scholarly journals Effects of Clinic First Educational Interventions on Resident Wellness and Engagement

2020 ◽  
Vol 52 (6) ◽  
pp. 422-426
Author(s):  
Holly Hofkamp ◽  
Alex Verdieck ◽  
Anthony Cheng ◽  
NithyaPriya Ramalingam ◽  
Rebecca Rdesinski ◽  
...  
Keyword(s):  
Family Medicine ◽  
Residency Program ◽  
Structural Changes ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Dysfunctional Family ◽  
Oregon Health ◽  
Resident Wellness ◽  
Training Clinics

Background and Objectives: Tensions between clinical and hospital training, along with dysfunctional family medicine training clinics, have resulted in continuity clinic being the least favorite part of training for some residents. These factors are all contributors to burnout. We hypothesized that following Clinic First action steps to prioritize and enhance outpatient clinic would positively affect resident wellness and clinic engagement. This study describes our interventions and their effects within the Oregon Health & Science University (OHSU) Family Medicine 4-year Portland residency program. Methods: In July 2017 the Oregon Health & Science University Family Medicine Portland residency program implemented scheduling and curricular interventions inspired by the Clinic First model. We conducted a mixed-methods cross-sectional study using focus groups and surveys to understand the effects of these interventions on resident wellness and engagement. Results: Clinic First-inspired interventions, particularly a 2+2 scheduling model, decreased transitions within the day, and a clinic immersion month were associated with improved residents’ perception of wellness. These interventions had variable effects on clinic engagement. Eighty-eight percent of interns surveyed about the month-long clinic orientation in the beginning of residency reported that they felt prepared managing continuity patients in the clinic setting and their upcoming rotations. Conclusions: This study demonstrates that Clinic First-inspired structural changes can be associated with improvement in resident perceptions of wellness and aspects of clinic engagement. This can give educators a sense of hope as well as tangible steps to take to improve these difficult and important issues.

Perceptions of Final Year Medical Students about Family Medicine as A Career Choice in Pakistan

2020 ◽  
Author(s):  
Dur-e- Nishat
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical Profession ◽  
Healthcare Services ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Chi Square Test

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices

2020 ◽  
Vol 41 (1) ◽  
pp. 51-59
Author(s):  
Gisèle Diendéré ◽  
Imen Farhat ◽  
Holly Witteman ◽  
Ruth Ndjaboue
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Risk Communication ◽  
Shared Decision Making ◽  
Cross Sectional Study ◽  
Clinical Encounter ◽  
Values Clarification ◽  
Shared Decision ◽  
Cross Sectional ◽  
Medical Consultations

Background Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients’ and observers’ ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. Methods In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item “observing patient involvement” score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Results Agreement was low between observers’ and patients’ ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers’ ratings using RCVC-observer were correlated to patients’ ratings using either SDM-Q9 ( rpb = −0.16; P = 0.01) or RCVC-patients ( rpb = 0.24; P = 0.03). Observers’ OPTION-5 scores and patients’ ratings using RCVC-questions were moderately correlated ( rφ = 0.33; P = 0.04). Conclusion There was moderate to no alignment between observers’ and patients’ ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

scholarly journals Decreased choroidal and scleral thicknesses in highly myopic eyes with posterior staphyloma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Un Chul Park ◽  
Eun Kyoung Lee ◽  
Bo Hee Kim ◽  
Baek-Lok Oh
Keyword(s):  
Choroidal Thickness ◽  
Structural Changes ◽  
Meta Analysis ◽  
Cross Sectional Study ◽  
Pathologic Myopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Swept Source ◽  
Posterior Staphyloma ◽  
Myopic Maculopathy

AbstractIn this cross-sectional study, we investigated choroidal thickness (CT) and scleral thickness (ST) in highly myopic eyes and their associations with ocular factors. Patients underwent widefield swept-source optical coherence tomography (OCT) to measure the CT and ST at the subfovea and 3000 μm superior, inferior, temporal, and nasal to the fovea and macular curvature. A total of 237 eyes (154 patients) were included. At all five measurement points, thinner CTs and STs were associated with longer axial lengths (r = − 0.548 to − 0.357, all P < 0.001) and greater macular curvatures (r = − 0.542 to − 0.305, all P < 0.001). The CT and ST were significantly thinner in eyes with posterior staphyloma than in those without at all measurement points (all P ≤ 0.006) but did not differ between eyes with the wide macular and narrow macular type of staphyloma. Eyes with myopic maculopathy of category ≥ 3 according to the International Meta-Analysis for Pathologic Myopia classification had significantly thinner CTs and STs than those with category ≤ 2 (all P ≤ 0.005). In highly myopic eyes, a decrease in the CT and ST was more pronounced in eyes with more structural changes, such as longer axial length, steeper macular curvature, and the presence of posterior staphyloma.

scholarly journals Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood

2020 ◽  
Vol 8 (2) ◽  
pp. e001268
Author(s):  
Angela Koipuram ◽  
Sandra Carroll ◽  
Zubin Punthakee ◽  
Diana Sherifali
Keyword(s):  
Quality Of Life ◽  
Risk Perception ◽  
South Asian ◽  
Online Survey ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Design And Methods

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.

scholarly journals Microperimetry-Assessed Functional Alterations and OCT-Changes in Patients after Retinal Detachment Surgery Using Pars Plana Vitrectomy and SF6 Tamponade

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1157
Author(s):  
María D. Díaz-Barreda ◽  
Isabel Bartolomé-Sesé ◽  
Ana Boned-Murillo ◽  
Antonio Ferreras ◽  
Elvira Orduna-Hospital ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Structural Changes ◽  
Cross Sectional Study ◽  
Retinal Sensitivity ◽  
Cross Sectional ◽  
Swept Source ◽  
Integrity Assessment ◽  
Integrity Index ◽  
Pars Plana

