The fetus as a patient: a sustainable approach for clinical interactions in the field of new prenatal medicine?

2018 ◽  
pp. 3-14
Author(s):  
Dagmar Schmitz ◽  
Angus Clarke ◽  
Wybo Dondorp
Keyword(s):  
Prenatal Medicine ◽  
Clinical Interactions

A Comparison of Experiential and Observational Approaches for Enhancing the Interpersonal Communication Skills of Speech-Language Pathology Students

1981 ◽  
Vol 46 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Deborah R. Klevans ◽  
Helen B. Volz ◽  
Robert M. Friedman
Keyword(s):  
Interpersonal Communication ◽  
Skills Training ◽  
Speech Language Pathology ◽  
Student Speech ◽  
Verbal Skills ◽  
Interpersonal Effectiveness ◽  
Helping Relationship ◽  
Interpersonal Skills Training ◽  
Language Pathology ◽  
Clinical Interactions

The effects of two short-term interpersonal skills training approaches on the verbal behavior of student speech-language pathologists were evaluated during peer interviews. Students who had participated in an experiential program in which they practiced specific verbal skills used significantly more verbal behaviors though to facilitate a helping relationship than did students whose training had consisted of observing and analyzing these verbal skills in clinical interactions. Comparisons with results of previous research suggest that length of training may be a crucial variable as students appear to need considerable time and practice to master the complex skills necessary for interpersonal effectiveness.

Do people with schizophrenia display theory of mind deficits in clinical interactions?

2004 ◽  
Vol 34 (3) ◽  
pp. 401-412 ◽  
Author(s):  
R. McCABE ◽  
I. LEUDAR ◽  
C. ANTAKI
Keyword(s):  
Theory Of Mind ◽  
Mental Health Professionals ◽  
Negative Symptoms ◽  
Experimental Studies ◽  
Chronic Schizophrenia ◽  
Mental States ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Clinical Interactions ◽  
Therapy Sessions

Background. Having a ‘theory of mind’ (ToM) means that one appreciates one's own and others' mental states, and that this appreciation guides interactions with others. It has been proposed that ToM is impaired in schizophrenia and experimental studies show that patients with schizophrenia have problems with ToM, particularly during acute episodes. The model predicts that communicative problems will result from ToM deficits.Method. We analysed 35 encounters (>80 h of recordings) between mental health professionals and people with chronic schizophrenia (out-patient consultations and cognitive behaviour therapy sessions) using conversation analysis in order to identify how the participants used or failed to use ToM relevant skills in social interaction.Results. Schizophrenics with ongoing positive and negative symptoms appropriately reported first and second order mental states of others and designed their contributions to conversations on the basis of what they thought their communicative partners knew and intended. Patients recognized that others do not share their delusions and attempted to reconcile others' beliefs with their own but problems arose when they try to warrant their delusional claims. They did not make the justification for their claim understandable for their interlocutor. Nevertheless, they did not fail to recognize that the justification for their claim is unconvincing. However, the ensuing disagreement did not lead them to modify their beliefs.Conclusions. Individuals with schizophrenia demonstrated intact ToM skills in conversational interactions. Psychotic beliefs persisted despite the realization they are not shared but not because patients cannot reflect on them and compare them with what others believe.

Feeling stuck: exploring experiences of junior doctors

2021 ◽  
pp. 1-7
Author(s):  
Lauren Alexander ◽  
Eimear Counihan ◽  
Deirdre McNally ◽  
Leonard Douglas
Keyword(s):  
Reflective Practice ◽  
Clinical Supervision ◽  
Psychiatric Hospitals ◽  
Junior Doctors ◽  
Further Training ◽  
Paper Version ◽  
Item Questionnaire ◽  
Open Coding ◽  
System Factors ◽  
Clinical Interactions

