scholarly journals Reducing Death Anxiety: The Impact of Advanced Care Planning

2020 ◽  
Vol 3 ◽  
Author(s):  
Kendra Hollenbeck ◽  
Tom Gutwein
Keyword(s):  
Informed Consent ◽  
Death Anxiety ◽  
Medical Center ◽  
Future Research ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Improve Quality ◽  
Advanced Directives ◽  
The Impact

Background/Objective: Death anxiety affects multiple areas of patient’s physical and mental health. Reducing this phenomenon has the potential to improve quality of end of life (EOL). The effects of spirituality, age, self-esteem, biological sex, presence of symptoms and level of isolation have been previously studied. Advanced care planning (ACP), a simple intervention, which has known positive impacts on quality of EOL by decreasing healthcare costs and undesired hospitalizations, however, only 33% of the population has completed it. This study will examine the correlation between death anxiety and ACP. We hypothesize that there will be a statistically significant lower level of death anxiety in participants with ACP.  Methods: The study population will include patients presenting to the Parkview Regional Medical Center ED who are ≥65, with a sample size of 1,000. We will use a translated and adapted version of the 17 question Likert-type Scale of Death Anxiety; developed and validated by Cai et al. in 2017. It will be presented via REDCap and will include electronic signature of informed consent. Finally, we will include questions about ACP and advanced directives. Participants will also complete a basic demographic survey to account for confounding factors. Analysis will include a Mann Whitney test, univariate and multivariate regressions.   Results: This project resulted in a IRB submission drafts of a study protocol, informed consent, SDA survey and REDCap data collection tool. The researchers are seeking Parkview Health-IRB approval in Fall 2020, with an anticipated study start date of Spring 2021.   Impact: This project has the potential to improve quality of life by decreasing death anxiety and resulting negative stress reactions. Interventions for decreasing death anxiety have not been extensively studied so directions for future research are broad and could include impacts of ACP in varying ages and contexts outside of the ED.  

scholarly journals Evaluating the efficacy of an Advanced Care Planning Program for Health Decisions in patients with advanced heart failure: protocol for a Randomized Clinical Trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Beatriz Sánchez ◽  
Carlos Guijarro ◽  
María Velasco ◽  
María Jesús Vicente ◽  
Miguel Galán ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Decision Making ◽  
Advanced Heart Failure ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Health Decisions ◽  
The Impact

Abstract Background An Advanced Care Planning (ACP) program of health decisions is the result of a process of reflection and relationship-building between the patient, their relatives and health professionals. It is based on respect for patients’ autonomy, involving them in making decisions about their disease in a way that is shared between the medical team, the patient and their relatives. Up until now, the efficacy of an ACP has not been measured in the existing literature, and therefore it is unknown if these programs reach their goal. The main objective of our study is to evaluate the efficacy of an ACP program for decision-making in patients with advanced heart failure (HF) in comparison to usual follow up and care. This objective will be evaluated by the Patient Activation Measure test, which measures the participation and self-management of the patient in decision-making. Secondary objectives: to evaluate the effect of the program on quality of life, to know if the patients wishes expressed through the ACP program are fulfilled, to measure the impact of the program on patients’ caregivers, to determine the satisfaction of patients included in the program and to evaluate the effect on quality of death. Methods Randomized multicentre clinical trial at four hospitals in Madrid. Once they are included in the study, patients’ allocation to groups (control vs intervention) will be made by alternative sampling. ACP will be applied to the intervention group, whereas in the Control Group usual follow-up will be carried out in HF units. All patients will fulfil questionnaires and tests related to the objectives of the study again after a 12-month follow-up period in order to gauge the effect of ACP in patients with advanced HF. Discussion The characteristics of patients with advanced HF make them a model for designing ACP programs, given the high prevalence of this disease, the progressive increase in its incidence and it’s clinical characteristics. Until now, the efficacy of this type of program has not been measured, so this Clinical Trial can provide relevant data for future ACP projects. Trial registration ClinicalTrials.gov Identifier: NCT04424680. Registered 9 June 2020. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04424680?term=NCT04424680&draw=2&rank=1.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

Citizen Deliberation Online

2019 ◽  
pp. 689-712
Author(s):  
Patrícia Rossini ◽  
Jennifer Stromer-Galley
Keyword(s):  
Political Engagement ◽  
Future Research ◽  
The Internet ◽  
Digital Platforms ◽  
The Core ◽  
Political Conversation ◽  
Political Talk ◽  
Citizen Deliberation ◽  
The Impact

Political conversation is at the heart of democratic societies, and it is an important precursor of political engagement. As society has become intertwined with the communication infrastructure of the Internet, we need to understand its uses and the implications of those uses for democracy. This chapter provides an overview of the core topics of scholarly concern around online citizen deliberation, focusing on three key areas of research: the standards of quality of communication and the normative stance on citizen deliberation online; the impact and importance of digital platforms in structuring political talk; and the differences between formal and informal political talk spaces. After providing a critical review of these three major areas of research, we outline directions for future research on online citizen deliberation.

