public and health-care professionals. We define professionalism in medicine, provide examples of challenges in professionalism relevant to podiatric medicine, and offer resources on ethics and professionalism in medicine. “Medical professionalism” is the set of attitudes, values, and conduct exhibited by medical providers resulting from placing patients’ and society’s interests above their own. The primacy of patient welfare has been at the core of a set of values held by medical professionals since the drafting of the Hippocratic Oath, and it remains at the center of medical professionalism today. (J Am Podiatr Med Assoc 94(2): 206-209, 2004)

scholarly journals Diagnosing Juvenile Huntington’s Disease: An Explorative Study among Caregivers of Affected Children

2020 ◽  
Vol 10 (3) ◽  
pp. 155 ◽  
Author(s):  
Mayke Oosterloo ◽  
Emilia K. Bijlsma ◽  
Christine de Die-Smulders ◽  
Raymund A. C. Roos
Keyword(s):  
Health Care ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Health Care Professionals ◽  
Interpretative Phenomenological Analysis ◽  
Diagnostic Delay ◽  
Diagnostic Process ◽  
Delay In Diagnosis ◽  
Juvenile Huntington’S Disease ◽  
The One

Objective: To investigate the reasons for the diagnostic delay of juvenile Huntington’s disease patients in the Netherlands. Methods: This study uses interpretative phenomenological analysis. Eligible participants were parents and caregivers of juvenile Huntington’s disease patients. Results: Eight parents were interviewed, who consulted up to four health care professionals. The diagnostic process lasted three to ten years. Parents believe that careful listening and follow-up would have improved the diagnostic process. Although they believe an earlier diagnosis would have benefited their child’s wellbeing, they felt they would not have been able to cope with more grief at that time. Conclusion: The delay in diagnosis is caused by the lack of knowledge among health care professionals on the one hand, and the resistance of the parent on the other. For professionals, the advice is to personalize their advice in which a conscious doctor’s delay is acceptable or even useful.

scholarly journals Identity Formation in Adolescents with Concentration Problems, High Levels of Activity or Impulsiveness: A Pragmatic Qualitative Study

2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Audhild Løhre
Keyword(s):  
Qualitative Study ◽  
Identity Formation ◽  
Well Being ◽  
The Other ◽  
Adhd Diagnosis ◽  
Individual Interviews ◽  
Impulsive Behaviour ◽  
The Core ◽  
Being There ◽  
Core Symptoms

Students showing core symptoms of ADHD face additional challenges in school. This study asks how children and adolescents with inattentiveness, high levels of activity or impulsiveness perceive their symptom-like behaviour and how this may affect their identity, friendships and well-being. Researchers conducted individual interviews with 12 students (10–16 years) selected to attend a school programme aimed at improving their concentration. Six students had an ADHD diagnosis. The interviews were analysed, guided by theoretical reading. The students’ narratives fit a discursive perspective showing that identity developed through interactions with others. All students told about their disturbing concentration problems. Students disliked having a short fuse and talking before thinking, and they admitted that impulsive behaviour could threaten their friendships. On the other hand, students with high levels of activity described this as fun in interaction with friends. Nobody mentioned that concentration problems affected friendships, and none of the core symptoms seemed to influence well-being. There were no obvious differences between students with or without an ADHD diagnosis. The students’ stories, therefore, show that teachers should know their students with inattentiveness, hyperactivity or impulsiveness individually to learn about their challenges and preferences.

Exploring primary health care professionals’ perceptions about a patient feedback intervention to improve patient safety in Spanish primary health care centres: a qualitative study

2020 ◽  
Vol 37 (6) ◽  
pp. 821-827
Author(s):  
Maria J Serrano-Ripoll ◽  
Joana Ripoll ◽  
Erica Briones-Vozmediano ◽  
Joan Llobera ◽  
Maria A Fiol-deRoque ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Improve Patient Safety ◽  
Feedback Intervention ◽  
Patient Feedback ◽  
Primary Health ◽  
Feedback Data ◽  
Improve Patient

