Virtual Patient Simulation

Author(s):  
Daniel T. Nystrom ◽  
Douglas E. Paull ◽  
Ashley N. D. Meyer ◽  
Hardeep Singh

Medical diagnosis has begun to draw attention as a patient safety concern that is valid, yet difficult to study. In the current study, we implement a virtual patient simulation to assess different information sampling techniques practiced by a variety of health care providers including physicians, nurses, health technicians, and pharmacists who were tasked with diagnosing a virtual patient. Results suggest there are three different information sampling approaches used to arrive at a medical diagnosis: iteration, batch, and haste. In the iterative approach, clinicians sampled a series of hypothesis-generating sources of information (e.g., patient history, physical exam, etc.) that were immediately followed by a series of diagnostic tests (e.g., X-ray, EKG, etc.) and this process was repeated for 2-4 cycles before arriving at a diagnosis. In the batch approach, hypothesis-generating sources of information were sampled in a single series or “batch” that was then followed by a single series of diagnostic tests. In the haste approach, only a few sources of hypothesis-generating information were sampled before arriving at a medical diagnosis, and none of the information sampled was tested using diagnostic tests. Results suggest virtual patient simulation is a useful format to observe the emergence of clinicians’ diagnostic process and to collect a variety of measures and outcomes associated with medical diagnosis.

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Samina Ismail ◽  
Shemila Abbasi ◽  
Sobia Khan ◽  
Abdul Monem ◽  
Gauhar Afshan

AbstractAims:The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.Methods:In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.Results:From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.Conclusions:Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.


Author(s):  
Lynnea Myers ◽  
Sharon M. Karp ◽  
Mary S. Dietrich ◽  
Wendy S. Looman ◽  
Melanie Lutenbacher

Abstract Autism spectrum disorder (ASD) affects 1:59 children, yet little is known about parents’ perceptions of family-centered care (FCC) during the diagnostic process leading up to diagnosis. This mixed-methods study explored key elements of FCC from 31 parents of children recently diagnosed with ASD using parallel qualitative and quantitative measures. Parents rated highly their receipt of FCC and discussed ways providers demonstrated FCC. However, the majority of parents indicated that the period when their child was undergoing diagnosis was stressful and reported symptoms of depression and anxiety. The study points to ways in which health care providers can enhance FCC provided to families when a child is undergoing ASD diagnosis.


2019 ◽  
Author(s):  
Sefonias Getachew ◽  
Aragaw Tesfaw ◽  
Mirgissa Kaba ◽  
Andreas Wienke ◽  
Lesley Taylor ◽  
...  

Abstract Background Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. Methods A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants proved verbal consent before participating. A thematic analysis was performed using Open Code 4.02. Results Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. Conclusions Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.


2019 ◽  
Author(s):  
Sefonias Getachew ◽  
Aragaw Tesfaw ◽  
Mirgissa Kaba ◽  
Andreas Wienke ◽  
Lesley Taylor ◽  
...  

Abstract Background Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. Methods A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants proved verbal consent before participating. A thematic analysis was performed using Open Code 4.02. Results Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. Conclusions Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.


2018 ◽  
Vol 97 (8) ◽  
pp. 727-730
Author(s):  
Lilia A. Titova ◽  
E. A. Dobrynina ◽  
N. N. Chaykina ◽  
G. V. Kuzmicheva

Introduction. In the healthcare system of the Russian Federation, in the changed social and economic conditions, against the background of increasing requirements to the quality of medical care, the problem of studying factors affecting the professional activity of medical personnel is being updated. The purpose of the study is the theoretical justification of ways to improve the work process of medical personnel by organizing the stream passage of patients in the polyclinic of the Belgorod Cancer Clinic. Material and methods. Questioning of 189 patients of the polyclinic of the “Belgorod Cancer Clinic”, selected according to the principle of random sampling. They evaluated the work of the dispensary in the field of stream control on a specially created questionnaire, which included 14 questions. Results. The conducted sociological research revealed the dissatisfaction of patients with a number of positions: the presence of a queue to the doctor (61.2%), the work of individual offices (ultrasound, x-ray room) and medical specialists of the consulting and diagnostic department (44.6%); lack of information in patients about the possibilities of diagnosis and treatment in clinics (47%). The primary visit in the morning, the narrow corridors of the polyclinic - all this creates the inconvenience of waiting for a doctor. Only 13% of respondents rated the service as 5 points, 30% - 4 points, 33% - 3 points, 19% - 2 points and 5% - 1 point. The admission rate of the doctor is 20 patients per shift, but the average value of the stream rate of patients on admission corresponds to an average of 35 patients per day. This increase in the workload negatively affects the dissatisfaction with the organization of the treatment and diagnostic process both for doctors and nurses. Conclusions. The professional activity of primary health care providers directly depends on the adequacy of the workload. The use of social monitoring makes it possible to organize a detailed and adequate regulation of the activities of medical personnel.


