scholarly journals Communication Problems in Cases Addressed by Clinical Ethics Conferences

JAHR ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 9-17
Author(s):  
Motomu Shimoda
Keyword(s):  
Clinical Setting ◽  
Clinical Ethics ◽  
Basic Concept ◽  
Family Members ◽  
Care Providers ◽  
Care Policy ◽  
Communication Problems ◽  
Coping Process ◽  
Or Practice ◽  
The Relationship

In the clinical ethics conference, individual cases are examined as problems to be addressed in a clinical setting. Various types of conflict over care policy are found in each case among the persons concerned–patients, their family members, and care providers–caused by differences of concept or practice of care, basic values, etc. Since these conflicts mostly arise in the form of communication problems, this article classifies some patterns of conversation model, analyzes the structure of the relationship among those concerned, and considers major points. By focusing on the mechanism of individual communication problems, a basic concept of the coping process is proposed.

scholarly journals Stories of Dependency and Power: The Value of Live-In Elder Care in Israel

2020 ◽  
Vol 6 ◽  
pp. 237802311989320 ◽  
Author(s):  
Shiri Regev-Messalem
Keyword(s):  
Minimum Wage ◽  
Power Relations ◽  
Elder Care ◽  
Family Members ◽  
Care Work ◽  
Elderly Persons ◽  
Care Providers ◽  
Empirical Examination ◽  
Monetary Value ◽  
The Relationship

This article offers a qualitative empirical examination of the ways in which Israeli family members of elderly persons evaluate live-in elder care and translate their evaluations into monetary value. The author explores the relationship between family members’ views of appropriate wages for live-in elder care providers and their perceptions of their own power relations with their parents’ caregivers. The findings demonstrate that family members who perceive such power to be held one-sidedly, either by themselves or by their caregivers, also argue that the state’s minimum wage is appropriate for the work of caregiving. The findings also establish that family members who recognize codependence in their relationships with caregivers believe that live-in caregivers should receive a wage much higher than the minimum. Exposing the convoluted relationship between perceptions of power and perceptions of value in live-in care shifts our understanding of the possible mechanisms that shape the low monetary value assigned to care work.

Perceived Effectiveness of Artificial Intelligence based Decision Support System in a Clinical Setting: A Systematic Literature Review (Preprint)

2020 ◽  
Author(s):  
Avishek Choudhury
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Decision Support ◽  
Literature Review ◽  
Decision Support System ◽  
Support System ◽  
Clinical Setting ◽  
Clinical Decision Making ◽  
Theoretical Perspective ◽  
Care Providers

UNSTRUCTURED Objective: The potential benefits of artificial intelligence based decision support system (AI-DSS) from a theoretical perspective are well documented and perceived by researchers but there is a lack of evidence showing its influence on routine clinical practice and how its perceived by care providers. Since the effectiveness of AI systems depends on data quality, implementation, and interpretation. The purpose of this literature review is to analyze the effectiveness of AI-DSS in clinical setting and understand its influence on clinician’s decision making outcome. Materials and Methods: This review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta- Analyses reporting guidelines. Literature will be identified using a multi-database search strategy developed in consultation with a librarian. The proposed screening process consists of a title and abstract scan, followed by a full-text review by two reviewers to determine the eligibility of articles. Studies outlining application of AI based decision support system in a clinical setting and its impact on clinician’s decision making, will be included. A tabular synthesis of the general study details will be provided, as well as a narrative synthesis of the extracted data, organised into themes. Studies solely reporting AI accuracy an but not implemented in a clinical setting to measure its influence on clinical decision making were excluded from further review. Results: We identified 8 eligible studies that implemented AI-DSS in a clinical setting to facilitate decisions concerning prostate cancer, post traumatic stress disorder, cardiac ailment, back pain, and others. Five (62.50%) out of 8 studies reported positive outcome of AI-DSS. Conclusion: The systematic review indicated that AI-enabled decision support systems, when implemented in a clinical setting and used by clinicians might not ensure enhanced decision making. However, there are very limited studies to confirm the claim that AI based decision support system can uplift clinicians decision making abilities.

P25 The relationship between ARV drug levels, drug resistance, adherence and treatment failure in a routine clinical setting

HIV Medicine ◽  
2000 ◽  
Vol 1 (3) ◽  
pp. 180-180
Author(s):  
J Lloyd ◽  
C Sabin ◽  
D Pillay ◽  
T Jones ◽  
P Hoggard ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Failure ◽  
Clinical Setting ◽  
Drug Levels ◽  
Routine Clinical Setting ◽  
The Relationship

scholarly journals Influence of chronotype on daily mood fluctuations: pilot study in patients with depression

BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Konstantin F. Brückmann ◽  
Jürgen Hennig ◽  
Matthias J. Müller ◽  
Stanislava Fockenberg ◽  
Anne-Marthe Schmidt ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pilot Study ◽  
Negative Affect ◽  
Clinical Setting ◽  
Early Morning ◽  
Healthy Controls ◽  
Patient Subgroup ◽  
Depression Risk ◽  
Gender And Age ◽  
The Relationship

