scholarly journals Does information structuring improve recall of discharge information? A cluster randomized clinical trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257656
Author(s):  
Victoria Siegrist ◽  
Rui Mata ◽  
Wolf Langewitz ◽  
Heike Gerger ◽  
Stephan Furger ◽  
...  
Keyword(s):  
Communication Strategies ◽  
Skills Training ◽  
Completion Rates ◽  
Post Discharge ◽  
Immediate Recall ◽  
Physician Relationship ◽  
Cluster Randomized ◽  
The Impact ◽  
Discharge Communication

Objectives The impact of the quality of discharge communication between physicians and their patients is critical on patients’ health outcomes. Nevertheless, low recall of information given to patients at discharge from emergency departments (EDs) is a well-documented problem. Therefore, we investigated the outcomes and related benefits of two different communication strategies: Physicians were instructed to either use empathy (E) or information structuring (S) skills hypothesizing superior recall by patients in the S group. Methods For the direct comparison of two communication strategies at discharge, physicians were cluster-randomized to an E or a S skills training. Feasibility was measured by training completion rates. Outcomes were measured in patients immediately after discharge, after 7, and 30 days. Primary outcome was patients’ immediate recall of discharge information. Secondary outcomes were feasibility of training implementation, patients’ adherence to recommendations and satisfaction, as well as the patient-physician relationship. Results Of 117 eligible physicians, 80 (68.4%) completed the training. Out of 256 patients randomized to one of the two training groups (E: 146 and S: 119) 196 completed the post-discharge assessment. Patients’ immediate recall of discharge information was superior in patients in the S-group vs. E-group. Patients in the S-group adhered to more recommendations within 30 days (p = .002), and were more likely to recommend the physician to family and friends (p = .021). No differences were found on other assessed outcome domains. Conclusions and practice Implications Immediate recall and subsequent adherence to recommendations were higher in the S group. Feasibility was shown by a 69.6% completion rate of trainings. Thus, trainings of discharge information structuring are feasible and improve patients’ recall, and may therefore improve quality of care in the ED.

The Importance of the Patient-Physician Relationship in Myelodysplastic Syndromes.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1340-1340 ◽  
Author(s):  
Mary L. Thomas ◽  
Kathleen Heptinstall ◽  
Audrey Hassan
Keyword(s):  
Quality Of Life ◽  
Focus Groups ◽  
Myelodysplastic Syndromes ◽  
Treatment Options ◽  
The United States ◽  
Significant Finding ◽  
Physician Relationship ◽  
The Impact ◽  
The Relationship

Abstract Most physicians presume their relationship with the patient is a crucial component when managing chronic illness, such as myelodysplastic syndromes (MDS). This assumption was validated in a convenience sample of 70 adults with MDS who participated in five focus groups throughout the United States. The primary purpose of this qualitative study was to explore the impact of MDS on patients’ quality of life (QOL). The groups were facilitated by an advanced practice nurse with clinical expertise in MDS and qualitative research experience. Given the exploratory nature of the study design, discussions proceeded in differing directions; however, core questions were asked at each session (based on Ferrell’s work exploring QOL in patients with cancer (Oncology Nursing Forum, 1996). Sessions were audio-taped and professionally transcribed. Transcripts were coded and emerging themes identified using thematic analysis methods aided by the qualitative analysis program N5 (QSR International). The sample was 93% Caucasian, 51% male, with a mean age of 69 ± 9 years; 26% lived alone. Known MDS subtype was: 19 RA, 19 RARS, 11 RAEB, 3 5q-, 2 other (16 unknown); median time since diagnosis was 26 months (3 - 276). 73% received growth factors, 61% transfusions, 19% azacitidine, 16% thalidomide, 14% iron chelation; 29% all other; many patients received multiple (often concurrent) therapies. A significant finding from the focus groups revealed a detailed depiction of the patient-physician relationship from the patient’s perspective (discussed by 46 of the 62 patients who actively participated). Patients acknowledged many barriers that interfered with the relationship. These barriers were system related (e.g., extreme time constraints for physicians, priority to others who were more ill) or treatment related (e.g., lack of cure, limited treatment options). In addition, patients identified physician attributes that adversely impacted the relationship, including seeming indifference to the patient’s concerns, displays of arrogance, limited knowledge about MDS and its treatment, and especially, lack of confidence in managing the illness. In contrast, positive physician attributes that enhanced the relationship included: providing comprehensible explanations, willingness to seek assistance or opinions from MDS experts when the physician was unsure of the best treatment approach, and displays of compassion and concern. Patients identified displaying respect and interest in them as individuals as essential elements in establishing and maintaining a therapeutic relationship. Patients reacted to a difficult patient-physician relationship in various ways. Those patients who ascribed to the view that a physician had a revered position and was not to be challenged tended to suffer in silence, and remained anxious or depressed. Other patients described a more proactive position, where they continually sought new information about the disease and managing side effects and even felt responsible to explore other treatment options. However, this approach required much work and energy, and did not consistently alleviate the patient’s anxiety. MDS is a complex disease, where advances in understanding its pathology and identifying new treatments are beginning to have an impact in routine clinical practice. Data from this study suggest that physicians need to be aware of the barriers present in the patient-physician relationship and strive to ameliorate them. In so doing, patient’s anxiety, depression, and hyper-vigilance may be diminished, and quality of life enhanced.