Objectives: Staff working in mental health services provide care for individuals with a variety of difficulties, which can pose treatment challenges. Perceived lack of progress in patients can engender uncomfortable feelings within the clinician, such as frustration, ‘heartsink’ and ‘feeling stuck’. The aim of this study was to explore the phenomenon of ‘feeling stuck’ amongst NCHDs in psychiatry. Methods: A total of 30 participants were recruited from three psychiatric hospitals to complete a 15-item questionnaire. The survey was designed to pursue a thematic analysis. Participants were asked to complete the survey anonymously, either online or paper version. The analysis was carried out by two researchers using open coding, with themes finalised through collective discourse. Results: Three themes were elicited from the data. The central theme – ‘causes of feeling stuck’ – consisted of three subthemes (patient, doctor and system factors). Participants were adept at describing patient and system factors, but reflected on doctor factors, such as countertransference, less often and in less detail. Other themes, explored in less detail by respondents, were ‘the experience of feeling stuck’ and ‘responses to feeling stuck’, with participants tending to seek solutions to, rather than an understanding of, these feelings. Conclusions: Trainee psychiatrists can clearly identify the situations where they are ‘stuck’ with clinical interactions. In spite of clinical supervision and reflective practice groups, they desire further training in managing these scenarios. NCHDs would benefit from further training, using these ‘stuck’ interactions as material, to further develop their understanding of the underlying factors in both themselves and their patients.

Role Network Analysis of Team Interactions and Individual Activities: Application to VTE Prophylaxis

2017 ◽  
Vol 61 (1) ◽  
pp. 896-900 ◽  
Author(s):  
Ann Schoofs Hundt ◽  
Pascale Carayon ◽  
Yushi Yang ◽  
Jason Stamm ◽  
Vaibhav Agrawal ◽  
...  
Keyword(s):  
Network Analysis ◽  
Flow Model ◽  
Visual Representations ◽  
Hospitalized Patients ◽  
Healthcare Team ◽  
Analysis Method ◽  
Team Members ◽  
Vte Prophylaxis ◽  
Team Interactions ◽  
Clinical Interactions

In this paper, we describe the role network analysis method to capture and visually convey healthcare team members’ clinical interactions as well as individual activities performed in light of VTE prophylaxis management for hospitalized patients. Our visual representations expand on the role network analysis work of Pasmore (1988) and flow model of Beyer and Holtzblatt (1998) and offer a deeper sociotechnical representation of the work of healthcare team members.

scholarly journals Incidência de Interações Medicamentosas e Avaliação Clínica nos Pacientes de um Hospital Público Brasileiro

2020 ◽  
Vol 24 (3) ◽  
pp. 202-210
Author(s):  
Fabiana Cristina Furquim ◽  
Cristina Eunice Okuyama ◽  
Sandro Rostelato-Ferreira ◽  
Carla Leticia Rivero-Wendt ◽  
Helder Oliveira ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Positive Association ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Documentary Evidence ◽  
Potential Ddis ◽  
Cross Sectional ◽  
De Se ◽  
Clinical Interactions

