scholarly journals On mediating agents’ moves and how they might affect patient-centredness in mediated medical consultations

2021 ◽  
Vol 11 ◽  
Author(s):  
Demi K. Krystallidou
Keyword(s):  
Informed Consent ◽  
Translation Studies ◽  
Urban Hospital ◽  
Verbal Cues ◽  
Medical Encounter ◽  
Video Recordings ◽  
Medical Consultations ◽  
Ethical Approval ◽  
Written Informed Consent ◽  
Patient Centredness

The present study aims to shed some light on indicators that might potentially challenge patient-centredness (as practised by self-professed patient-centred doctors) within a mediated medical encounter, and to contribute to the fields of linguistics, translation studies and medical communication. Selected instances of transcribed video recordings are analysed within the framework of Goffman’s footing and participation roles, while transcribed audio recorded interviews with participants in the triad are taken into consideration as well. Both verbal and non-verbal cues (i.e., gaze) are taken into account. The data is drawn from a corpus of video-recorded mediated consultations in a urban hospital in Belgium. Hospital ethical approval and subjects’ written informed consent have been obtained

scholarly journals Medical terminology circulation and interactional organisation in interpreter-mediated medical encounters

2021 ◽  
Vol 11 ◽  
Author(s):  
Sara Pittarello
Keyword(s):  
Informed Consent ◽  
Active Participation ◽  
Point Of View ◽  
Personal Interest ◽  
Medical Terminology ◽  
Institutional Talk ◽  
Italian Hospital ◽  
Ethical Approval ◽  
Medical Interpreters ◽  
Written Informed Consent

Two medical encounters taking place in a Northern Italian hospital are analysed in this paper from a qualitative point of view, based on the author’s previous research. The aim is to reveal the strategies adopted by medical interpreters, in these two specific cases, to translate medical terminology and promote/exclude interlocutors’ active participation. This latter aspect is influenced by the way the interaction is socially and linguistically organised and, in particular, by how interlocutors’ utterances are translated. The prevalence of dyadic or triadic sequences and especially the shifts between such communication exchanges are pivotal in fostering or hindering interlocutors’ participation. Furthermore, medical interactions, as a form of institutional talk, enshrine specific expectations, which are mainly of a cognitive nature but may also be affective, as in the two encounters observed. By conveying such expectations and expressions of personal interest, interpreters have proved to contribute to the fair distribution of active participation among primary interlocutors. Hospital ethical approval and subjects’ written informed consent have been obtained.

Investigating the interpreter’s role(s)

Interpreting ◽  
2016 ◽  
Vol 18 (2) ◽  
pp. 172-197 ◽  
Author(s):  
Demi Krystallidou
Keyword(s):  
Informed Consent ◽  
Analytical Framework ◽  
Verbal Interaction ◽  
Medical Consultations ◽  
Significant Interest ◽  
Ethical Approval ◽  
Belgian Hospital

Although the interpreter’s function in interaction has attracted significant interest in the literature, the focus is often restricted to verbal interaction alone. This paper introduces an analytical framework, based on Goffman’s construct of role, to examine how participants’ actions: (i) carry communicative meaning that complements their use of language; ii) are interdependent with those of other participants. The analysis also takes into account the normative frameworks which, to a certain extent, shape the interpreter’s and the doctor’s actions. Transcribed excerpts of two authentic medical consultations are examined, along with video stills. The recordings, with interpreting between Dutch and Russian, were made at a Belgian hospital; informed consent and ethical approval were obtained. It is shown that interpreters’ use of non-verbal resources can favour the patient’s inclusion in interaction when s/he is bypassed by the doctor, possibly interested in involving only the interpreter and in leaving little, if any, opportunity for the patient’s voice to be heard.

scholarly journals Compassion fatigue as bruises in the soul: A qualitative study on nurses

2021 ◽  
pp. 096973302110032
Author(s):  
Tove Gustafsson ◽  
Jessica Hemberg
Keyword(s):  
Content Analysis ◽  
Informed Consent ◽  
Compassion Fatigue ◽  
Ethics Committee ◽  
Private Person ◽  
The Gift ◽  
Ethical Approval ◽  
Life Itself ◽  
The University ◽  
Written Informed Consent