Abstract Background Patient feedback interventions are receiving increasing attention given their potential to improve health care provision. However, primary health care (PHC) professionals’ acceptability and perceived utility of this type of interventions remain largely unexplored. Objectives The aim of this study was to explore PHC professionals’ perceptions, opinions and suggestions about a patient feedback intervention currently being designed to improve patient safety in Spanish PHC centres. Methods We conducted an exploratory qualitative study with 43 PHC professionals. Information was obtained from three semi-structured interviews and four focus groups. All data were audio-recorded, transcribed and analyzed using content analysis by three analysts. Results The patient feedback intervention was acceptable to health care professionals, who perceived it as a useful strategy to improve health care processes and activate patients. A number of factors potentially limiting the acceptability and perceived utility of the intervention were identified (low patient safety culture, low patient-centred care orientation and limited credibility of patient feedback data). Recommendations for designing and implementing the proposed intervention in the Spanish PHC centres were identified in relation to the following areas: ‘collection and analysis of feedback data’; ‘feedback display’; ‘feedback delivery’ and; ‘implementation of safety improvement initiatives’. Conclusions Although the proposed intervention was generally perceived as useful and acceptable, our study identified a number of tensions about the practical aspects of using the patient-reported data and the credibility of the data and what actions would arise from its use. The intervention has been adapted to address these tensions before its formal evaluation in a randomized clinical trial.

Birthday Blues

Crisis ◽  
2011 ◽  
Vol 32 (3) ◽  
pp. 134-142 ◽  
Author(s):  
Alyson Williams ◽  
David While ◽  
Kirsten Windfuhr ◽  
Harriet Bickley ◽  
Isabelle M. Hunt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Health Care Professionals ◽  
Psychiatric Patients ◽  
National Sample ◽  
Clinical Population ◽  
Increased Risk ◽  
Patient Groups ◽  
Male Patients

Background: Socioculturally meaningful events have been shown to influence the timing of suicide, but the influence of psychiatric disorder on these associations has seldom been studied. Aims: To investigate the association between birthday and increased risk of suicide in the general population and in a national sample of psychiatric patients. Methods: Data on general population suicides and suicide by individuals in recent care of mental health services were examined for day of death in relation to one’s birthday using Poisson regression analysis. Results: An increased risk of suicide was observed on day of one’s birthday itself for males in both the general population (IRR = 1.39, 95% CI = 1.18–1.64, p < .01) and the clinical population (IRR = 1.48, 95% CI = 1.07–2.07, p = .03), especially for those aged 35 years and older. In the clinical population, risk was restricted to male patients aged 35–54 and risk extended to the 3 days prior to one’s birthday. Conclusions: Birthdays are periods of increased risk for men aged 35 and older in the general population and in those receiving mental health care. Raising health-care professionals’ awareness of patient groups at greater risk at this personally significant time may benefit care planning and could facilitate suicide prevention in these individuals.

scholarly journals Pancreatic Laceration in a Female Collegiate Soccer Athlete: A Case Report

2013 ◽  
Vol 48 (2) ◽  
pp. 271-276
Author(s):  
Michael E. Powers ◽  
Michelle Tropeano ◽  
Diana Priestman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Hospital Setting ◽  
Pancreatic Injury ◽  
Care Providers ◽  
Rare Injury ◽  
Delay In Diagnosis ◽  
Upper Abdominal ◽  
High Index Of Suspicion

Objective: To characterize the diagnosis of pancreatic trauma in an athletic population and to raise awareness among health care providers of the possibility of this life- and organ-threatening injury. Background: An 18-year-old, previously healthy female collegiate soccer athlete sustained a direct blow from an opponent's knee between the left and right upper abdominal quadrants while attempting to head the ball. She initially presented with only minimal nausea and discomfort, but this progressed to abdominal pain, tenderness, spasm, and vomiting. She was referred to the emergency department, where she was diagnosed with a pancreatic laceration. Differential Diagnosis: Duodenal, hepatic, or splenic contusion or laceration; hemorrhagic ovarian cyst. Treatment: The patient underwent a distal pancreatectomy and total splenectomy. Uniqueness: Pancreatic injuries, particularly those severe enough to warrant surgical intervention, are extremely rare in athletes. Conclusions: Recognition of a pancreatic injury can be very challenging outside the hospital setting. This is problematic, because a delay in diagnosis is a significant source of preventable morbidity and mortality after this rare injury. Thus, early identification depends on a high index of suspicion, a thorough examination, and close observation. It is imperative that athletic trainers and other health care professionals be able to identify this condition so that referral and management can occur without delay.

Improving Communication Skills in Health Care

2013 ◽  
Vol 20 (3) ◽  
pp. 109-117
Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Skills Training ◽  
International Medical Graduate ◽  
Medical Graduate ◽  
Health Care Environment ◽  
Medical Interpreters ◽  
Accent Modification

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

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