Efficacy and safety of 3D printing-assisted percutaneous nephrolithotomy in complex renal calculi

This study evaluated the efficacy and safety of 3D printing technology combined with percutaneous nephrolithotomy in the treatment of complex renal calculi. Ninety patients with complex renal calculi were randomly divided into a 3D printing group (45 patients) and a control group (45 patients). In the 3D printing group, a patient-specific 1:1 3D printing model was established based on the patient's thin-layer CT scanning data. A 3D printing model was used for preoperative communication between doctors and patients. Preoperative puncture training, channel design, residual stone prediction, and percutaneous nephrolithotomy were performed under the guidance of a 3D printing model and B-ultrasound. The control group was treated with the conventional B-ultrasound-guided puncture method. Results suggest that there was a statistically significant difference between the two groups (P < 0.05). The overall score of the doctor-patient communication objects in the 3D printing group was 19.32 ± 1.57 points, and in the control group, it was 14.51 ± 2.13 points. The operation time of the 3D printing group was 103.21 ± 13.49 min, and that of the control group was 126.12 ± 25.87 min. The calculi clearance rate of the 3D printing group was 96%, while that of the control group was 80%. The incidence of postoperative complications was 6.67% in the 3D printing group and 22.22% in the control group. Compared with traditional percutaneous nephrolithotomy, 3D printing technology combined with percutaneous nephrolithotomy can significantly enhance the effectiveness of doctor–patient communication, shorten operation time, reduce operation bleeding, improve the stone clearance rate, reduce the incidence of complications and shorten the length of hospital stay. The proposed method is thus a safe and effective method to treat complex renal calculi.

What is in the toolkit (and what are the tools)? How to approach the study of doctor–patient communication

Doctor–patient communication is important, but is challenging to study, in part because it is multifaceted. Communication can be considered in terms of both the aspects of the communication itself, and its measurable effects. These effects are themselves varied: they can be proximal or distal, and can focus on subjective measures (how patients feel about communication), or objective measures (exploring more concrete health outcomes or behaviours). The wide range of methodologies available has resulted in a heterogeneous literature which can be difficult to compare and analyse.Here, we provide a conceptual approach to studying doctor–patient communication, examining both variables which can controlled and different outcomes which can be measured. We present methodologies which can be used (questionnaires, semistructured interviews, vignette studies, simulated patient studies and observations of real interactions), with particular emphasis on their respective logistical advantages/disadvantages and scientific merits/limitations. To study doctor–patient communication more effectively, two or more different study designs could be used in combination.We have provided a concise and practically relevant review of the methodologies available to study doctor–patient communication to give researchers an objective view of the toolkit available to them: both to understand current research, and to conduct robust and relevant studies in the future.

Communication Experiences of Pekanbaru City Patients Receiving In Vitro Fertilisation (IVF) Treatment in Malaysia Fertility Clinics

Doctor-patient communication is important in all medical consultations including for In Vitro Fertilisation (IVF) treatment. An unfavourable communication experience can cause a patient to stop taking the treatment, move to another local fertility clinic, or even seek treatment abroad. There are still few studies documenting communication experiences of patients with infertility seeking reproductive treatment in other countries. This study aimed to describe the communication experiences of Indonesian IVF patients receiving IVF treatment from medical practitioners in fertility clinics in Malaysia. This study used Benner's interpretive phenomenology framework in its approach and when analysing the results. Data collection was carried out using in-depth and semi-structured interviews with 11 IVF patients from Pekanbaru city Indonesia who received IVF treatment in fertility clinics in Malaysia. This study found three main themes shared by the IVF patients’ communication experiences: 1) memorable experiences (friendliness and caring, empathy, honesty and openness, clarity and adequacy of the information, and easiness of communication; 2) less memorable experiences (less interpersonal communication, less warm non-verbal communication, and miscommunication); and 3) communication barriers (English). These findings have important implications for both the prospective patients receiving cross-border fertility treatment in the future and for service providers providing fertility treatment to improve doctor-patient communication. Keywords: Health communication, doctor-patient communication, communication experience, infertility, cross-border reproductive care, in vitro fertilisation treatment.

Discourse of Power from the Aspect of Interruption in Medical Encounters

The discourse of medical encounters is an excellent example of both institutional talk and the discourse of power and its prominent features can be analysed from various aspects. This paper deals with interruption as an important characteristic of both doctor-patient communication and institutional talk in general. The research is focused on comparing the ways doctors and patients interrupt each other and the amount of power they need for this. First, some previous research in this field has been reviewed – it is discussed how interruptions are different from overlaps, how typical it is for patients to interrupt their doctors, how and why doctors and patients interrupt each other and whether they have equal rights when it comes to interrupting their interlocutors. As we aimed at checking these results and investigating if, how and when patients interrupted their doctors, a corpus of 37 recordings made in a tertiary referral hospital in Belgrade, Serbia, in the department of pulmonology, has been analysed. Examples of interruptions by doctors and patients were analysed according to the principles of conversation analysis and critical discourse analysis. The obtained results confirmed an ever-present asymmetry in doctor-patient communication, although it was not as conspicuous as it had been stated in some previous research. Finally, the difference between the ways in which doctors and patients interrupt each other and the reasons behind these interruptions were emphasized.