The Effect of Statistics on Enjoyment and Perceived Credibility in Sports Media

2021 ◽  
pp. 216747952199839
Author(s):  
Dustin Hahn
Keyword(s):  
New Media ◽  
Future Research ◽  
Media Industry ◽  
Sports Media ◽  
Perceived Credibility ◽  
Competitive Environments ◽  
Dependent Variables ◽  
Media Source ◽  
The Impact

Evolving media landscapes toward increasingly diverse and competitive environments in both traditional and new media requires producers regularly examine the quality of their productions. One growing line of research identifies the increasing presence and significance of statistics in sports media programming. This experiment measures the effect of statistics on enjoyment and perceived credibility by sport consumers while considering level of fanship, media source, and variations in placement within Instagram posts. Results uncover evidence that validates previous observations about statistics in media while contradicting others. Specifically, findings reveal that statistics enhance enjoyment and improve perceived credibility. Observations were consistent across fanship level. However, additional findings also suggest media source and placement of statistics influences both enjoyment and credibility as well. For both dependent variables, statistics in both the Instagram caption and image yielded significantly greater enjoyment and credibility than some other conditions including posts without statistics at all. The impact of these and other findings on sports media industry and scholarship, along with limitations and directions for future research, are discussed.

scholarly journals Community intervention strategies to reduce the impact of financial strain and promote financial well-being: a comprehensive rapid review

2021 ◽  
Vol 28 (1) ◽  
pp. 42-50
Author(s):  
Nicole M. Glenn ◽  
Lisa Allen Scott ◽  
Teree Hokanson ◽  
Karla Gustafson ◽  
Melissa A. Stoops ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Community Intervention ◽  
Well Being ◽  
Small Sample ◽  
Financial Strain ◽  
Rapid Review ◽  
Research Centre ◽  
Future Research ◽  
The Impact

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May–September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.

scholarly journals Physician beliefs about the impact of meaningful use of the EHR

2014 ◽  
Vol 05 (03) ◽  
pp. 789-801 ◽  
Author(s):  
D.Y. Ting ◽  
M. Healey ◽  
S.R. Lipsitz ◽  
A.S. Karson ◽  
J. S. Einbinder ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Care Physicians ◽  
Meaningful Use ◽  
The United States ◽  
Improve Quality ◽  
Cross Sectional ◽  
Incentive Program ◽  
Physician Beliefs ◽  
The Impact

SummaryBackground: As adoption and use of electronic health records (EHRs) grows in the United States, there is a growing need in the field of applied clinical informatics to evaluate physician perceptions and beliefs about the impact of EHRs. The meaningful use of EHR incentive program provides a suitable context to examine physician beliefs about the impact of EHRs.Objective: Contribute to the sparse literature on physician beliefs about the impact of EHRs in areas such as quality of care, effectiveness of care, and delivery of care.Methods: A cross-sectional online survey of physicians at two academic medical centers (AMCs) in the northeast who were preparing to qualify for the meaningful use of EHR incentive program.Results: Of the 1,797 physicians at both AMCs who were preparing to qualify for the incentive program, 967 completed the survey for an overall response rate of 54%. Only 23% and 27% of physicians agreed or strongly agreed that meaningful use of the EHR will help them improve the care they personally deliver and improve quality of care respectively. Physician specialty was significantly associated with beliefs; e.g., 35% of primary care physicians agreed or strongly agreed that meaningful use will improve quality of care compared to 26% of medical specialists and 21% of surgical specialists (p=0.009). Satisfaction with outpatient EHR was also significantly related to all belief items.Conclusions: Only about a quarter of physicians in our study responded positively that meaningful use of the EHR will improve quality of care and the care they personally provide. These findings are similar to and extend findings from qualitative studies about negative perceptions that physicians hold about the impact of EHRs. Factors outside of the regulatory context, such as physician beliefs, need to be considered in the implementation of the meaningful use of the EHR incentive program.Citation: Emani S, Ting DY, Healey M, Lipsitz SR, Karson AS, Einbinder JS, Leinen L, Suric V, Bates DW. Physician beliefs about the impact of meaningful use of the EHR: A cross-sectional study. Appl Clin Inf 2014; 5: 789–801http://dx.doi.org/10.4338/ACI-2014-05-RA-0050

scholarly journals Reduction in Endometrioma Size with Three Months of Aromatase Inhibition and Progestin Add-Back

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sanjay K. Agarwal ◽  
Warren G. Foster
Keyword(s):  
Cohort Study ◽  
Informed Consent ◽  
Pelvic Pain ◽  
Prospective Cohort ◽  
Medical Center ◽  
High Dose ◽  
Aromatase Inhibition ◽  
Ovarian Endometrioma ◽  
The Impact ◽  
Norethindrone Acetate

