scholarly journals COVID-19 Pandemic Impact on Physicians’ Decision-making: Digoxin Toxicity in View of Combination of Hydroxychloroquine and Azithromycin: A Case Report

2020 ◽  
Vol 8 (T1) ◽  
pp. 150-153
Author(s):  
Mohammed Hamzah Mezaal ◽  
Hasan Ali Farhan ◽  
Zainab Atiyah Dakhil
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Health Care Providers ◽  
Digoxin Toxicity ◽  
Care Providers ◽  
Global Pandemic ◽  
History Of ◽  
Multiple Levels ◽  
Evidence Based Therapy ◽  
Baseline Therapy

BACKGROUND: Since the WHO declaration of COVID-19 being a global pandemic, the population in general and health-care providers, in particular, became under extraordinary pressure that remarkably impacts their decisions at multiple levels as all of us should make decisions quickly while being uncertain in many times. CASE REPORT: We are reporting a 64-year-old lady with a medical history of atrial fibrillation and mitral regurgitation that treated with digoxin and warfarin therapy, she was suspected to be a COVID-19 case and prescribed empirical hydroxychloroquine and azithromycin combination without proper adjustment of her baseline therapy, accordingly she developed adverse effect of this combination in the form of digoxin toxicity and long QT, this case highlights how this unprecedented pandemic affects the decision-making of physicians. CONCLUSION: We should be critical and vigilant in making a decision of prescription or marketing non-evidence-based therapy, and when we are obligated for this decision, we should take all precautions to minimize the adverse effects of these drugs.

The Myth of the Perfect Pregnancy

2019 ◽  
Author(s):  
Lara Freidenfelds
Keyword(s):  
Twentieth Century ◽  
Health Care Providers ◽  
Maternal Education ◽  
Colonial America ◽  
Care Providers ◽  
Early Nineteenth Century ◽  
Unrealistic Expectation ◽  
History Of ◽  
Late Twentieth ◽  
Late Twentieth Century

The Myth of the Perfect Pregnancy is a history of why Americans came to have the unrealistic expectation of perfect pregnancies and to mourn even very early miscarriages. The introduction explains that miscarriage is a common phenomenon and a natural part of healthy women’s childbearing: approximately 20 percent of confirmed pregnancies spontaneously miscarry, mostly in the first months of gestation. Eight topical chapters describe childbearing and pregnancy loss in colonial America; the rise of birth control from the late eighteenth century to the present; changes in parenting from the early nineteenth century to the present that increasingly focused attention on the emotional relationship between parent and child; the twentieth-century rise of prenatal care and maternal education about embryonic growth; the twentieth-century blossoming of a consumer culture that marketed baby items to pregnant women; the abortion debates from the mid-twentieth century to the present; the late twentieth-century introduction of obstetric ultrasound and its evolution into a pregnancy ritual of “meeting the baby” as early as eight weeks’ gestation; and the late twentieth-century introduction of home pregnancy testing and the identification of pregnancy as early as several days before a missed period. The conclusion offers suggestions for how women and their families, health-care providers, and the maternity care industry can better handle pregnancy and address miscarriage.

scholarly journals Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Shirley Chien-Chieh Huang ◽  
Alden Morgan ◽  
Vanessa Peck ◽  
Lara Khoury
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Care Providers ◽  
Telephone Interviews ◽  
Written Information ◽  
Geriatric Unit ◽  
Patient Health

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

scholarly journals Plain Language Summary: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

2021 ◽  
Vol 164 (4) ◽  
pp. 704-711
Author(s):  
Samantha Anne ◽  
Sandra A. Finestone ◽  
Allison Paisley ◽  
Taskin M. Monjur
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Pain Management ◽  
Health Care Providers ◽  
Clinical Practice Guideline ◽  
Shared Decision ◽  
Care Providers ◽  
Plain Language ◽  
Opioid Prescribing

This plain language summary explains pain management and careful use of opioids after common otolaryngology operations. The summary applies to patients of any age who need treatment for pain within 30 days after having a common otolaryngologic operation (having to do with the ear, nose, or throat). It is based on the 2021 “Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations.” This guideline uses available research to best advise health care providers, and it includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.

scholarly journals Patient Portal, Patient-Generated Images, and Medical Decision-Making in a Pediatric Ambulatory Setting

2020 ◽  
Vol 11 (05) ◽  
pp. 764-768
Author(s):  
Karolin Ginting ◽  
Adrienne Stolfi ◽  
Jordan Wright ◽  
Abiodun Omoloja
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Medical Decision Making ◽  
Pediatric Population ◽  
Private Insurance ◽  
Medical Decision ◽  
Ambulatory Setting ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals

Abstract Background Electronic health record (EHR) patient portals are a secure electronic method of communicating with health care providers. In addition to sending secure messages, images, and videos generated by families can be sent to providers securely. With the widespread use of smart phones, there has been an increase in patient-generated images (PGI) sent to providers via patient portals. There are few studies that have evaluated the role of PGI in medical decision-making. Objectives The study aimed to characterize PGI sent to providers via a patient portal, determine how often PGI-affected medical decision-making, and determine the rate of social PGI sent via patient portal. Methods A retrospective chart review of PGI uploaded to a children's hospital's ambulatory patient portal from January 2011 to December 2017 was conducted. Data collected included patient demographics, number and type of images sent, person sending images (patient or parent/guardian), and whether an image-affected medical decision-making. Images were classified as medical related (e.g., blood glucose readings and skin rashes), nonmedical or administrative related (e.g., medical clearance or insurance forms), and social (e.g., self-portraits and camp pictures). Results One hundred forty-three individuals used the portal a total of 358 times, sending 507 images over the study period. Mean (standard deviation) patient age was 9.5 (5.9) years, 50% were females, 89% were White, and 64% had private insurance. About 9% of images were sent directly by patients and the rest by parents/guardians. A total of 387 (76%) images were sent for medical related reasons, 20% for nonmedical, and 4% were deemed social images. Of the 387 medical related images, 314 (81%) affected medical decision-making. Conclusion PGI-affected medical decision-making in most cases. Additional studies are needed to characterize use of PGI in the pediatric population.

scholarly journals Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers

2018 ◽  
Vol 09 (04) ◽  
pp. 772-781 ◽  
Author(s):  
Meghan Reading ◽  
Dawon Baik ◽  
Melissa Beauchemin ◽  
Kathleen Hickey ◽  
Jacqueline Merrill
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Care Providers ◽  
Self Monitoring ◽  
Major Barrier ◽  
Utaut Model ◽  
History Of ◽  
Mhealth Technology

Background Patient-generated health data (PGHD) collected digitally with mobile health (mHealth) technology has garnered recent excitement for its potential to improve precision management of chronic conditions such as atrial fibrillation (AF), a common cardiac arrhythmia. However, sustained engagement is a major barrier to collection of PGHD. Little is known about barriers to sustained engagement or strategies to intervene upon engagement through application design. Objective This article investigates individual patient differences in sustained engagement among individuals with a history of AF who are self-monitoring using mHealth technology. Methods This qualitative study involved patients, health care providers, and research coordinators previously involved in a randomized, controlled trial involving electrocardiogram (ECG) self-monitoring of AF. Patients were adults with a history of AF randomized to the intervention arm of this trial who self-monitored using ECG mHealth technology for 6 months. Semistructured interviews and focus groups were conducted separately with health care providers and research coordinators, engaged patients, and unengaged patients. A validated model of sustained engagement, an adapted unified theory of acceptance and use of technology (UTAUT), guided data collection, and analysis through directed content analysis. Results We interviewed 13 patients (7 engaged, 6 unengaged), 6 providers, and 2 research coordinators. In addition to finding differences between engaged and unengaged patients within each predictor in the adapted UTAUT model (perceived ease of use, perceived usefulness, facilitating conditions), four additional factors were identified as being related to sustained engagement in this population. These are: (1) internal motivation to manage health, (2) relationship with health care provider, (3) supportive environments, and (4) feedback and guidance. Conclusion Although it required some modification, the adapted UTAUT model was useful in understanding of the parameters of sustained engagement. The findings of this study provide initial requirement specifications for the design of applications that engage patients in this unique population of adults with AF.

scholarly journals An Integrative Review of the Influences on Decision-Making of Young People About Human Papillomavirus Vaccine

2018 ◽  
Vol 35 (1) ◽  
pp. 39-50
Author(s):  
Helen Sisson ◽  
Yvonne Wilkinson
Keyword(s):  
Decision Making ◽  
Human Papillomavirus ◽  
Parental Involvement ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Infection ◽  
School Nurses ◽  
Human Papillomavirus Vaccine ◽  
Care Providers ◽  
To Receive

The human papillomavirus (HPV) vaccine is a key intervention in the prevention of HPV infection and associated cancers. This review emphasizes the importance of understanding what influences decision-making about this vaccine. Guided by the work of Whittemore and Knafl, and Pluye and Hong, we identified 25 studies, from which four prominent themes emerged: fear and risk, pain, parental involvement, and involvement of others. Fear of cervical cancer was a strong motivation to receive the vaccine, and the extent of parental involvement also had an impact on decision-making. Recommendations to receive the vaccine by health-care providers were also an important influence. School nurses are fundamental to the promotion and delivery of the HPV vaccine and should stress the significant role that it plays in the prevention of cancer. Additionally, school nurses should ensure that discussions about HPV infection and vaccine include parents where appropriate and should distinctly recommend vaccination to those eligible.