scholarly journals Self-Reported Social Media Use among Ophthalmology Residents

2021 ◽  
Vol 13 (02) ◽  
pp. e195-e199
Author(s):  
Arjun Watane ◽  
Hasenin Al-khersan ◽  
Meghana Kalavar ◽  
Bilal Ahmed ◽  
Michael Venincasa ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Medical Information ◽  
Training Programs ◽  
Media Use ◽  
Social Media Use ◽  
Account Information ◽  
Physician Relationship ◽  
The Impact

Abstract Objective To assess ophthalmology trainees' self-reported use of and attitudes toward social media. Methods An online survey was distributed by email to ophthalmology residency applicants of the Bascom Palmer Eye Institute between September 2016 and January 2020. Results Of the 1,688 email recipients, the survey was filled by 208 ophthalmology trainees (12.3%). Nearly all trainees reported using social media for personal purposes (92.3%), while less than half used social media for professional purposes (43.4%). There were mixed sentiments regarding the impact of social media on the patient–physician relationship, with the majority feeling that it challenges a physician's authority (55.2%) but also empowers the patient (57.5%) and encourages shared care (92.8%). Twenty-five percent of trainees had reviewed professional social media guidelines, and most rated the quality of medical information on social media as “poor” (60.9%). There were low rates of trainees looking up patients (13.8%), providing their account information to patients (1.5%), responding to patients' messages (2.6%), following patients' accounts (2.6%), and being followed by patients (2.6%). Conclusion The majority of ophthalmology trainees are active on social media. As these trainees enter practice, ophthalmology will likely see a rise in social media use. Training programs should consider a formal social media policy that is shared with all trainees as part of their education.

scholarly journals Memory Training as a Method for Reducing the Misinformation Effect

2019 ◽  
Author(s):  
Malwina Szpitalak ◽  
Adrianna Woltmann ◽  
Romuald Polczyk ◽  
Magdalena Kękuś
Keyword(s):  
Human Memory ◽  
Memory Training ◽  
Misinformation Effect ◽  
Memory Errors ◽  
Immediate Recall ◽  
Truth Effect ◽  
Training Courses ◽  
The Impact ◽  
Original Information

Abstract The two experiments presented in this study investigate the impact of memory training on the misinformation effect. This effect is particularly important in the forensic context as exposing a witness to misinformation may adversely affect the content of their testimony. During the training, the participants were acquainted with seven (Experiment 1) or six (Experiment 2) types of memory errors. It was expected that knowledge of the unreliability of human memory would reduce the misinformation effect and therefore improve the quality of testimony. These hypotheses were confirmed in both experiments. The efficacy of both the complete and reduced training courses was not statistically different. Additionally, in Experiment 1 the effectiveness of warning against misinformation was replicated: respondents warned about misinformation were more resistant to it than those not warned. The tainted truth effect was also present: people warned against non-existent misinformation had lower correctness in the memory test than non-warned ones. Finally, immediate recall of the content of the original information had no impact on the misinformation effect.

scholarly journals Health Communication for medical students: Progress and Challenges in Public Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Faria de Moura Villela
Keyword(s):  
Public Health ◽  
Medical Students ◽  
Health Services ◽  
Health Communication ◽  
Medical Training ◽  
Communication Strategies ◽  
Effective Communication ◽  
Communication Process ◽  
Physician Relationship