Background: Nurses who are constantly being exposed to patients’ suffering can lead to compassion fatigue. There is a gap in the latest research regarding nurses’ experiences of compassion fatigue. Little is known about how compassion fatigue affects the nurse as a person, and indications of how it affects the profession are scarce. Aim: The aim of this study was to explore compassion fatigue experienced by nurses and how it affects them as persons and professionals. Research design, participants, and research context: A qualitative explorative approach was used. The data consisted of texts from interviews with seven nurses in various nursing contexts. Content analysis was used. Ethical consideration: Ethical approval was sought and granted from an ethics committee at the university where the researchers were based, and written, informed consent was obtained from all the participants. Findings: Five themes were discovered: Compassion as an empathic gift and compassion fatigue as a result of compassion overload, Compassion fatigue as exhausting the nurse as a professional and private person, Compassion fatigue as a crisis with potentially valuable insights, Compassion fatigue can be handled by self-care and focus on self, and Compassion fatigue is affected by life itself and multifaceted factors. Discussion: Compassion stress and overload can lead to compassion fatigue. Compassion fatigue affects the nurse’s ability to compassion, and the caring is no longer experienced in the same way; the nurses experienced it as being deprived of the gift of compassion. Compassion fatigue implicates a crisis with potentially valuable insights. Conclusion: Compassion fatigue can be symbolized as bruises in the soul, hurtful, but with time it can fade away, although it leaves a sense of caution within the nurse, which can affect the suffering patient.

The patients have a story to tell: Informed consent for people who use illicit opiates

2020 ◽  
Vol 27 (3) ◽  
pp. 666-672
Author(s):  
Jane McCall ◽  
J Craig Phillips ◽  
Andrew Estafan ◽  
Vera Caine
Keyword(s):  
Cognitive Impairment ◽  
Informed Consent ◽  
Social Workers ◽  
Thematic Analysis ◽  
Descriptive Study ◽  
Ethical Considerations ◽  
Opiate Use ◽  
Ethical Approval ◽  
The University ◽  
Written Informed Consent

Background: There is a significant discourse in the literature that opines that people who use illicit opiates are unable to provide informed consent due to withdrawal symptoms and cognitive impairment as a result of opiate use. Aims: This paper discusses the issues related to informed consent for this population. Ethical considerations: Ethical approval was obtained from both the local REB and the university. Written informed consent was obtained from all participants. Method: This was a qualitative interpretive descriptive study. 22 participants were interviewed, including 18 nurses, 2 social workers and 2 clinic support workers. The findings were analyzed using thematic analysis, which is a way of systematically reducing the complexity of the information to arrive at generalized explanations. Results: The staff at the clinic were overwhelming clear in their judgment that people who use opiates can and should be able to participate in research and that their drug use is not a barrier to informed consent. Conclusions: It is important to involve people who use opiates in research. Protectionist concerns about this population may be overstated. Such concerns do not promote the interests of research participants. People who use heroin need to be able to tell their story.

scholarly journals Errata

2017 ◽  
Vol 1 (5) ◽  
pp. 352-353
Keyword(s):  
Informed Consent ◽  
Silicone Oil ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Healthy Children ◽  
Retrospective Case ◽  
Posterior Scleritis ◽  
Ethical Approval ◽  
Written Informed Consent

