Patient-Centered Empowerment Through Evidence-Based Engagement in Sensitive Clinical Settings

2020 ◽  
pp. 155-175
Author(s):  
Iris Reychav ◽  
Roger W. McHaney ◽  
Lin Zhu ◽  
Rami Moshonov
Keyword(s):  
Pap Test ◽  
Well Being ◽  
Clinical Settings ◽  
Evidence Based ◽  
Coding System ◽  
Educational Materials ◽  
Patient Centered ◽  
Shared Information ◽  
The Relationship

Patient-centered empowerment is enhanced through evidence-based engagement in stressful medical situations. The current study provided expert-vetted educational materials in dynamic text and video formats using the 5S approach. The materials are relevant, reliable, and readable for patients with abnormal Pap test results. Findings indicated patients that understood the information better were more engaged. Engagement was measured using a coding system that kept track of explicitly shared information, requested recommendations, and tacit knowledge during patient-physician interaction. Other outcomes were that dynamic text had a greater impact on engagement in both initial and follow-up meetings. Important findings included that those who found the dynamic text relevant had their social well-being, self-esteem, optimism, and acceptance improved in initial meetings. Those who found the dynamic text reliable were more confident in the relationship with their physician in follow-up meetings and felt their social well-being was improved in both initial and follow-up meetings.

Exceptional patients: Narratives of connections

2013 ◽  
Vol 12 (4) ◽  
pp. 269-276 ◽  
Author(s):  
Joan C. Engebretson ◽  
Noemi E. Peterson ◽  
Moshe Frenkel
Keyword(s):  
Well Being ◽  
Decision Making Process ◽  
Clinical Settings ◽  
Crucial Importance ◽  
Higher Power ◽  
Personal Connections ◽  
External Connections ◽  
The Relationship ◽  
Health And Well Being ◽  
Provided Examples

AbstractObjective:This study sought to better understand the patient s perspective of the experience of recovery from cancer that appeared to defy medical prognoses.Methods:Fourteen cases of medically verified exceptional outcomes were identified. A qualitative approach, employing long narrative interviews was used. Data was analyzed using a cross case thematic analytic approach.Results:The major overarching theme was connections, both internal and external. Internal included connections with God or a higher power and with oneself. The external connections, the focus of this paper, included 1) personal connections with friends and family, 2) connections with the medical system: the physician, nurses and other staff, and 3) connections with other patients. They described the nature of these relationships and the importance of frequent contact with family and friends as providing significant emotional and instrumental support. They expressed confidence in receiving care from a reputable clinic, and with very little probing illustrated the importance of the relationship with their providers. They articulated the significance of the compassionate qualities of the physician and identified communication attributes of their physician that were important in establishing this connection. These attributes were demeanor, availability, honesty, sensitivity in the decision making process. They provided examples of positive connections with nurses and other staff as well as with other patients through their illness process.Significance of results:The importance of connections in these illness narratives was richly illustrated. These issues often are overlooked in clinical settings; yet they are of crucial importance to the health and well-being of the patients.

scholarly journals Family Caregiving for Individuals With Heart Failure: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (22) ◽  
Author(s):  
Lisa Kitko ◽  
Colleen K. McIlvennan ◽  
Julie T. Bidwell ◽  
J. Nicholas Dionne-Odom ◽  
Shannon M. Dunlay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Family Caregiving ◽  
Heart Association ◽  
Well Being ◽  
Clinical Settings ◽  
Financial Health ◽  
Future Directions ◽  
Scientific Statement ◽  
The Relationship ◽  
Health And Well Being

Many individuals living with heart failure (HF) rely on unpaid support from their partners, family members, friends, or neighbors as caregivers to help manage their chronic disease. Given the advancements in treatments and devices for patients with HF, caregiving responsibilities have expanded in recent decades to include more intensive care for increasingly precarious patients with HF—tasks that would previously have been undertaken by healthcare professionals in clinical settings. The specific tasks of caregivers of patients with HF vary widely based on the patient’s symptoms and comorbidities, the relationship between patient and caregiver, and the complexity of the treatment regimen. Effects of caregiving on the caregiver and patient range from physical and psychological to financial. Therefore, it is critically important to understand the needs of caregivers to support the increasingly complex medical care they provide to patients living with HF. This scientific statement synthesizes the evidence pertaining to caregiving of adult individuals with HF in order to (1) characterize the HF caregiving role and how it changes with illness trajectory; (2) describe the financial, health, and well-being implications of caregiving in HF; (3) evaluate HF caregiving interventions to support caregiver and patient outcomes; (4) summarize existing policies and resources that support HF caregivers; and (5) identify knowledge gaps and future directions for providers, investigators, health systems, and policymakers.