Abstract Introduction Health communication has gained space in medical debates, especially in the public health, since the quality of the communication process, until the context of the patient-physician relationship. The recently inaugurated Medicine courses in Brazil recognize the importance of this interface in the training of medical professionals since the first semester. Methods A questionnaire prepared by professors was applied to medical students from a Brazilian Midwest public university to evaluate their prior knowledge acquired of health communication. Fourteen questions previously prepared were subdivided into three categories. The category chosen for the presentation of these data were: The importance of the study of health communication for Medicine and Public Health. Results Sixty students were interviewed, and 78% of participants assessed the health communication as very important for the medical sciences. 47% say that within the university, this communication is good; 30% consider regular and only 18% feel great. 96% of the students believe that education is the most important factor in determining the quality of health communication process, even when compared with age variables and internet access. The importance of the study of communication to the doctor-patient relationship was considered beneficial, and 74% classified it as essential. Conclusions Thus, we noted that most respondents recognize the importance of health communication in their own training and doctor's relationship with the community. However, it is detected the existence of communication failures in the Brazilian health services, which shows the need for medical training to develop innovative and effective communication strategies in public health. The importance of the study of communication to the patient-physician relationship was considered beneficial, and classified as essential, for medical formation, which reflects in the Brazilian health care system. Key messages Communication failures in the Brazilian health services need attention: it's necessary to develop effective communication strategies in public health. The importance of health communication is recognized in students training and doctor's relationship with the community.

A comparison of quality of life and symptoms in kidney cancer patients receiving sorafenib versus placebo

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4534-4534 ◽  
Author(s):  
R. Dhanda ◽  
K. Gondek ◽  
J. Song ◽  
D. Cella ◽  
R. M. Bukowski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Cancer ◽  
Multiple Comparisons ◽  
Well Being ◽  
Phase Iii ◽  
Completion Rates ◽  
Treatment Difference ◽  
Patient Reported ◽  
The Impact

4534 Background: Results from the Phase III TARGETs study showed that sorafenib significantly prolonged progression-free survival compared with placebo in patients with advanced renal cell carcinoma. Overall survival was longer with sorafenib than placebo with a hazard ratio of 0.72. The impact of sorafenib treatment on health-related quality of life (HRQL) and symptoms was also evaluated. Methods: HRQL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G). Symptoms were measured by the FACT-Kidney Cancer Symptom Index (FKSI), in which patients used a Likert scale (0–4) to respond to each of 15 items. FACT-G and FKSI were administered at baseline, at Day 1 of each cycle, and at end-of-treatment visit. Statistical analyses used a random coefficient model over five cycles, using MSKCC risk and treatment as factors and baseline score and relative days as covariates, adjusted for multiple comparisons with Bonferroni correction. Results: A total of 903 patients were randomized. The FACT-G completion rates at baseline, and Cycles 2, 3, 4, and 5 were; 96%, 91%, 95%, 99%, and 100%, respectively. The FKSI completion rates were; 94%, 89%, 94%, 97%, and 100%, respectively. The completion rate within each patient reported outcome (PRO) measure, across all visits, was 93%. At baseline, there was no between-treatment difference in score for either FACT-G or FKSI. There was no treatment difference after adjusting for multiple comparisons in mean FACT-G total score (p = 0.96) or its domains (physical well-being [p = 0.92]; emotional well-being [p = 0.46]); social well-being [p = 0.75]; functional well-being [p = 0.94]), and no difference in total score of FKSI over time. FKSI single-item analysis showed that sorafenib-treated patients had significantly less symptoms vs placebo (e.g. cough [p < 0.0001], fevers [p = 0.0015], ‘worry that condition will worsen’ [p = 0.0004], shortness of breath [p ≤ 0.0312], and ‘ability to enjoy life’ [p = 0.0119]). Only ‘concern about treatment side-effects’ favored placebo patients (p < 0.0001). Conclusions: Sorafenib demonstrates clinical benefit without adversely impacting overall HRQL, and has a positive impact on individual symptoms. [Table: see text]

A health-related quality-of-life (HRQoL) analysis of pomalidomide + low-dose dexamethasone + daratumumab in relapsed refractory multiple myeloma (RRMM) after lenalidomide treatment.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8025-8025
Author(s):  
Donna Ellen Reece ◽  
Nizar J. Bahlis ◽  
Christy Joy Samaras ◽  
Michael Sebag ◽  
Jesus G. Berdeja ◽  
...  
Keyword(s):  
Low Dose ◽  
Completion Rates ◽  
Health Score ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
The Impact ◽  
Ongoing Phase ◽  
Clinical Trial Information