Summary Depression risk is associated with a late chronotype pattern often described as an ‘evening chronotype’. Fluctuations in mood over consecutive days have not yet been measured according to chronotype in in-patients with depression. A total of 30 in-patients with depression and 32 healthy controls matched for gender and age completed a chronotype questionnaire and twice-daily ratings on mood for 10 consecutive days (registered in the German Clinical Trials Register: DRKS00010215). The in-patients had Saturdays and Sundays as hospital-leave days. The relationship between chronotype and daily mood was mediated by the weekday–weekend schedule with higher levels of negative affect in the evening-chronotype patient subgroup at weekends. Results are discussed with respect to a probably advantageous standardised clinical setting with early morning routines, especially for patients with evening chronotypes.

scholarly journals Families' perception, knowledge, and psychological stressors associated with transition of care from the intensive care unit

2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Family Members ◽  
Expected Improvement ◽  
Transition Of Care ◽  
Care Providers ◽  
Icu Discharge ◽  
Family Perceptions

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.

scholarly journals Colorectal cancer screening behaviors of general surgeons and first-degree family members: a survey-based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Hasan Gorkem Cay ◽  
Ersin Bayrakdar ◽  
Aysima Ince ◽  
Esra Nur Ince ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Family Members ◽  
High Volume ◽  
Routine Screening ◽  
Care Providers ◽  
Crc Screening ◽  
First Degree Relatives ◽  
General Surgeons ◽  
Low Volume ◽  
Screening Behaviors

Abstract Background Colorectal cancer (CRC) screening rates are low in the general population and among health care providers. The aim of this study was to evaluate the CRC screening practices of general surgeons who provide specialized diagnostic testing and CRC treatment and to examine the CRC screening behaviors of their first-degree family members. Methods A cross-sectional survey was conducted among general surgeons who attended the 21st National Surgical Congress in Turkey held from April 11th to 15th, 2018. The survey included items on demographics, screening-related attitude, CRC screening options, barriers to CRC screening, and surgeons’ annual volumes of CRC cases. Results A total of 530 respondents completed the survey. Almost one-third of the responding surgeons (29.4%, n = 156) were aged over 50 years, among whom approximately half (47.1%, n = 74) reported having undergone CRC screening and preferring a colonoscopy as the screening modality (78.4%). Among general surgeons aged 50 years and older, high-volume surgeons (≥25 CRC cases per year) were more likely to undergo screening compared with low-volume surgeons (< 25 CRC cases per year). The respondents aged below 50 years reported that 56.1% (n = 210) of their first-degree relatives were up-to-date with CRC screening, mostly with colonoscopy. Compared to low-volume surgeons aged below 50 years, high-volume surgeons’ first-degree relatives were more likely to be up-to-date with CRC screening. Conclusion The survey results demonstrated that routine screening for CRC among surgeons and/or their first-degree relatives is currently not performed at the desired level. However, high-volume surgeons are more likely to participate in routine screening.

Effect of older adults in the family on the sandwich generation's pursuit of entrepreneurship: evidence from China

2021 ◽  
pp. 1-20
Author(s):  
Yiwei Liu ◽  
Wenjing Wang ◽  
Zhen Cong ◽  
Zhirui Chen
Keyword(s):  
Older Adults ◽  
Family Members ◽  
Mediating Effect ◽  
Entrepreneurial Activity ◽  
Basic Unit ◽  
Instrumental Support ◽  
Middle Aged ◽  
Social Wellbeing ◽  
The Relationship ◽  
Elderly Family

Abstract Household entrepreneurship is a basic unit of entrepreneurial activity, and a crucial aspect of connecting personal and social wellbeing. This study examines the relationship between the proportion of elderly family members and household entrepreneurship. This study also assesses the mediating effect of the middle-aged generation's support to their parents and the moderating effect of the parents’ support with respect to the proportion of elderly family members and entrepreneurship. We use data from the China Family Panel Studies. We adopt the instrumental variable method to deal with endogeneity, robustness and credibility of the estimation results. The results show that a higher proportion of elderly family members impedes household entrepreneurship. Moreover, the financial and instrumental support provided by the middle-aged generation to their parents significantly mediates the relationship between the proportion of elderly family members and household entrepreneurship. In turn, parents’ financial support to the middle-aged generation moderates the focal relationship; however, parents’ instrumental support does not moderate the focal relationship. These findings emphasise the need to develop a comprehensive social security network for older adults that will indirectly promote household entrepreneurship, and improve personal and social wellbeing.