An Ethical Approval Statement and/or Statement of Informed Consent should have been included for the articles listed below. Their corresponding statements are presented following the article information: Emerson GG, Kim JE, Packo KH, Flynn HW Jr. Guidelines for intraoperative time-out before corneal scraping and before fluid–air exchange. J Vitreoretin Dis. 2017;1(1):79-80. (Original DOI: 10.1177/2474126416680932) Ethical Approval: Ethical approval was not sought for the present study because no identifiable images or information were used and because this was a special correspondence. Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images were used. Ryder SJ, Tutiven JL, Gayer S, Miller D, Flynn HW Jr, Townsend JH. Retinal detachment repair in a patient with active Zika virus infection. J Vitreoretin Dis. 2017;1(1):81-83. (Original DOI: 10.1177/2474126416685495) Statement of Informed Consent: Informed consent was not sought for this case report because no identifiable images were used. Dubey N, Minija CK, Shanmugam MP. Intravitreal dexamethasone implant in a case of recurrent posterior scleritis. J Vitreoretin Dis. 2017;1(1):84-87. (Original DOI: 10.1177/2474126416681324) Statement of Informed Consent: Written informed consent was obtained from the patient to perform the procedure and have photographs taken. Kim H, Wang A, Mititelu M. Case series of anti-vascular endothelial growth factor and photodynamic therapy in the treatment of circumscribed choroidal hemangiomas. J Vitreoretin Dis. 2017;1(2):133-137. (Original DOI: 10.1177/2474126416687424) Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images were used. Cunningham WJ, Michael E, Welch S, Crosby N, Host B, Polkinghorne P. The Auckland Endophthalmitis Study: the incidence and management of endophthalmitis following intravitreal bevacizumab. J Vitreoretin Dis. 2017;1(3):175-180. (Original DOI: 10.1177/2474126417690987) Ethical Approval: Ethical approval for this study was waived by the Health and Disabilities Ethics Committees of New Zealand because the details of our study were such that ethics approval was not required. Statement of Informed Consent: Not applicable. Lee AC, Opremcak EM, Hunt C, et al. Severe corneal complications associated with corneal lubricant used during surgery. J Vitreoretin Dis. 2017;1(3):187-190. (Original DOI: 10.1177/2474126417698880) Ethical Approval: Ethical approval was not sought for the present study because it was a retrospective report and no identifiable data were included in the study. Statement of Informed Consent: Informed consent was not sought for the present study images because no identifiable images were used. Chen Y, Shah V, Jeroudi AM, Blinder KJ, Shah GK. Surgical detachment of the anterior hyaloid membrane from the posterior lens capsule: two techniques. J Vitreoretin Dis. 2017;1(3):214-217. (Original DOI: 10.1177/2474126417698873) Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images or data were used. Yau GL, Chin EK, Parke DW III, Bennett SR, Almeida DRP. West Nile virus chorioretinitis with foveal involvement: evolution of lesions on optical coherence tomography. J Vitreoretin Dis. 2017;1(3):218-221. (Original DOI: 10.1177/2474126417697593) Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images were used. Rahman R, Khan K, Stephenson J, Amjad M. Nonposturing surgery for persistent macular hole using heavy silicone oil (Oxane HD) endotamponade. J Vitreoretin Dis. 2017;1(4):246-250. (Original DOI: 10.1177/2474126417712645) Ethical Approval: Ethical approval was not sought for the present study because of the following reasons: The basis for this decision was made on the fact that there would be no change to the standard of care for patients studied and we were evaluating our service for failed macular holes treatment offered to patients. Statement of Informed Consent: Informed consent was not sought for the present study because it was not required as no identifiable images were used. Sundy M, Malihi M, Chang EY, et al. Retinal artery occlusions in healthy children. J Vitreoretin Dis. 2017;1(4):257-260. (Original DOI: 10.1177/2474126417710138) Statement of Informed Consent: Informed consent was not obtained for this multicenter retrospective case series because no identifiable images were used. Oellers P, Eliott D. Good visual outcome following vitrectomy for epiretinal membrane with foveal tissue herniation. J Vitreoretin Dis. 2017;1(4):278-280. (Original DOI: 10.1177/2474126417709382) Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images were used. Kovach JL. Persistent placoid maculopathy treatment response imaged with OCT angiography. J Vitreoretin Dis. 2017;1(4):281-283. (Original DOI: 10.1177/2474126417712646) Statement of Informed Consent: Informed consent was not sought for the present study because no identifiable images were used. Reyes-Capó D, Ventura CV, Tekin M, Lam BL, Berrocal AM. ABCA4 mutation in a patient with juvenile neuronal ceroid lipofuscinosis. J Vitreoretin Dis. 2017;1(4):284-286. (Original DOI: 10.1177/2474126417714136) Statement of Informed Consent: Written informed consent was obtained from the subject for the use of photographs for professional publication.

Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

274 Tumoral and peripheral immunophenotype of refractory vs relapse to PD-(L)1 blockade in patients with advanced non-small cell lung cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A299-A299
Author(s):  
Maria Ascierto ◽  
Matthew Hellmann ◽  
Nathan Standifer ◽  
Song Wu ◽  
Han Si ◽  
...  
Keyword(s):  
Gene Expression ◽  
Informed Consent ◽  
Checkpoint Inhibitors ◽  
Patient Response ◽  
Calcium Dependent ◽  
Immune Exhaustion ◽  
Previously Treated ◽  
Expression Pathways ◽  
Relapsed Disease ◽  
Written Informed Consent

BackgroundDespite the encouraging successes of immune checkpoint inhibitors, many patients do not benefit and are either refractory or relapse. The mechanisms of refractory or relapsed disease following PD-(L)1 blockade are largely unknown. To identify characteristics associated with refractory or relapsed disease we explored the immune and genomic landscape of samples derived from NSCLC patients who previously received PD-(L)1 blockade and had blood and fresh tumor biopsies collected at the time of progression.MethodsPatient response categories were defined prospectively; ‘refractory’ defined as progression within 16 weeks of initiating PD-(L)1 and ‘relapse’ defined as initial clinical benefit (CR, PR, SD) followed by progression. RNAseq (n=52) and PD-L1 IHC (n=22) were performed on tumor tissue. Immune profiling of whole blood was assessed using flow cytometry or Biomark HD (Fluidigm) gene expression panel (n=54 and n=62, respectively). Differential gene expression was defined as unadjusted p<0.05 and fold-difference >1.5. Pathways analysis was conducted by David tool. Patient samples were collected during screening for clinical trial of second line immunotherapy. Written informed consent was obtained from the patients for publication of this abstract.ResultsIn patients with NSCLC previously treated with PD-(L)1 blockade, tumors of relapsed patients were characterized by increased expression of genes associated with interferon signaling (e.g. CXCL9, SPIC, IFNg), immune suppression (e.g. ARG1, TGFB), immune exhaustion (e.g. ADORA2A), and increased PD-L1 expression (by gene expression and IHC). Refractory disease was associated with increased cadherin signaling and calcium-dependent-cell-adhesion gene expression pathways. In the periphery, reduced quantities of B cells and activated (HLA-DR+ or CD38+) or proliferating (Ki67+) CD8+ T cells were observed in refractory patients.ConclusionsThe tumor and peripheral compartments of patients with NSCLC previously treated with PD-(L)1 blockade differ based on prior response. Relapsed patients tend to have signals of sturdy immune activation and chronic inflammation thus ultimately leading to immune exhaustion. These results may help inform rational therapeutic strategies to overcome resistance to PD-(L)1 blockade in NSCLC.Trial RegistrationNCT02000947Ethics ApprovalResearch on human samples here analyzed have been performed in accordance with the Declaration of Helsinki.ConsentWritten informed consent was obtained from the patient for publication of this abstract.

Informed Consent and Patient Participation in the Medical Encounter: A List of Questions for an Informed Choice About the Type of Anesthesia

2000 ◽  
Vol 44 (2) ◽  
pp. 117-118
Author(s):  
E. PACI ◽  
M. G. BARNESCHI ◽  
G. MICCINESI ◽  
S. FALCHI ◽  
L. METRANGOLO ◽  
...  
Keyword(s):  
Informed Consent ◽  
Patient Participation ◽  
Informed Choice ◽  
Medical Encounter

scholarly journals Written Informed Consent—Translating into Plain Language. A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 232
Author(s):  
Agnieszka Zimmermann ◽  
Anna Pilarska ◽  
Aleksandra Gaworska-Krzemińska ◽  
Jerzy Jankau ◽  
Marsha N. Cohen
Keyword(s):  
Informed Consent ◽  
Plain Language ◽  
Consent Forms ◽  
Software Analysis ◽  
Informed Consent Form ◽  
Education Levels ◽  
Polish Language ◽  
University Degree ◽  
Study Participants ◽  
Written Informed Consent

Background: Informed consent is important in clinical practice, as a person’s written consent is required prior to many medical interventions. Many informed consent forms fail to communicate simply and clearly. The aim of our study was to create an easy-to-understand form. Methods: Our assessment of a Polish-language plastic surgery informed consent form used the Polish-language comprehension analysis program (jasnopis.pl, SWPS University) to assess the readability of texts written for people of various education levels; and this enabled us to modify the form by shortening sentences and simplifying words. The form was re-assessed with the same software and subsequently given to 160 adult volunteers to assess the revised form’s degree of difficulty or readability. Results: The first software analysis found the language was suitable for people with a university degree or higher education, and after revision and re-assessment became suitable for persons with 4–6 years of primary school education and above. Most study participants also assessed the form as completely comprehensible. Conclusions: There are significant benefits possible for patients and practitioners by improving the comprehensibility of written informed consent forms.

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