scholarly journals Communication as a Key Issue in the Care of Diabetes Mellitus

2015 ◽  
Vol 22 (3) ◽  
pp. 305-310
Author(s):  
Elena-Daniela Grigorescu ◽  
Cristina Mihaela Lăcătuşu ◽  
Gina Eosefina Botnariu ◽  
Raluca Maria Popescu ◽  
Alina Delia Popa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Modern Medicine ◽  
Therapeutic Education ◽  
Communicative Interaction ◽  
Patient Centered ◽  
Patient’S Satisfaction ◽  
Communication Techniques ◽  
Physician Patient ◽  
The Impact

Abstract The physician-patient communication has an essential role in establishing and supporting the relationship between these two partners. Moreover, modern medicine highlights the patient-centered approach. Publications assessing the impact of an efficient physicianpatient communication on medical care results in diseases such as diabetes and hypertension have revealed a positive correlation between patient’s satisfaction about the communication with the physician and values of blood pressure, glycated hemoglobin and pain intensity. Interventions needed in both doctors and patients for developing communication abilities were paid special attention in order to achieve an appropriate improvement in their communicative interaction during periodical appointments. In the field of diabetes mellitus, the medical challenge is to improve patients’ knowledge about medical care; this aim is achieved only by therapeutic education, using high-quality communication techniques.

scholarly journals Bioethical aspects of robotics in surgery

JAHR ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 127-137
Author(s):  
Elena Vvedenskaya
Keyword(s):  
Radical Change ◽  
Modern Medicine ◽  
Type Model ◽  
Physician Patient Relationship ◽  
Routine Tasks ◽  
Patient Will ◽  
The One ◽  
Physician Patient ◽  
The Impact ◽  
The Relationship

The article discusses the bioethical aspects of robotics in surgery and assesses the impact of this process on the relationship between the physician and the patient. An engineering model is gradually replacing the traditional paternalistic model of the physician-patient relationship. If paternalism implies the doctor’s attitude to the patient as his sick child, which requires compassion, help, and great responsibility on the part of the doctor, then when implementing the second model, the doctor, like a technical executor, performs only the responsibilities provided by the job description. On the one hand, the dominance of a technical-type model carries the threat of depersonalizing the patient and eliminating contact between the physician and the patient. On the other hand, this contributes to a radical change in the concept of medicine. Why people usually go to doctors? For establishing a diagnosis, prescribing a course of treatment, a prescription, and performing medical manipulations? Machines, leaving a human with a completely different role in the relationship between the physician and the patient, will increasingly perform these actions. The release of doctors from routine tasks will allow them to pay more attention to patient care, fully demonstrating their human qualities. The article analyzes the surgeon’s place in modern medicine and makes an attempt to determine which category the surgery belongs to, “machine territory” or “human territory”.

Spirituality, Resistance, and Modern Medicine

2017 ◽  
Author(s):  
Jonathan B. Imber
Keyword(s):  
Health Care ◽  
Modern Medicine ◽  
Clinical Encounter ◽  
Systemic Reform ◽  
Public Attention ◽  
Patient Centered ◽  
Medical Encounter ◽  
Health Care Professions ◽  
Patients Experience ◽  
Physician Patient

This is an account of the enduring nature of tensions between patient-centered and social, now global, analyses that reflect the principal interests of sociologists in medicine and the health care professions. System-wide critiques have received the greatest public attention, but at the same time patient-focused accounts of physician-patient interactions offered new ways to account for problems of communication in the medical encounter. The system-wide critiques have increased over the decades, and the systemic reform of health care has become among the most politically controversial subjects in American life. But these debates conceal more than they reveal about transformations in the ways that the clinical encounter has been scrutinized and challenged by a focus on how patients experience illness and how doctors and nurses recognize their responsibilities toward culturally and religiously diverse populations.

