scholarly journals Student Academy: A Pilot Design Thinking Workshop to Teach Community Medicine

2021 ◽  
Author(s):  
Blake Lesselroth ◽  
Hannah Park ◽  
Helen Monkman ◽  
Shannon Ijams ◽  
Ryan Yarnall ◽  
...  
Keyword(s):  
Health Professionals ◽  
Design Thinking ◽  
Clinical Work ◽  
Social Needs ◽  
Patient Centered ◽  
Work Settings ◽  
Physician Assistant Students ◽  
Health Related ◽  
Pilot Design ◽  
Future Practice

The medical literature shows that social determinants of health have a significant impact upon health outcomes. However, health professionals often lack the skills to address these determinants at the systems-level. Therefore, we developed a Design Thinking workshop to teach about health-related social needs and to practice designing person-centered solutions. We piloted the workshop with 53 medical and physician assistant students; 69.8% responded to the post-workshop questionnaire. Nearly 80% of students agreed the workshop helped them understand the effect of context on clinical outcomes and demonstrated how to design patient-centered solutions. However, only 50% of respondents anticipated using the Design Thinking methods in their future practice. We need to identify more effective ways to demonstrate the practical application of Design Thinking to clinical work settings.

scholarly journals Trauma-Informed Care in Primary Health Settings—Which Is Even More Needed in Times of COVID-19

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 340 ◽  
Author(s):  
Teresa Tomaz ◽  
Ivone Castro-Vale
Keyword(s):  
Core Competencies ◽  
Clinical Work ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Patient Centered ◽  
Trauma Informed Care ◽  
Health Related ◽  
Physical Disorders ◽  
Trauma Informed ◽  
Patient Relationships

Included in the general practitioner’s (GP) core competencies is the ability to adopt a person-centered approach, and the use of the biopsychosocial model in their clinical work. Traumatic events (TEs) are frequently experienced within the population and are known to dysregulate the stress response system and to be associated with psychiatric and physical disorders. GPs may feel reluctant to confront TEs for a variety of reasons, such as a lack of sufficient training in trauma-informed care or a fear of causing harm when discussing a patient’s more complicated issues, among others. This perspective paper aims to review the existing studies that support the practice of trauma-informed healthcare and to summarise best practices. Studies have shown that patients appreciate the questions that clinicians ask them about trauma-related issues and that they understand that this can be important for their healthcare. Furthermore, asking about trauma-related issues in a patient-centered and empathic way can result in better doctor–patient relationships, which improves the levels of satisfaction of both the patient and the doctor with the consultation, as well as improved health-related outcomes. As past traumatic experiences increase the risk of developing post-traumatic stress disorder on exposure to a new TE, the onset of the COVID-19 pandemic has led to trauma-informed care becoming even more important if the strategy is to continue to invest in preventive medicine.

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

scholarly journals Short-term Efficacy of Upper-Extremity Exercise Training in Patients With Chronic Airway Obstruction: A Systematic Review

2009 ◽  
Vol 89 (5) ◽  
pp. 443-455 ◽  
Author(s):  
Stefania Costi ◽  
Mauro Di Bari ◽  
Paolo Pillastrini ◽  
Roberto D'Amico ◽  
Ernesto Crisafulli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Exercise Training ◽  
Pulmonary Rehabilitation ◽  
Health Related Quality ◽  
Inclusion Criteria ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related

