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Communication after cancellations in orthopaedics: The patient perspective

World Journal of Orthopedics 2014年第1期5卷 45-50页

作者： Saurabh S Mehta David J Bryson Jitendra Mangwani Lucy Cutler Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester General Hospital Department of Orthopaedics University Hospitals of Leicester NHS Trust Leicester Royal Infirmary

AIM: To examine patients' perceptions on communication surrounding the cancellation of orthopaedic operations and to identify areas for improvement in ***: A prospective survey was undertaken at a university teaching hospital within the department of Trauma and Orthopaedics. patients admitted to an acute orthopaedic unit, whose operations were cancelled, were surveyed to assess patient satisfaction and preferences for notification of cancellation of their operations. patients with an abbreviated mental test score of patients unable to complete the survey independently, those under 16 years of age, and any patient notified of the cancellation by any of the authors were excluded from this study. patients were surveyed themorning after their operation had been cancelled thus ensuring that every opportunity was given for the medical staff to discuss the cancellation with the patient. The survey included questions on whether or not patients were notified of the cancellation of their surgery, the qualifications of the person discussing the cancellation, and patient preferences on the process. Satisfaction was assessed via 5-point Likert scale ***: Sixty-five consecutive patients had their operations cancelled on 75 occasions. Fifty-four point seven percent of the patients who had cancellations were notified by a nurse and 32% by a doctor. No formal communication occurred for 13.3% cancellations and no explanation was provided for a further 16%. patients reported that they were dissatisfied with the explanation provided for 36 of the 75(48%) cancellations. Of those patients who were dissatisfied, 25(69.4%) were notified by a nurse. Twenty-three of the 24(96%) patients notified by a doctor were satisfied with the explanation and that communication. Of those patients who were notified by a nurse 83% patients reported that they would have preferred it if a doctor had discussed the cancellation with them. There was a significant difference

关键词： Communication patient satisfaction Orthopaedic surgery Cancellation

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Case report:improved behavioral and psychiatric symptoms with repetitive transcranial magnetic stimulation at the bilateral DLPFC combined with cognitive and behavioral therapy in a patient with unilateral thalamic hemorrhage

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中华物理医学与康复杂志 2022年第12期44卷 1134-1134页

Objective This case demonstrates the clinical potential of bilateral rTMS treatment in patients with intractable neurocognitive impairment after thalamic *** The patient received a total of 10 sessions of bilateral rTMS over 2 weeks,applied at the DLPFCs,with high frequency in the left hemisphere and low frequency in the right *** each rTMS treatment,computer-based cognitive-behavioral therapy was administered for30 min.

关键词： stimulation patient clinical

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Secondary sclerosing cholangitis from percutaneous transhepatic biliary drainage in a patient with gallbladder cancer after surgery: A case report

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Journal of Interventional Medicine 2020年第1期3卷 58-59页

作者： Zhongbao Tan Qingqing Wang Xuequn Mao Rong Zou Jian Zhang Zhenhai Di Huanjing Wang Department of Interventional Radiology Affiliated Hospital of Jiangsu UniversityJiangsu212001China

Secondary sclerosing cholangitis(SSC)is a chronic cholestatic liver disease characterized by fibrosis and stricture of the bile *** in association with multiple factors such as spontaneous choledochoduodenal fistula and metastatic gallbladder cancer has rarely been ***,to the best of our knowledge,reports of SSC after percutaneous transhepatic biliary drainage(PTBD),especially in cases with diffuse calcification of the bile duct walls,have not been *** report a case of SSC from PTBD in a patient with gallbladder cancer after *** patient underwent external percutaneous biliary drainage for malignant bile duct obstruction after *** exchanges were performed at the first and the sixth month after PTBD using an internal and external drainage *** months after the third catheter exchange,findings of laboratory and imaging examinations were suggestive of *** liver function tests of the patient were suggestive of *** computed tomography showed diffuse calcification of the bile duct *** showed intrahepatic biliary stenosis or dilatation.

关键词： patient biliary percutaneous

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Evaluation of retail pharmacists’’ perception on patient safety

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Asian Journal of Pharmaceutical Sciences 2016年第1期11卷 142-143页

作者： SivanANDy Palanisamy Tan Tyng Wei Tan Wee Loon Lim Chong Yee Department of Pharmacy Practice School of Pharmacy International Medical University

patient safety has become a focus of clinical care and research in recent years. However, the potential for medical care to cause harm has been appreciated throughout the history of medicine (1)The safety culture of an organization is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health and safety management.