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group; macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

scholarly journals Patients’ Perspectives about Lifestyle Behaviors and Health in the Context of Family Medicine: A Cross-Sectional Study in Portugal

2021 ◽  
Vol 18 (6) ◽  
pp. 2981
Author(s):  
Rosália Páscoa ◽  
Andreia Teixeira ◽  
Micaela Gregório ◽  
Rosa Carvalho ◽  
Carlos Martins
Keyword(s):  
Family Medicine ◽  
Family Doctor ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Future Research ◽  
Lifestyle Behaviors ◽  
Sectional Study ◽  
Self Assessment ◽  
Cross Sectional ◽  
The Family

Lifestyle interventions are recognized as essential in the prevention and treatment of non-communicable diseases. Previous studies have shown that Portuguese patients tend to give more importance to diagnostic and laboratory tests than to lifestyle measures, and seem unaware that behavioral risks are the main modifiable risk factors. The study aimed to analyze patients’ perspectives about lifestyle behaviors and health in the context of family medicine in Portugal. A population-based cross-sectional study was carried out in Portugal (the mainland). A total of 900 Portuguese patients aged ≥20 years, representative of the population, were surveyed using face-to-face questionnaires. Participants were selected by the random route method. Descriptive statistics and non-parametric tests were performed to evaluate differences between the personal beliefs and the personal behavior self-assessment, as well as between the level of importance given to the family doctor to address health behaviors and the reported approach implemented by the family doctor, and its association with bio-demographic variables. The results indicate that the vast majority of this Portuguese cohort has informed beliefs regarding lifestyle behaviors, tends to overestimate their own behavior self-assessment, and strongly agrees that it is important that their family doctor asks/advises on these lifestyle behaviors, although the proportion of those who totally agree that their family doctor usually does this is significantly lower. Differences concerning bio-demographic variables were found. Future research directions should focus on the politics, economics, and policy aspects that may have an impact in this area. It will also be important to understand more broadly the relationships between lifestyle behaviors and clinical, physical, and sociodemographic variables.

scholarly journals Family functioning of elderly with depressive symptoms

2014 ◽  
Vol 48 (3) ◽  
pp. 469-476 ◽  
Author(s):  
Rosely Almeida Souza ◽  
Gislaine Desani da Costa ◽  
Cintia Hitomi Yamashita ◽  
Fernanda Amendola ◽  
Jaqueline Correa Gaspar ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Family Functioning ◽  
Family Health ◽  
Female Gender ◽  
Well Being ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Dysfunctional Family ◽  
The Family

Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.


scholarly journals Association between sexuality and quality of life in older adults

2021 ◽  
Vol 55 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Diego Pires Cruz ◽  
Cristiane dos Santos Silva ◽  
Randson Souza Rosa ◽  
Gabriele da Silva Santos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Northeastern Brazil ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Training Development ◽  
Regression Tests

ABSTRACT Objective: To analyze the association between the experiences of sexuality and quality of life in older adults. Method: Cross-sectional study developed with a total of 300 older adults living in northeastern Brazil. Data collection was carried out entirely online between August and October 2020. Participants completed the online questionnaire containing three instruments for assessing bio sociodemographic data, sexuality and quality of life. Data analysis was performed using the Mann-Whitney, Kruskal-Wallis, Spearman correlation and multivariate linear regression tests, adopting a 95% confidence interval (p < 0.05). Results: Older adults experience better affective relationships and have better quality of life in sensory abilities and intimacy. In the regression analysis, only affective relationships (β = 0.510; [95% CI: 0.340–0.682]; p < 0.001) and physical and social adversities (β = −0.180; [95% CI:−1.443–0.434]; p < 0.001) remained associated with the general quality of life of older adults. Conclusion: Health professionals must invest in training, development of individual and group educational interventions, in addition to promoting the strengthening of bonds between older adults so that they feel free and comfort in expressing their intimate needs.

scholarly journals Inappropriate laboratory testing requests: perspectives of clinical laboratory professionals

2021 ◽  
Vol 3 (3) ◽  
pp. 249-256
Author(s):  
Sultan Alasmari ◽  
Keyword(s):  
Laboratory Testing ◽  
Clinical Laboratory ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Medical Laboratory ◽  
Cross Sectional ◽  
Laboratory Staff ◽  
Level Of Satisfaction ◽  
Physician Awareness ◽  
Laboratory Examinations

Introduction: Laboratory examinations constitute a major factor in achieving the correct clinical diagnosis for patients. However, the ordering of unnecessary or inappropriate laboratory testing remains common, with consequent consumption of laboratory resources whether human or material. The present work evaluated the level of satisfaction of laboratory practitioners toward the appropriateness of laboratory tests ordered by physicians. Methods: This cross-sectional study involved a total of 256 medical laboratory practitioners representing different qualifications and health care sectors, who answered several questions concerning their knowledge and attitudes toward inappropriate laboratory testing ordered by physicians. Results: More than 85% of respondents agreed with the definition provided in the survey, which is substantially consistent with prior studies. More than 90% affirmed the associated drain on time and resources. However, discrepant responses were received concerning physician awareness of test availability, and participants reported laboratory staff arguments with physicians due to orders for unnecessary tests. Data showed that unnecessary orders were mainly requested by physicians of less experience. Conclusions: Ultimately, dissatisfaction was manifest among clinical laboratory professionals, and educational interventions are required to moderate request behaviors.

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