2021 ◽  
Author(s):  
Alemneh Mengie ◽  
Gemmechu Hasen ◽  
Sultan Suleman

Abstract Background In Ethiopia, despite the frequent reports that demonstrate the use of herbal medicine for treatment of many ailments, there is no finding that describes the prevalence and associated factors with prehospital use of herbal medicine. Therefore, the present study was aimed to assess the prevalence of the prehospital use of herbal medicine and associated factors as well as safety concern in the South western Ethiopia. Methodology: A Hospital based cross-sectional study design was employed among patients admitted to Medical wards in Jimma Medical Center (JMC) (n=217) from June to September, 2021. The pre-tested questionnaire was used for data collection. Moreover, literatures were reviewed to identity the potential toxicity and/or drug interactions (if any,) associated with the herbal medicine used before admission by patients. The Statistical Package for Social Science (SPSS) version 21.0 (Chicago, SPSS Inc.) was used for data analysis. The results were summarized using descriptive statistics. The bivariate logistic regression was used to check the association between the outcomes and independent variables. Then, multivariate logistic regression was employed for independent variables possessing p-value of less than 0.05 to identify the strength of association between variables at 5% level of significance. Results The current study revealed that about 34% of respondents revealed the prehospital use of herbal medicine. The majority respondents (78.7%) did not discuss with their health care providers about prehospital use of herbal medicine. The factors like age (AOR: 0.281, 95% CI: 0.115, 0.683), educational level (AOR: 2.672, 95% CI: 1.101, 6.485) and insurance coverage (AOR: 2.082, 95% CI: 1.083, 4.004) were significantly associated with prehospital use of herbal medicine. Moreover, ‘Dammakese’ (Ocimum gratissimum L), ‘Tenadam’ (Ruta chalepensis L), ‘Makkanisa’ (Croton macrostachyus), ‘Jinjibli’ (Zingiber officinale), ‘Barzaafi Adii’ (Eucalyptus globulus Labill), ‘Qabarichoo’ (Echinops kebericho, Mesfin) and ‘Papaya’ (Carica papaya L) were the most commonly used herbs before admission to hospital. From published literatures review we revealed that the Zingiber officinale, Carica papaya L, Eucalyptus globulus Labill and Ruta chalepensis L possess the potential interaction with many conventional medicines as well as toxic effects. Conclusions The present study revealed that the prehospital use of herbal medicine was relatively high in which majority of patients did not disclose to the health care providers. Its use was significantly associated with age, educational level and insurance coverage. In addition, some of herbs used are associated with safety issues. Therefore, health care providers should thoroughly discuss with their patients regarding the prehospital use of herbal medicine.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina L. Alfieri ◽  
Jennifer D. Kusma ◽  
Nia Heard-Garris ◽  
Matthew M. Davis ◽  
Emily Golbeck ◽  
...  

Abstract Objective To compare hesitancy toward a future COVID-19 vaccine for children of various sociodemographic groups in a major metropolitan area, and to understand how parents obtain information about COVID-19. Methods Cross-sectional online survey of parents with children < 18 years old in Chicago and Cook County, Illinois, in June 2020. We used logistic regression to determine the odds of parental COVID-19 vaccine hesitancy (VH) for racial/ethnic and socioeconomic groups, controlling for sociodemographic factors and the sources where parents obtain information regarding COVID-19. Results Surveys were received from 1702 parents and 1425 were included in analyses. Overall, 33% of parents reported VH for their child. COVID-19 VH was higher among non-Hispanic Black parents compared with non-Hispanic White parents (Odds Ratio (OR) 2.65, 95% Confidence Interval (CI): (1.99–3.53), parents of publicly insured children compared with privately insured (OR 1.93, (1.53–2.42)) and among lower income groups. Parents receive information about COVID-19 from a variety of sources, and those who report using family, internet and health care providers as information sources (compared to those who don’t use each respective source) had lower odds of COVID-19 VH for their children. Conclusions The highest rates of hesitancy toward a future COVID-19 vaccine were found in demographic groups that have been the most severely affected by the pandemic. These groups may require targeted outreach efforts from trusted sources of information in order to promote equitable uptake of a future COVID-19 vaccine.


2020 ◽  
Author(s):  
Iqbal Pramukti ◽  
Carol Strong ◽  
Yajai Sitthimongkol ◽  
Agus Setiawan ◽  
Moses Glorino Rumambo Pandin ◽  
...  

BACKGROUND The COVID-19 pandemic has negatively affected the mental health of university students. OBJECTIVE This study examined the psychological responses toward COVID-19 among university students from 3 countries—Indonesia, Taiwan, and Thailand. METHODS We used a web-based, cross-sectional survey to recruit 1985 university students from 5 public universities (2 in Indonesia, 1 in Thailand, and 1 in Taiwan) via popular social media platforms such as Facebook, LINE, WhatsApp, and broadcast. All students (n=938 in Indonesia, n=734 in Thailand, and n=313 in Taiwan) answered questions concerning their anxiety, suicidal thoughts (or sadness), confidence in pandemic control, risk perception of susceptibility to infection, perceived support, resources for fighting infection, and sources of information in the context of the COVID-19 pandemic. RESULTS Among the 3 student groups, Thai students had the highest levels of anxiety but the lowest levels of confidence in pandemic control and available resources for fighting COVID-19. Factors associated with higher anxiety differed across countries. Less perceived satisfactory support was associated with more suicidal thoughts among Indonesian students. On the other hand, Taiwanese students were more negatively affected by information gathered from the internet and from medical staff than were Indonesian or Thai students. CONCLUSIONS Our findings suggest that health care providers in Thailand may need to pay special attention to Thai university students given that high levels of anxiety were observed in this study population. In addition, health care providers should establish a good support system for university students, as the results of this study indicate a negative association between support and suicidal thoughts.


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