scholarly journals The relationship of dispositional compassion with well-being: a study with a 15-year prospective follow-up

2019 ◽  
Vol 15 (6) ◽  
pp. 806-820 ◽  
Author(s):  
Aino I. L. Saarinen ◽  
Liisa Keltikangas-Järvinen ◽  
Laura Pulkki-Råback ◽  
Claude Robert Cloninger ◽  
Marko Elovainio ◽  
...  
Keyword(s):  
Well Being ◽  
Relationship Of ◽  
The Relationship

Abstract NS3: A Comprehensive Post-Acute Stroke Services (COMPASS) Website for Public Use

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sylvia Coleman ◽  
Meghan Radman ◽  
Mysha Sissine ◽  
Pamela Duncan ◽  
Cheryl Bushnell ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Human Services ◽  
Transitional Care ◽  
Care Plan ◽  
Evidence Based ◽  
Care Providers ◽  
Educational Materials ◽  
Health And Human Services ◽  
Stroke Services

Background: Stroke patients, caregivers, and health and human services are in need of organized, evidence-based resources to improve post-acute care and outcomes. Educational materials vetted by stakeholders are scarce and difficult to develop. The COMprehensive Post-Acute Stroke Services (COMPASS) Study developed online resources by discipline for clinical providers, patients, caregivers, and health and human services teams. Purpose: This presentation introduces the COMPASS website content available and ready for immediate use to support post-acute stroke care quality improvement. Methods: Materials were developed as a component of the PCORI-funded COMPASS Study designed to implement and evaluate comprehensive transitional care (TC) for stroke survivors. Patients discharged home from 41 NC hospitals after a stroke or TIA received COMPASS TC which incorporated Centers for Medicare and Medicaid (CMS) recommendations: a follow-up phone call within two days of discharge; a comprehensive follow-up clinic visit; and delivery of a patient care plan. An interdisciplinary team of health care providers, stakeholders, and researchers developed patient and caregiver educational materials tested for sixth grade literacy, a community resource directory, and training materials for implementation of COMPASS TC that are available on the COMPASS website at www.nccompass-study.org/. Results: Educational products, including a directory of resources, training manuals, recorded webinars, instructional handouts, animated videos, and patient/caregiver materials are on the COMPASS website. An electronic application called COMPASS-Care Plan (CP) also developed can be readily integrated into Epic and Cerner electronic health records. COMPASS-CP was developed to streamline the delivery of the TC model. Since the website was made public July 1, 2019, there have been 616 views from 15 countries with the majority reviewing patient/caregiver resources. Conclusions: The COMPASS website provides health and human services teams with organized, evidence-based resources to support delivery and management of post-acute transitional care for patients and caregivers.

Unemployment and Mental Well-Being: Elaboration of the Relationship

1992 ◽  
Vol 22 (2) ◽  
pp. 261-274 ◽  
Author(s):  
Eero Lahelma
Keyword(s):  
General Health Questionnaire ◽  
Well Being ◽  
Paid Work ◽  
Cross Sectional ◽  
Several Variables ◽  
Adverse Impacts ◽  
The Impact ◽  
Mental Well Being ◽  
The Relationship

The relationship between unemployment and mental well-being was studied in 703 Finnish women and men who were originally employed in industry (manufacturing). A population survey with a follow-up measurement was carried out in 1983 and 1984. Mental well-being was measured by a 12-item version of the General Health Questionnaire. The association between unemployment and mental ill-health proved to be a strong one. Cross-sectional analyses and analyses on the improvement of mental well-being were made. The impact of employment status on mental ill-health, as well as its improvement, was controlled for by means of logistic regression analysis (GUM). Several variables included in the design did not alter the main result, apart from the fact that the impact of unemployment was stronger among men than among women. The impact of unemployment proved to be independent and direct. The author compares these results with other studies that have used a similar approach, and discusses the significance of paid work in developed capitalist societies in an understanding of the adverse impacts of unemployment.

scholarly journals Establishing an oncocardiology service

Herz ◽  
2020 ◽  
Vol 45 (7) ◽  
pp. 626-631
Author(s):  
L. H. Lehmann ◽  
M. Totzeck
Keyword(s):  
Cancer Patients ◽  
Clinical Studies ◽  
Ethical Issues ◽  
Diagnostic Tools ◽  
Evidence Based ◽  
Therapeutic Approaches ◽  
Patient Centered ◽  
Set Up ◽  
Integrate Research

Abstract Oncocardiology is an emerging field in cardiovascular healthcare. Besides establishing surveillance and follow-up strategies for cancer patients, it will be essential to set up specialized oncocardiology services. However, there is a lack of clinical studies to give evidence-based recommendations regarding cardiological diagnostic and therapeutic approaches for cancer patients. An oncocardiology service is a patient-centered structure that aims to integrate research and interdisciplinary patient care to bridge this gap. We discuss the current challenges in developing an oncocardiology service and review the literature on this topic. We further provide an overview of the essential diagnostic tools and upcoming ethical issues to be considered in the management of oncology patients.