"Hand as Foot Teaching Method" Application in Upper Cervical Anatomy and Common Diseases

Background“Hand as Foot teaching method” has been applied to the clinical teaching of various orthopaedic subspecialties and achieved good results, but it has not been carried out in the specialized teaching of spine surgery, especially the upper cervical spine. The orthopedics teaching team of the Second Affiliated Hospital of Harbin Medical University applied this teaching method to the clinical teaching of atlantoaxial anatomical relationships and common atlantoaxial diseases.MethodsThe "Hand as Foot Teaching Method" was used to teach key and difficult points for master students of osteology in the Second Affiliated Hospital of Harbin Medical University, supplemented by PPT + anatomical specimens to assist the teaching process.Results"Hand as Foot Teaching Method" can concretize the complex anatomical structure of upper cervical vertebra, thus deepening students' understanding and memory of difficult points, enhancing teacher-student interaction and activating the teaching atmosphere.Conclusion"Hand as Foot Teaching Method" can be applied to the clinical teaching of atlantoaxial knowledge. Compared with the simple application of PPT + model teaching, this teaching method is more helpful for students to grasp difficulties quickly and in three dimensions, significantly improve the teaching quality, and can even be applied to preoperative doctor-patient communication. It has application and promotion value in clinical teaching of spinal surgery.

Visibility of Chinese ad hoc medical interpreters through text ownership: A case study

Professional interpreters’ visibility in the European context has been widely discussed in the field of community interpreting, but the visibility of untrained ad hoc interpreters in non-European contexts such as China has received little academic attention. By adopting the concept of “text ownership” proposed by Angelelli (2004a), this study examines Chinese ad hoc interpreters’ manifestations of visibility in an authentic medical setting. Based on field observations, audio recordings and interviews, the study reports on four types of visibility demonstrated by ad hoc interpreters: (a) replacing the interlocutor; (b) expressing affect towards a patient; (c) exploring answers; and (d) brokering comprehension. Other forms of visibility are also identified, such as omissions of doctors’ or patients’ remarks and small talk between doctor and interpreter. Interpreters’ deeply held views on social factors as well as the institutional and social norms they have been exposed to are believed to influence their manipulation of medical discourses. This study concludes that in a context where professional medical interpreting services are unavailable, ad hoc interpreters may act as linguistic facilitators by taking on various roles that go beyond mere interpreting. However, their excessive visibility may give rise to potential clinical risks, especially when direct doctor–patient communication is compromised. Attention is drawn to the importance of proper training as well as to the need for the professionalization of medical interpreting in China.

Antibiotic Prescribing and Doctor-Patient Communication During Consultations for Respiratory Tract Infections: A Video Observation Study in Out-of-Hours Primary Care

Objective: Communication skills can reduce inappropriate antibiotic prescribing, which could help to tackle antibiotic resistance. General practitioners often overestimate patient expectations for an antibiotic. In this study, we describe how general practitioners and patients with respiratory tract infections (RTI) communicate about their problem, including the reason for encounter and ideas, concerns, and expectations (ICE), and how this relates to (non-)antibiotic prescribing in out-of-hours (OOH) primary care.Methods: A qualitative descriptive framework analysis of video-recorded consultations during OOH primary care focusing on doctor-patient communication.Results: We analyzed 77 videos from 19 general practitioners. General practitioners using patient-centered communication skills received more information on the perspective of the patients on the illness period. For some patients, the reason for the encounter was motivated by their belief that a general practitioner (GP) visit will alter the course of their illness. The ideas, concerns, and expectations often remained implicit, but the concerns were expressed by the choice of words, tone of voice, repetition of words, etc. Delayed prescribing was sometimes used to respond to implicit patient expectations for an antibiotic. Patients accepted a non-antibiotic management plan well.Conclusion: Not addressing the ICE of patients, or their reason to consult the GP OOH, could drive assumptions about patient expectations for antibiotics early on and antibiotic prescribing later in the consultation.

Doctor-patient relationship improved during COVID-19 pandemic, but weakness remains

Objective To assess the quality of the doctor-patient relationship (DPR) in China and possible influencing factors during the COVID-19 period from the patient’s perspective. Methods An online survey was carried out nationwide from March 12, 2020 to March 30, 2020 in China via a convenience sampling strategy. Patients who met the inclusion criteria were invited to complete a questionnaire regarding the quality of DPR, including sociodemographic information, the Patient-Doctor Relationship Questionnaire (PDRQ-9), and influencing factors for DPR during the pandemic. Results A total of 1903 patients were included. Our result showed that participants had a higher PDRQ-9 score during the COVID-19 pandemic (4.18 ± 0.51) than that before the COVID-19 pandemic (3.86 ± 0.67). Importance-performance analysis (IPA) revealed that doctor-patient communication, patient satisfaction, consultation time, doctor’s attitude, and medical knowledge were specific aspects that needed to be prioritized to improve the DPR. Multiple linear regression analysis suggested that positive media reports, telemedicine, and national policies had a significantly positive effect on the DPR during the pandemic (P < 0.05). Conclusion In general, the DPR had been improved during the COVID-19 pandemic. Our research found the key points that needed to be prioritized to improve the DPR during the pandemic, which may provide effective suggestions for building a harmonious DPR in the future.