scholarly journals Awareness of Oral Cancer Among Dental Patients in Mecca, Saudi Arabia

2020 ◽  
Vol 14 (1) ◽  
pp. 369-374
Author(s):  
Mashael Alqahtani ◽  
Alla Nahhas ◽  
Lujain Malibari ◽  
Maryam Alghamdi ◽  
Sara Bazuhier ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Cancer ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Dental Patients ◽  
Adequate Knowledge ◽  
History Of ◽  
Demographical Data

Background: Oral Cancer (OC) is a serious health problem affecting the oral cavity, which may lead to death. Alcohol, tobacco, and chewing betel are the main risk factors. Early diagnosis and adequate knowledge of OC may improve the survival rate. Objective: This study aimed to assess the knowledge about oral cancer among dental patients in Mecca. Methods: A cross-sectional study was conducted in the dental clinics of Mecca. Interviewer-administered questionnaires were distributed to 416 respondents aged 18 or older, who spoke Arabic or English, had no history of OC, and participated voluntarily. The questionnaire consisted of three sections. The first regarded demographical data, the second measured knowledge about OC, and the third was concerned with education regarding OC provided by health-care providers. The interviewers also educated the participants by handing brochures with information about OC. Results: Knowledge about OC among dental patients in Mecca was found to be significantly low. Only 102 of the 416 participants (24.5%) had any knowledge. Only 3.4% of all participants had been educated about OC by their health-care providers. Conclusion: The results of this study show a considerable lack of general knowledge about OC among dental patients in Mecca. Health programs should be developed to raise the community’s awareness.

The Perspectives of Women and Their Health-Care Providers Regarding Using an ECA to Support Mode of Birth Decisions

2021 ◽  
Vol 30 (3) ◽  
pp. 135-144
Author(s):  
Somphit Chinkam ◽  
Courtney Steer-Massaro ◽  
Ivan Herbey ◽  
Zhe Zhang ◽  
Timothy Bickmore ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Medical Center ◽  
Decision Aids ◽  
Tertiary Care ◽  
Easy Access ◽  
Care Providers ◽  
Embodied Conversational Agent ◽  
Tertiary Care Medical Center ◽  
Mode Of Birth

This study used focus groups to assess the feasibility and acceptability of adapting an Embodied Conversational Agent (ECA) to support decision-making about mode of birth after previous cesarean. Twelve women with previous cesareans, and eight prenatal providers at an academic, tertiary-care medical center, viewed a prototype ECA and were asked to share feedback on the potential role in helping women prepare for decision-making. Both groups felt that although it was somewhat “robot-like,” the ECA could provide easy access to information for patients and could augment the visit with providers. Future work is needed to improve ECA visual appeal and clarify the role and timing for utilization of decision aids using ECA technology to enhance the shared decision-making process.

Supporting Pediatric Patients and Their Families at the End of Life: Perspectives From Bereaved Parents

2020 ◽  
Vol 37 (12) ◽  
pp. 1009-1015
Author(s):  
Laura K. Sedig ◽  
Jessica L. Spruit ◽  
Trisha K. Paul ◽  
Melissa K. Cousino ◽  
Harlan McCaffery ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Health Care Providers ◽  
Life Experiences ◽  
The United States ◽  
Parental Perception ◽  
Care Providers ◽  
Supportive Services ◽  
Bereaved Parents ◽  
Actual Decision

Background: Cancer remains the leading cause of death by disease for children in the United States. It is imperative to optimize measures to support patients and families facing the end of a child’s life. This study asked bereaved parents to reflect on their child’s end-of-life care to identify which components of decision-making, supportive services, and communication were helpful, not helpful, or lacking. Methods: An anonymous survey about end-of-life experiences was sent to families of children treated at a single institution who died of a malignancy between 2010 and 2017. Results: Twenty-eight surveys were returned for a 30.8% response rate. Most of the bereaved parents (61%) reported a desire for shared decision-making; this was described by 52% of families at the end of their child’s life. There was a statistically significant association between how well death went and whether the parental perception of actual decision-making aligned with desired decision-making ( P = .002). Families did not utilize many of the supportive services that are available including psychology and psychiatry (only 22% used). Respondents felt that additional services would have been helpful. Conclusions: Health care providers should strive to participate in decision-making models that align with the preferences of the patient and family and provide excellent communication. Additional resources to support families following the death of a child should be identified for families or developed and funded if a gap in available services is identified.

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