The patient-centered medical home as an intervention strategy for diabetes mellitus: A systematic review of the literature

2020 ◽  
Vol 16 ◽  
Author(s):  
Lisa S. McManus ◽  
Karen A. Dominguez-Cancino ◽  
Michele K. Stanek ◽  
Juan. M. LeyvaMoral ◽  
Carola E. Bravo-Tare ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Care Coordination ◽  
Medical Home ◽  
Health Care Expenditures ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Team Based Care ◽  
The Impact

Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impact health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering teambased care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in delivering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes. Objective: To review the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understand the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health related outcomes. Method: The systematic review was performed according to the Cochrane method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systematically searched for articles. The Oxford Centre for Evidence-based Medicine levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies. Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care management resulted in more screenings and better preventive care. Pharmacy-led interventions and technology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions. Conclusion : The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as universal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes.

scholarly journals Toward Patient-Centered Cancer Care: Patient Perceptions of Problematic Events, Impact, and Response

2012 ◽  
Vol 30 (15) ◽  
pp. 1784-1790 ◽  
Author(s):  
Kathleen M. Mazor ◽  
Douglas W. Roblin ◽  
Sarah M. Greene ◽  
Celeste A. Lemay ◽  
Cassandra L. Firneno ◽  
...  
Keyword(s):  
Medical Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Information Exchange ◽  
Health Care Systems ◽  
Care Patient ◽  
Physician Patient Relationship ◽  
Patient Centered ◽  
Delay In Diagnosis ◽  
The Impact

Purpose Cancer treatments are complex, involving multiple clinicians, toxic therapies, and uncertain outcomes. Consequently, patients are vulnerable when breakdowns in care occur. This study explored cancer patients' perceptions of preventable, harmful events; the impact of these events; and interactions with clinicians after such events. Patients and Methods In-depth telephone interviews were conducted with cancer patients from three clinical sites. Patients were eligible if they believed: something “went wrong” during their cancer care; the event could have been prevented; and the event caused, or could have caused, significant harm. Interviews focused on patients' perceptions of the event, its impact, and clinicians' responses to the event. Results Ninety-three of 416 patients queried believed something had gone wrong in their care that was preventable and caused or could have caused harm. Seventy-eight patients completed interviews. Of those interviewed, 28% described a problem with medical care, such as a delay in diagnosis or treatment; 47% described a communication problem, including problems with information exchange or manner; and 24% described problems with both medical care and communication. Perceived harms included physical and emotional harm, disruption of life, effect on family members, damaged physician-patient relationship, and financial expense. Few clinicians initiated discussion of the problematic events. Most patients did not formally report their concerns. Conclusion Cancer patients who believe they experienced a preventable, harmful event during their cancer diagnosis or care often do not formally report their concerns. Systems are needed to encourage patients to report such events and to help physicians and health care systems respond effectively.

scholarly journals Design of Therapeutic Education Workshops for Home Heamodialysis in a Patient-Centered CKD Research: A Qualitative Study

2021 ◽  
Author(s):  
Abdallah. Guerraoui ◽  
Roula. Galland ◽  
Flora Belkahla-Delabruyere ◽  
Odile Didier ◽  
Veronique. Berger ◽  
...  
Keyword(s):  
Family Environment ◽  
Therapeutic Education ◽  
Structured Interviews ◽  
Patient Centered ◽  
Home Dialysis ◽  
Patient’S Experience ◽  
Education Workshop ◽  
Choice Of Treatment ◽  
The Impact

Abstract Rationale & Objective: A quarter of the patients did not receive any information on any modality before the start of Renal Remplacement Therapy (RRT). We have therapeutic education workshops for all RRT except for home heamodialysis (HHD). We aimed to identify and describe the needs of patients and caregivers for RRT with HHD. Lastly, to conceive and carry out a Therapeutic Education Workshop. Setting & Participants: Two sequential methods of qualitative data collection were undertaken: (1) interviews with a patient who had been on HHD and a doctor specialized in HHD (2) semi-structured interviews with HHD patients in our center. Analytic Approach: Thematic analysis. Results: We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) HHD allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-treatment experience - Impact on life, and (6) factors that impact the choice of treatment with HHD.We designed a model for a therapeutic education workshop in a group of patients and caregivers. . Conclusions: Our study confirmed previous results obtained about the major barriers, facilitators, and potential solutions to HHD. There are three important points regarding HHD: (1) the impact of the HHD on the caregiver, (2) the experience of patients already treated with HHD, and (3) the role of nurses and nephrologists in informing and educating. A program to develop patient-to-patient peer mentorship, allowing patients to discuss their dialysis experience, would be invaluable.