Interações droga-droga (IDDs) são responsáveis por problemas terapêuticos e as principais causas de reações adversas a medicamentos que levam a hospitalização. O objetivo do trabalho foi analisar a incidência de IDDs em pacientes admitidos em hospital público no Brasil, em 2015. Em um estudo transversal, 351pacientes foram selecionados com IDDs utilizando-se o banco de dados da Micromedex®, e as interações foram classificadas de acordo com a severidade e documentação. Os potenciais IDDs foram avaliados durante o acompanhamento farmacoterapêutico diário por anamnese farmacêutica e a análise dos exames laboratoriais foi realizada. Um total de 2.937 potenciais IDDs foram identificados e 28,42% deles tinham sinais e sintomas clínicos confirmados em 87 pacientes (29%). Entre os pacientes que apresentaram interações, 62,07% tinham mais que 60 anos. Neste grupo de idade, 61,27% de todos os sinais e sintomas clínicos observados foram também identificados, demonstrando uma associação positiva entre interações clínicas e idade. Além disso, uma correlação positiva entre o número de drogas prescritas e a ocorrência de sinais clínicos também foram observados. Muitos IDDs observados foram de severidade moderada e estavam relacionados a alterações das pressões arteriais e níveis glicêmicos. Este estudo demonstrou que IDDs estão diretamente relacionados a idade e número de drogas prescritas. E a grande frequência de IDDs com documentação fraca alertam para a necessidade de se analisar esse tipo de interação. Sendo assim, este estudo mostrou que potenciais IDDs e sinais e sintomas clínicos significantes em pacientes só reforçam a necessidade de se apoiar a farmácia clínica.   Palavras-chave: Interação Droga-Droga (IDD). Pacientes Internados. Farmacoterapia, Poli Farmácia. Sinais e Sintomas.   Abstract Drug-drug interactions (DDIs) are responsible for therapeutic problems and the main causes of adverse drug reactions that require hospitalization. The aim of this study was to analyze the incidence of DDIs in patients admitted in a Public Hospital in Brazil, in 2015. In a cross-sectional study, DDIs were screened in 351 patients, using Micromedex® database, that classify interactions according to severity and documentary evidence. Potential DDIs were assessed at the daily pharmacotherapeutic follow-up through pharmaceutical anamnesis and analysis of laboratory tests were performed. A total of 2,937 potential DDIs were identified and 28.42% of these had confirmed signs and symptoms clinical in 87 patients (29%). Among the patients that presented interactions, 62.07% were older than 60 years. In this age group, 61.27% of all signs and symptoms clinical observed in the study were also identified, demonstrating a positive association between the occurrence of clinical interactions and age. In addition, a positive correlation between the number of drugs prescribed and the occurrence of signs clinicals was also observed. Most DDIs observed were of moderate severity and were related to imbalance of blood pressure and glycemic levels. This study demonstrated that DDIs are directly related to the age and number of drugs prescribed. And the greater frequency of DDIs with fair documentary evidence alerts to the need to consider all the possible interactions. Thereafter, this study showed that potential DDIs and sign and clinical symptoms  are significant in patients and reinforce the need to support Clinical Pharmacy.   Keywords: Drug-Drug Interaction (DDI). Inpatients. Pharmacotherapy. Poly Pharmacy. Sign and Symptom.    

scholarly journals Risk communication: ethics, psychology, law

2021 ◽  
Vol 26 (9) ◽  
pp. 4678
Author(s):  
E. O. Taratukhin
Keyword(s):  
Risk Communication ◽  
Cultural Practice ◽  
Point Of View ◽  
Evidence Based ◽  
Psychological Perspective ◽  
State Health ◽  
Holistic View ◽  
Cultural Phenomenon ◽  
Based Medicine ◽  
Clinical Interactions

When communicating with a patient, a doctor is within a certain cultural practice (science-based medicine and state health care system), falling outside the limits of which is not legal. However, a broader understanding of medicine as a cultural phenomenon with a focus on health also requires a more varied perspective on patient care. The patient’s problem can be more complex than looking at it from science- and evidence-based point of view. Therefore, in risk communication as an element of work with adherence or as part of signing informed consent, different ways are needed to consider a patient’s situation. An ethical and psychological perspective on clinical interactions allows for a more holistic view of the disease.

Pediatric Chronic Critical Illness, Prolonged ICU Admissions, and Clinician Distress

2021 ◽  
Author(s):  
Alison H. Miles ◽  
Cynda H. Rushton ◽  
Brian M. Wise ◽  
Aka Moore ◽  
Renee D. Boss
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Critical Illness ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Goals Of Care ◽  
Chronic Critical Illness ◽  
Conventional Content Analysis ◽  
Clinical Interactions

AbstractTo gain an in-depth understanding of the experience of pediatric intensive care unit (PICU) clinicians caring for children with chronic critical illness (CCI), we conducted, audiotaped, and transcribed in-person interviews with PICU clinicians. We used purposive sampling to identify five PICU patients who died following long admissions, whose care generated substantial staff distress. We recruited four to six interdisciplinary clinicians per patient who had frequent clinical interactions with the patient/family for interviews. Conventional content analysis was applied to the transcripts resulting in the emergence of five themes: nonbeneficial treatment; who is driving care? Elusive goals of care, compromised personhood, and suffering. Interventions directed at increasing consensus, clarifying goals of care, developing systems allowing children with CCI to be cared for outside of the ICU, and improving communication may help to ameliorate this distress.

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