Building Healthy Children: A preventive intervention for high-risk young families

2021 ◽  
pp. 1-16
Author(s):  
Elizabeth M. Demeusy ◽  
Elizabeth D. Handley ◽  
Jody Todd Manly ◽  
Robin Sturm ◽  
Sheree L. Toth
Keyword(s):  
High Risk ◽  
Child Maltreatment ◽  
Preventive Intervention ◽  
Well Being ◽  
Psychological Aggression ◽  
Evidence Based ◽  
Healthy Children ◽  
Young Mothers ◽  
Inconsistent Parenting

Abstract The Building Healthy Children (BHC) home-visiting preventive intervention was designed to provide concrete support and evidence-based intervention to young mothers and their infants who were at heightened risk for child maltreatment and poor developmental outcomes. This paper presents two studies examining the short- and long-term effectiveness of this program at promoting positive parenting and maternal mental health, while preventing child maltreatment and harsh parenting. It also examines the intervention's sustained effect on child symptomatology and self-regulation. At baseline, young mothers and their infants were randomly assigned to receive BHC or Enhanced Community Standard. Families were assessed longitudinally across four time points. Data were also collected from the child's teacher at follow-up. Mothers who received BHC evidenced significant reductions in depressive symptoms at mid-intervention, which was associated with improvements in parenting self-efficacy and stress as well as decreased child internalizing and externalizing symptoms at postintervention. The follow-up study found that BHC mothers exhibited less harsh and inconsistent parenting, and marginally less psychological aggression. BHC children also exhibited less externalizing behavior and self-regulatory difficulties across parent and teacher report. Following the impactful legacy of Dr. Edward Zigler, these findings underline the importance of early, evidence-based prevention to promote well-being in high-risk children and families.

scholarly journals Serum Anti-14-3-3 Zeta Autoantibody as a Biomarker for Predicting Hepatocarcinogenesis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ting Wang ◽  
Xue-ying Huang ◽  
Su-jun Zheng ◽  
Ye-ying Liu ◽  
Si-si Chen ◽  
...  
Keyword(s):  
Clinical Settings ◽  
Serum Samples ◽  
Novel Proteins ◽  
Human Sera ◽  
Early Hcc ◽  
Novel Biomarkers ◽  
Normal Human ◽  
Serial Serum ◽  
The Relationship

Hepatocellular carcinoma (HCC) is a common malignancy worldwide. Alpha-fetoprotein (AFP) is still the only serum biomarker widely used in clinical settings. However, approximately 40% of HCC patients exhibit normal AFP levels, including very early HCC and AFP-negative HCC; for these patients, serum AFP is not applicable as a biomarker of early detection. Thus, there is an urgent need to identify novel biomarkers for patients for whom disease cannot be diagnosed early. In this study, we screened and identified novel proteins in AFP-negative HCC and evaluated the feasibility of using autoantibodies to those protein to predict hepatocarcinogenesis. First, we screened and identified differentially expressed proteins between AFP-negative HCC tissue and adjacent non-tumor liver tissue using SWATH-MS proteome technology. In total, 2,506 proteins were identified with a global false discovery rate of 1%, of which 592 proteins were expressed differentially with 175 upregulated and 417 downregulated (adjusted p-value <0.05, fold-change FC ≥1.5 or ≤0.67) between the tumor and matched benign samples, including 14-3-3 zeta protein. For further serological verification, autoantibodies against 14-3-3 zeta in serum were evaluated using enzyme-linked immunosorbent, Western blotting, and indirect immunofluorescence assays. Five serial serum samples from one patient with AFP-negative HCC showed anti-14-3-3 zeta autoantibody in sera 9 months before the diagnosis of HCC, which gradually increased with an increase in the size of the nodule. Based on these findings, we detected the prevalence of serum anti-14-3-3 zeta autoantibody in liver cirrhosis (LC) patients, which is commonly considered a premalignant liver disease of HCC. We found that the prevalence of autoantibodies against 14-3-3 zeta protein was 16.1% (15/93) in LC patient sera, which was significantly higher than that in patients with chronic hepatitis (0/75, p = 0.000) and normal human sera (1/60, 1.7%, p = 0.01). Therefore, we suggest that anti-14-3-3 zeta autoantibody might be a biomarker for predicting hepatocarcinogenesis. Further follow-up and research of patients with positive autoantibodies will be continued to confirm the relationship between anti-14-3-3 zeta autoantibody and hepatocarcinogenesis.

Sign in / Sign up

Export Citation Format

Share Document