关键词： Retail pharmacists patient safety Perception Malaysia Survey

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Call for papers for a special issue on improving patient safety

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International Journal of Nursing Sciences 2023年第3期10卷 423-423页

作者： Huaping Liu School of Nursing Peking Union Medical CollegeBeijingChina

patient safety is a serious global health *** play a critical role in improving patient *** Special Focus Issue aims to report research and evidence-based practice about patient *** special issue welcomes original research papers,perspectives,conceptual papers,case reports,systematic reviews,and scoping review articles that address a range of topics including,but not limited to,the following areas:The four Cs of safety:Culture,Competency,Consequences&Continuous improvement.

关键词： Focus patient improving

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patient Participation in Communication about Treatment Decision-Making for Localized Prostate Cancer during Consultation Visits

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Health 2015年第11期7卷 1419-1429页

作者： Lixin Song Mark P. Toles Jinbing Bai Matthew E. Nielsen Donald E. Bailey Betsy Sleath Barbara Mark School of Nursing University of North Carolina (UNC) Chapel Hill USA Lineberger Comprehensive Cancer Center University of North Carolina (UNC) Chapel Hill USA Department of Urology School of Medicine University of North Carolina (UNC) Chapel Hill USA School of Nursing Duke University Durham USA Eshelman School of Pharmacy University of North Carolina Chapel Hill USA

Objectives: To describe the communication behaviors of patients and physicians and patient par-ticipation in communication about treatment decision-making during consultation visits for local-ized prostate cancer (LPCa). Methods: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including “none” (content not discussed);“low” (patient listening only);“moderate” (patient providing information or asking questions);and “high” (patient providing information and asking questions). Results: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) “moderate and high” in discussing health histories;2) “low” in discussing survival/mortality;3) “low and moderate” in discussing treatment options;4) “none and low” in discussing treatment impacts;and 5) “low” in discussing treatment preferences. Conclusions: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.

关键词： Localized Prostate Cancer (LPCa) Decision-Making patient-Provider Communication patient Participation Audio-Recording Consultation

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patient Perceptions of Current Disease Control in Poorly Controlled Diabetes

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Health 2014年第15期6卷 1964-1971页

作者： Anjali Gopalan Haley Moss Yuanyuan Tao Jingsan Zhu Kevin Volpp New York University School of Medicine New York USA The Perelman School of Medicine The University of Pennsylvania Philadelphia USA The Philadelphia VA Medical Center Philadelphia USA

Background: Studies suggest that patients do not understand the hemoglobin A1c value (A1c). However, clinicians may communicate information about glycemic control in other ways. Given this, this study evaluates patients’ understanding of current diabetes control, independent of the A1c, and the factors affecting this understanding. Method: Cross-sectional survey of patients with poorly controlled diabetes seen in urban clinics in fall of 2010. Results: 177 people completed the survey. 73.5% were women, 83.0% were African-American and the average age was 56.5 years. 80.2% of respondents reported having had diabetes for at least five years. 39% reported past participation in a diabetes education course. Average A1c was 9.9(S.D. 1.7)%;no differences were noted based on income, education, disease duration, or complication history. 23.7% described their disease control as “good” or “excellent” in spite of an average A1c of 9.5% (1.2). Notably, most of this group reported diabetes for over five years and did not differ in history of diabetes-related complications or educational attainment compared to those with more accurate perceptions of control. Conclusion: The high proportion of participants who reported “good” or “excellent” control in spite of mean A1c greater than 9.5% raises serious questions about the effectiveness of current communication methods for patients with poorly controlled diabetes.

关键词： Diabetes Hemoglobin A1c patient Education patient-Provider Communication

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patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2015年第1期4卷 7-12页

作者： Antar E. Aly Ibrahim M. Duhaini Samia M. Manaa Sayed M. Tarique Shehim E. Kuniyil Huda M. Al Naemi Hamad Medical Corporation Doha Qatar

Information about the peak skin dose and Dose Area product (DAP) from percutaneous transluminal coronary angioplasty (PTCA) and coronary angiography (CA) was collected from three catheter application rooms. The range of maximum photon energy was 50 - 125 kVp and the fluoroscopy time was 0.6 - 52 seconds. Values of up to 143 Gy·cm2 for DAP and 0.752 mGy for cumulative dose (CD) were found in CA procedures. Otherwise the DAP and CD for PTCA were found to be 143 Gy·cm2 and 2.287 mGy respectively in 3rd Quartile. The relation between the fluoroscopy time and the DAP is also considered. Objectives: The objective of this study is to obtain information about patient peak skin doses (PSD), dose area product (DAP), Fluoroscopy Time (FT) and Cumulative Dose (CD) from PTCA and CA which is the most predominant with respect to high skin doses in addition to other procedures. The aim of this study is also to assess the radiation dose received by patients undergoing interventional radiology procedures, by identifying the procedures that deliver the highest doses. This study is also helpful to establish the reference dose level for adult patients undergoing interventional procedure, and to provide recommendations on how to reduce dose on selected procedures that have been identified to deliver patient dose values near the ICRP (International Commission on Radiological Protection) threshold values.