The purpose of this study was to assess the impact of 3 months of aromatase inhibition together with progestin add-back on ovarian endometrioma size. This prospective cohort study was performed at University Medical Center (UC San Diego). Women trying to conceive were excluded. After informed consent, all women were treated with the aromatase inhibitor letrozole (5 mg/d) with norethindrone acetate (5 mg/d) add-back for 3 months. Pre- and posttreatment assessments of endometrioma sizes were performed by ultrasound. The impact of treatment on pain was determined using the patient assessed endpoints of the Biberoglu and Behrman scale. These included assessing dysmenorrhea, dyspareunia, and nonmenstrual pelvic pain each on a scale from 0 to 3. The primary endpoint of this study was the change in ultrasound documented endometrioma size. Fourteen endometriomas in 8 consecutive women were treated for 3 m. Mean endometrioma diameter decreased 50% from 4.6 ± 1.6 cm to 2.3 ± 1.6 cm (mean ± SD). This represents a 75% decrease in endometrioma volume. Endometriosis symptoms of dysmenorrhea, dyspareunia, and nonmenstrual pelvic pain also improved with treatment. In conclusion, a 3-month course of high dose aromatase inhibition with progestin add-back significantly reduces ovarian endometrioma size and warrants further investigation.

scholarly journals An Examination of Individualism within Employee Help-Seeking Networks

2018 ◽  
Vol 8 (4) ◽  
pp. 1
Author(s):  
Randall P. Settoon ◽  
Sang H. Lee
Keyword(s):  
Help Seeking ◽  
Medical Center ◽  
Future Research ◽  
Dense Networks ◽  
Helping Others ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Impact ◽  
The Relationship

Prior research focusing on the impact of individualistic orientations on the performance of cooperative behaviors has produced mixed results. Researchers have concluded that the self-focused orientation of individualists will lead them to be less cooperative than others. On the other hand, some scholars have argued that helping others is core to individualists’ self-concept and that competently assuming the role of help-giver is a source of intrinsic satisfaction. In this study, we test this proposition by examining individualistic orientations within employee help-seeking networks. Results from a sample of 107 employees within a regional medical center indicate that the level of individualism in helping-seeking networks is positively associated with help-seekers’ perceptions of support. Further, the results suggest that the relationship is stronger in dense networks. Implications of this work and directions for future research are discussed.

scholarly journals Latinxs with HIV: Depressive Cognitive Alterations as a Precursor to Cardio-Motor Deficits

2021 ◽  
Vol 10 (2) ◽  
pp. 10-22
Author(s):  
Aneesah Hyder ◽  
Martin Rosario
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Health ◽  
Future Research ◽  
Motor Deficits ◽  
Cultural Challenges ◽  
Cardiovascular Assessment ◽  
Health Related ◽  
The Impact ◽  
Cognitive Alterations

HIV is a debilitating infection that often presents with health-related complications, further reducing quality of life. Of the most common comorbidities accompanying HIV is depression, which can induce cognitive alterations alongside those resulting from the virus. Latinxs are disproportionately susceptible to both afflictions and face innumerable challenges in the identification and diagnosis of depression. Consequently, HIV-infected Latinxs may experience additional cognitive symptomatology from the simultaneous prevalence of depression and HIV, potentially affecting their gait and cardiovascular profiles. This study aimed to determine the impact of depression on cardio-motor components in HIV-infected Latinxs. Records of 291 stable HIV+ participants were collected from La Perla de Gran Precio Community Center, analyzed for depression, and respectively allocated to the depression group (70) and the group without depression (221). Cardio-motor values were obtained by conducting the Ross treadmill test, a submaximal cardiovascular assessment. An ANOVA revealed similarities in cardiomotor profiles between groups, alluding to the absence of depression-induced modifications to gait and cardiovascular health. Community exercise and cardiopulmonary intervention programs are beneficial to the quality of life in this population during all stages of HIV. However, HIV-infected Latinxs with depression face acute cultural challenges, causing diagnoses and treatment oversights and deficiencies for those who are suffering. Public health efforts should aim to remove barriers facing this population to ultimately reduce the inflated prevalence of both afflictions. Future research should focus on the crucial differentiation of Latinx depressive symptoms from those identical in HIV prior to reinvestigating cardiomotor alterations.

scholarly journals Entrepreneurial Innovation: the European Union perspective

2018 ◽  
Vol 18 (2) ◽  
pp. 137-154 ◽  
Author(s):  
Augustin Ignatov
Keyword(s):  
European Union ◽  
Future Research ◽  
The European Union ◽  
Business Innovation ◽  
The North ◽  
Quantitative Analyses ◽  
Entrepreneurial Innovation ◽  
Entrepreneurial Activities ◽  
The Impact

Abstract Entrepreneurship is the driving force of economic development and progress. A successful state, first of all, provides favourable conditions motivating the businesses to grow and flourish. Presently, the European Union is developing unevenly with multiple economic misbalances across the community, the West and the North being more competitive than the South and the East. The aim of the present research is to examine the framework of interdependence between the degree to which the governance quality and economic freedom in the European Union are supporting entrepreneurial activities and the performance of the community in terms of entrepreneurial innovation. The results reached through applying both qualitative and quantitative analyses show that the interdependence between entrepreneurial innovation and regulatory efficiency is strong for many of the European Union states which is determined by multiple factors including the institutional and economic ones. Also, the present paper underlines the importance of the proper regulatory framework for the efficient development of business innovation. The future research on this matter could consider in depth the impact of socio-cultural environment, its influence on the quality of governance and the impact of both upon the European entrepreneurial innovation.

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