Are Poor Families Satisfied With the Medical Care Their Children Receive?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 66-70
Author(s):  
David L. Wood ◽  
Chris Corey ◽  
Howard E. Freeman ◽  
Martin F. Shapiro
Keyword(s):  
Medical Care ◽  
Educational Interventions ◽  
Patient Communication ◽  
The Poor ◽  
Poor Families ◽  
Physician Patient Communication ◽  
Nationally Representative ◽  
Physician Patient ◽  
The Impact

While access to care has been shown to be worse for poor populations, few studies have examined the quality of care received by the poor vs the nonpoor. Furthermore, serious concerns have been raised about the impact of cost-containment efforts on the quality of health care for both the poor and nonpoor. The authors examine the interpersonal quality of medical care received by children from poor and nonpoor families by assessing parental satisfaction with physician-patient communication in a telephone survey of a nationally representative sample of households containing 2182 children and adolescents 17 years or younger. The majority of parents were satisfied with many aspects of their interactions with physicians. However, poor families were more likely to be not completely satisfied with the medical care their children received at their last health visit than nonpoor families (27% vs 12%, P < .001). With regard to specific aspects of the physician-patient communication, poor families were more likely to be not satisfied with the physician's provision of information about the illness (40% vs 21%, P > .001); the physician's discussion of examination findings (21% vs 9%, P < .001); and the opportunity provided by the physician to express their concerns (12% vs 6%, P < .001). Logistic regression demonstrated that poor patients were approximately twice as likely to be not satisfied with the medical encounter and with various aspects of their communication with the physician. It is concluded that the parents of poor children are less satisfied with their care. Both policy and educational interventions may be needed to address this problem.

scholarly journals Patients' perspectives on how to improve diabetes self-management and medical care: a qualitative study

2018 ◽  
Author(s):  
Ruth Ndjaboue ◽  
Selma Chipenda Dansokho ◽  
Maman Joyce Dogba ◽  
Bianca Boudreault ◽  
Roberta Price ◽  
...  
Keyword(s):  
Medical Care ◽  
Lived Experience ◽  
Diabetes Care ◽  
Health Professionals ◽  
Research Network ◽  
Self Management ◽  
Framework Analysis ◽  
Patient Centered ◽  
The Impact ◽  
Expert Patients

Background: The experience of living with a chronic disease such as diabetes can provide valuable knowledge about medical care and self-management. Such knowledge may be of use to people seeking to improve diabetes self-management and to health professionals seeking to provide better patient-centered care.Objective: To identify potential areas for improvement in diabetes care from the perspectives of people living with diabetes and their caregivers.Methods: We interviewed 21 people living with diabetes (hereafter called expert patients) who were patient partners in a national Patient-Oriented Research network. Expert patients were men and women from various backgrounds, including Indigenous people and immigrants to Canada. They had significant lived experience of diabetes and were able to offer diverse patient and caregiver perspectives. Three authors independently analyzed videos using inductive framework analysis, identifying themes through discussion and consensus. Results: From expert patients’ perspective, people living with diabetes benefit from acknowledging and accepting the reality of diabetes, receiving support from their family and care team, and not letting diabetes control their lives. To improve diabetes care, health professionals should understand and acknowledge the impact of diabetes on patients and their families, and communicate with patients openly, respectfully, with empathy and cultural competency. Conclusions: From the perspectives of expert patients, there are areas for improvements in diabetes care. These improvements are actionable individually by patients or health professionals and also collectively through collaboration between both groups. Improving the quality of care in diabetes is crucial for improving health outcomes in Canada.

What future for therapeutic education (TE)?

2020 ◽  
Vol 23 (2) ◽  
pp. 111
Author(s):  
Riccio, M.
Keyword(s):  
Diabetes Mellitus ◽  
Progressive Failure ◽  
Educational Interventions ◽  
Modern Medicine ◽  
Therapeutic Education ◽  
Healthcare Facilities ◽  
Digital World ◽  
Exponential Increase

The exponential increase in cases of type 2 diabetes mellitus (T2DM), particularly in developing countries, is combined with the progressive failure of healthcare facilities to provide adequate assistance. The role of Therapeutic Education (TE) in the treatment of T2DM has long been certified. However, despite efforts to implement educational interventions, these have proved to be largely insufficient in meeting current needs. Diabetology – like modern medicine – has therefore been looking into digitization as a possible solution. The increasingly widespread diffusion of the Network and the means for accessing it have in fact triggered a full-fledged race to computerization, a growth that is not always consistent. TE could not get away from these new circumstances. The digital world offers opportunities for reviewing and updating TE without denying or replacing its recent and prestigious past. This new way of doing TE, however, requires attention and new skills to be acquired and tested extensively. KEY WORDS therapeutic education; health literacy; digital therapeutic education; video; social media.

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