Addressing Mistreatment of Providers by Patients and Family Members as a Patient Safety Event

2021 ◽  
Author(s):  
Marianne Hatfield ◽  
Rebecca Ciaburri ◽  
Henna Shaikh ◽  
Kirsten M. Wilkins ◽  
Kurt Bjorkman ◽  
...  
Keyword(s):  
Patient Safety ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Tertiary Care ◽  
Family Members ◽  
Incident Reporting ◽  
Care Providers ◽  
Cross Sectional ◽  
Offensive Behavior ◽  
Safety Incident

OBJECTIVE: Mistreatment of health care providers (HCPs) is associated with burnout and lower-quality patient care, but mistreatment by patients and family members is underreported. We hypothesized that an organizational strategy that includes training, safety incident reporting, and a response protocol would increase HCP knowledge, self-efficacy, and reporting of mistreatment. METHODS: In this single-center, serial, cross-sectional study, we sent an anonymous survey to HCPs before and after the intervention at a 213-bed tertiary care university children’s hospital between 2018 and 2019. We used multivariable logistic regression to examine the effect of training on the outcomes of interest and whether this association was moderated by staff role. RESULTS: We received 309 baseline surveys from 72 faculty, 191 nurses, and 46 residents, representing 39.1%, 27.1%, and 59.7%, respectively, of eligible HCPs. Verbal threats from patients or family members were reported by 214 (69.5%) HCPs. Offensive behavior was most commonly based on provider age (85, 28.5%), gender (85, 28.5%), ethnicity or race (55, 18.5%), and appearance (43, 14.6%) but varied by role. HCPs who received training had a higher odds of reporting knowledge, self-efficacy, and experiencing offensive behavior. Incident reporting of mistreatment increased threefold after the intervention. CONCLUSIONS: We report an effective organizational approach to address mistreatment of HCPs by patients and family members. Our approach capitalizes on existing patient safety culture and systems that can be adopted by other institutions to address all forms of mistreatment, including those committed by other HCPs.

Exploring Psychosocial Determinants of Diversity Sensitive Task Perception and Behavioural Intentions in a Health Care Student Population: Recommendations for Diversity Education in Health Care

2021 ◽  
Author(s):  
Laura Van Raemdonck ◽  
Stijn Schelfhout ◽  
Wendelien Vantieghem ◽  
Riya George ◽  
Stéphanie De Maesschalck ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Student Population ◽  
Diversity Education ◽  
Care Providers ◽  
Psychosocial Determinants ◽  
Health Care Students ◽  
Behavioural Intentions ◽  
Task Perception ◽  
The Relationship

Abstract Background: Diversity sensitive task perception and diversity sensitive behavioural intentions are strong predictors of diversity sensitive care. Nevertheless, it has been less clear which psychosocial determinants are affecting these concepts in health care providers. This article also explores whether there are differences in relationships between these concepts, and how these concepts are interrelated. The study focussed on the following psychosocial determinants: (a) ethnocentric attitudes and (b) intercultural capabilities. The latter concept is drawn from the four-dimensional construct of intercultural intelligence. Methods: A survey was conducted in a health care student population (N = 364). In addition to classic survey questions, behavioural intentions were measured through the use of eight vignettes comprising situations characterised by diversity in health care. Results: Regression analyses show that ethnocentric attitudes were negatively associated with diversity sensitive task perception and behavioural intentions. Interestingly, we found no significant relationship between cognitive intercultural capabilities (IC) and diversity sensitivity. Motivational- and behavioural intercultural capabilities were significantly associated with diversity sensitive task perception and behavioural intentions. Motivational IC had a stronger relationship with task perception. Behavioural IC had a stronger relationship with behavioural intentions. Adding diversity sensitive task perception in a supplementary regression model as an independent variable on behavioural intentions caused a shift in associations. The significant association between motivational IC and behavioural intentions disappeared, and a significant association between diversity sensitive task perception and diversity sensitive behavioural intention appeared. Conclusion: Diversity education should increasingly focus on diminishing ethnocentric attitudes and encouraging behavioural IC and motivational IC in health care students. The paper also suggests two theoretical hypothesises. Firstly, metacognitive IC is a concept strongly related to two IC: motivational IC and behavioural IC. Secondly, the relationship between motivational IC and behavioural intentions is fully mediated by diversity sensitive task perception. Further research that substantiate these theoretical hypothesises is recommended.

Family succession, professionalization and internationalization: a study of Brazilian family businesses

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Augusto Dalmoro Costa ◽  
Aurora Carneiro Zen ◽  
Everson dos Santos Spindler
Keyword(s):  
Family Business ◽  
Family Members ◽  
Secondary Data ◽  
Family Businesses ◽  
Three Dimensions ◽  
Content Type ◽  
The Family ◽  
Two Generations ◽  
Internationalization Strategies ◽  
The Relationship

PurposeThe purpose of this paper is to investigate the relationship between family succession, professionalization and internationalization in family businesses within the Brazilian context.Design/methodology/approachThe paper presents a multiple-case study method with three Brazilian family businesses that have at least two generations of the owning family involved in the business and an international presence of at least three years. In-depth interviews and secondary data were undertaken with family and non-family members of each case.FindingsThe authors' results show that a family business can boost its internationalization by introducing both succession planning and professionalization on international activities. As family members tend to be more risk-averse and focused on keeping the family business within the family, professionalization is a way of improving the firm's ability to expand internationally. This process tends to lead to lower performance by the firm for the first few months or the first year after the investment, but afterward, international performance tends to grow exponentially.Originality/valueOnly a few studies have been concerned on the relationship of these three dimensions. Thus, the research takes into account that professionalization and succession lead family businesses to improve their internationalization strategies.

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