关键词： Interventional Radiology patient Dose Fluoroscopy Time Peak Skin Dose

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patient’s Perception of Autonomy Support and Shared Decision Making in Physical Therapy

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Open Journal of Preventive Medicine 2015年第9期5卷 387-399页

作者： Ignaas Devisch Katreine Dierckx Dominique Vandevelde Patricia De Vriendt Myriam Deveugele Department of Primary Care and Family Medicine Ghent University Ghent Belgium Department of Physical Therapy Ghent University Ghent Belgium Free University Brussels Brussels Belgium Artevelde University College Ghent Belgium

Background: Shared Decision Making (SDM) is primarily intended to enhance patient autonomy. To date, the relationship between patients’ perceived levels of involvement and autonomy support has never been investigated in the field of physical therapy. Based on the recently reported extremely low level of observed SDM in physical therapy, similarly poor patient perceptions are expected. Objective: The main objectives of this study were to examine patients’ perceptions of SDM and autonomy support in physical therapy and to explore the relationship between both. Design: patient survey after real consultations in physical therapy. Methods: patients completed the Dyadic Observing patient Involvement (Dyadic OPTION) instrument and the Health Care Climate Questionnaire (HCCQ) to examine patients’ perceived levels of SDM and autonomy support, respectively. Multilevel analyses were applied to determine the relationship between both perceptions. Results: Two hundred and twenty-nine patients, who were recruited by 13 physical therapists, agreed to participate. The median Dyadic OPTION score was 72.9 out of a total possible score of 100. The median HCCQ score was 94.3 out of a total possible score of 100. patients’ experienced level of SDM (b = 0.14;p patients’ age (b = 0.12;p = 0.001) contributed to patients’ perceived autonomy support. None of the physical therapist characteristics were related to patients’ perceived autonomy support. Limitations: Only 13 out of 125 therapists who were personally contacted agreed to participate. Conclusion: Using patients’ perceptions, we found that a relationship between SDM and autonomy support existed. In contrast to observational studies, our study also demonstrated that the participating physical therapists individually tailored patient support by adapting their implementation of SDM to each patient.

关键词： Shared Decision Making Autonomy Physical Therapy patient Autonomy

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patient safety practices and medical errors: Perception of health care providers at Jimma University Specialized Hospital, Southwest Ethiopia

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Open Journal of Preventive Medicine 2012年第2期2卷 162-170页

作者： Tsion Assefa Mirkuzie Woldie Shimeles Ololo Kifle Woldemichael Department of Epidemiology Jimma University Jimma Ethiopia Department of Health Education and Behavioral Sciences Jimma University Jimma Ethiopia Department of Health Services Management Jimma University Jimma Ethiopia

Background: Even though evidences are limited in developing countries, the probability of patients being harmed in hospitals when receiving care might be much greater than that of the industrialized nations. Thus, aim of this study was to assess patient safety practice and the perceived prevalence of medical errors at Jimma University Specialized Hospital, Southwest Ethiopia. Methods: A facility based cross-sectional study was conducted during June, July and August 2010 in Jimma University Specialized Hospital. patient safety grade and the perceived prevalence of medical errors were computed descriptively. Then, the effect of various independent variables on patient safety grade was assessed using multiple linear regressions analysis. Result: The overall patient safety grade as rated by the participants was excellent (7.2%), very good (20.7%), acceptable (36.0%), poor (30.0%) and failing (6.4%). Complications related to anesthesia occurred sometimes, rarely and never according to 30.8%, 43% and 15.8% of the respondents, respectively. Death in low mortality patients was reported to occur most of the time by 10.4% of the respondents. In addition, failure to rescue, infection due to medical care, postoperative hemorrhage, postoperative sepsis, birth injury to the neonate, obstetric trauma to the mother were reported to happened. Supervisor expectation and actions promoting patient safety (p patient safety grade. Conclusion: this study indicated that poor patient safety practice and potentially preventable medical errors in the hospital.

关键词： patient Safety patient Safety Grade Perceived Prevalence of Medical Errors

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