8025 Background: Treatment (Tx) of RRMM is complex and requires evaluation of disease and patient (pt) factors to maximize efficacy and minimize toxicity. HRQoL has become an important aspect of MM Tx, as survival has improved with therapeutic advances. Results of the ongoing phase 2 MM-014 trial (NCT01946477) have demonstrated that pomalidomide (POM) + low-dose dexamethasone (LoDEX) + daratumumab (DARA) is safe and effective in RRMM pts after first- or second-line lenalidomide (LEN)-based Tx failure. Here we report the impact of this regimen on HRQoL. Methods: RRMM pts with 1 to 2 prior Tx lines, LEN-based Tx as their most recent regimen, and progressive disease during or after their last Tx line received POM + LoDEX + DARA in 28-day cycles (MM-014 cohort B). HRQoL, an exploratory endpoint for cohort B, was assessed via EuroQol’s EQ-5D. Results: As of October 15, 2018, 108 pts were evaluable for HRQoL. Baseline characteristics were similar to those of the ITT population (N = 112). EQ-5D completion rates for each cycle (1-6) were ≥ 88%. Mean change from baseline in the EQ-5D index and VAS health score was stable through 6 Tx cycles. At cycle 6, 28.8% and 39.0% of pts achieved minimum clinically important improvement in the EQ-5D index (≥ 0.1) and VAS health score (≥ 6), respectively. EQ-5D index values were stable, with a trend toward improvement in usual activities, pain/discomfort, and anxiety/depression (Table). Conclusions: In RRMM pts with early-line LEN Tx failure, HRQoL was maintained or trended toward improvement with POM + LoDEX + DARA, despite the combination of 3 drugs with distinct toxicities. These findings further support the earlier use of POM-based Tx in RRMM immediately after LEN failure. Clinical trial information: NCT01946477. [Table: see text]

scholarly journals Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents’ skills training intervention for children with developmental disorders in rural Pakistan: a cluster randomized controlled trial

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Syed Usman Hamdani ◽  
Zill-e- Huma ◽  
Nadia Suleman ◽  
Parveen Akhtar ◽  
Huma Nazir ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Developmental Disorders ◽  
Controlled Trial ◽  
Skills Training ◽  
Health Related Quality ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related ◽  
Cluster Randomized

Abstract Background Globally, there is a large documented gap between needs of families and children with developmental disorders and available services. We adapted the World Health Organization’s mental health Gap-Intervention Guidelines (mhGAP-IG) developmental disorders module into a tablet-based android application to train caregivers of children with developmental disorders. We aimed to evaluate the effectiveness of this technology-assisted, family volunteers delivered, parents’ skills training intervention to improve functioning in children with developmental disorders in a rural community of Rawalpindi, Pakistan. Methods In a single-blinded, cluster randomized controlled trial, 30 clusters were randomised (1:1 ratio) to intervention (n = 15) or enhanced treatment as usual (ETAU) arm (n = 15). After screening, 540 children (18 participants per cluster) aged 2–12 years, with developmental disorders and their primary caregivers were recruited into the trial. Primary outcome was child’s functioning, measured by Childhood Disability Assessment Schedule for Developmental Disorders (DD-CDAS) at 6-months post-intervention. Secondary outcomes were parents’ health related quality of life, caregiver-child joint engagement, socio-emotional well-being of children, family empowerment and stigmatizing experiences. Intention-to-treat analyses were done using mixed-models adjusted for covariates and clusters. Results At 6-months post-intervention, no statistically significant mean difference was observed on DD-CDAS between intervention and ETAU (mean [SD], 47.65 [26.94] vs. 48.72 [28.37], Adjusted Mean Difference (AMD), − 2.63; 95% CI − 6.50 to 1.24). However, parents in the intervention arm, compared to ETAU reported improved health related quality of life (mean [SD] 65.56 [23.25] vs. 62.17 [22.63], AMD 5.28; 95% CI 0.44 to 10.11). The results were non-significant for other secondary outcomes. Conclusions In the relatively short intervention period of 6 months, no improvement in child functioning was observed; but, there were significant improvements in caregivers’ health related quality of life. Further trials with a longer follow-up are recommended to evaluate the impact of intervention. Trial registration Clinicaltrials.gov, NCT02792894. Registered April 4, 2016, https://clinicaltrials.gov/ct2/show/NCT02792894

The Impact of Education Groups for People with Schizophrenia on Social Functioning and Quality of Life

1996 ◽  
Vol 168 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Jacqueline M. Atkinson ◽  
Denise A. Coia ◽  
W. Harper Gilmour ◽  
Janice P. Harper
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Skills Training ◽  
Control Group ◽  
Community Based ◽  
Education Group ◽  
Set Up ◽  
Education Groups ◽  
The Impact

BackgroundEducation groups for people with schizophrenia have tended to concentrate on compliance with medication. This study examines impact on social behaviour and quality of life.MethodA catchment-wide service was set up for community-based patients. Patients who indicated an interest in education groups were randomly allocated to either an education group or a waiting list control group. Those who attended groups were compared with the control group.ResultsAbout one-quarter of community-based patients showed interest in attending education groups. Those who attended showed no change in mental state or compliance with medication (already high) but significant gains in quality of life, social functioning and social networks.ConclusionsFor patients who choose to attend education groups significant gains in social functioning and quality of life are possible without specific skills training.

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