Background, Objectives, and Measurements Patients with chronic airway obstruction (CAO) frequently experience dyspnea and fatigue during activities performed by accessory muscles of ventilation, which competitively participate in arm elevation. This systematic review of randomized controlled trials (RCTs) concerning patients with CAO addresses the effects of upper-extremity exercise training (UEET), added to lower-extremity training or comprehensive pulmonary rehabilitation, on the following patient-centered outcomes: exercise capacity, symptoms, ability to perform daily activities, and health-related quality of life. Methods Studies were retrieved using comprehensive database and hand-search strategies. Two independent reviewers determined study eligibility based on inclusion criteria. A detailed description of treatments was mandatory. Reviewers rated study quality and extracted information on study methods, design, intervention, and results. Results Forty publications were evaluated. Four RCTs met the inclusion criteria but had serious methodological limitations, which introduce possible biases that reduce their internal validity. The outcomes measured were heterogeneous, and the results were inconsistent regarding maximal exercise capacity, dyspnea, and health-related quality of life. No effect of UEET was demonstrated for measures of arm fatigue. Limitations and Conclusions The limited methodological quality of the studies retrieved prevented us from performing a meta-analysis, the results of which could be misleading. This systematic review shows that there is limited evidence examining UEET and that the evidence available is of poor quality. Therefore, a recommendation for the inclusion or exclusion of UEET in pulmonary rehabilitation programs for individuals with CAO is not possible. Further research is needed to definitively ascertain the effects of this training modality on patient-centered outcomes.

Health-Related Social Needs Among Emergency Department Patients with HIV

2021 ◽  
Author(s):  
Evan Gerber ◽  
Lillian Gelberg ◽  
Ethan Cowan ◽  
Tod Mijanovich ◽  
Donna Shelley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Social Needs ◽  
Health Related ◽  
Emergency Department Patients

scholarly journals Mechanisms Associated with Clinical Improvement in Interventions That Address Health-Related Social Needs: A Mixed-Methods Analysis

2019 ◽  
Vol 22 (5) ◽  
pp. 399-405 ◽  
Author(s):  
Seth A. Berkowitz ◽  
Amy Catherine Hulberg ◽  
Hilary Placzek ◽  
Anya Dangora ◽  
Jason Gomez ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Clinical Improvement ◽  
Social Needs ◽  
Health Related

scholarly journals Implementing Health Related Social Needs Screening in an Outpatient Clinic: A Cross-Sectional Study

2021 ◽  
Author(s):  
Raman Nohria ◽  
Nan Xiao ◽  
Rubeen Guardado ◽  
Mari-Lynn Drainoni ◽  
Cara Smith ◽  
...  
Keyword(s):  
Random Sample ◽  
Disease Burden ◽  
Implementation Strategies ◽  
Clinic Visit ◽  
Social Needs ◽  
Comorbid Disease ◽  
Cross Sectional ◽  
Visit Frequency ◽  
Clinic Site ◽  
Health Related

Abstract BackgroundTo date, health-related social needs (HRSN) screening implementation efforts have reported high rates of identified social needs. However, little is known about how screening processes may fail to leverage implementation strategies to optimize reach, and thereby unintentionally target non-representative groups for screening and referral programs. MethodsElectronic medical data were abstracted from 2016-2020 for 4,731 screened patients from 7 affiliated clinics of a federally-qualified health center (FQHC). Unscreened patients were pulled first as a random sample from the study period, then matched based on clinic site and clinic visit frequency. Sociodemographic traits, comorbid conditions, and outpatient encounter type and frequency were compared between the screened and unscreened patient cohorts using descriptive statistics.ResultsScreened patients (n-4731) had a median of 3.3 (+/- 2.5) unmet HRSN. Compared to a random sample of unscreened FQHC patients, screened patients had significantly more clinic visits (26.8 vs 16.3; p<0.05) and carried a higher comorbid disease burden (3+ conditions: 8% vs 2%; p<0.05). When the unscreened cohort was matched to the screened cohort for clinic site, these findings remained constant. Due to high visit frequency in the screened cohort, our analysis was matched for clinic visit frequency. Screened patients continued to demonstrate a higher comorbid disease burden (3+ conditions, 8% vs 3%; p<0.05), but only had a higher prevalence of 4 chronic conditions (diabetes, hypertension, chronic kidney disease, and anxiety/depression). ConclusionsWithout an a priori plan for implementation, we have found a predisposition to screen patients who visit outpatient services more often and have a higher comorbid disease burden. HRSN screening processes will benefit from implementation strategies to improve reach and to ensure maximal uptake of screening.

scholarly journals A history of health-related quality of life outcomes in psychiatry

2014 ◽  
Vol 16 (2) ◽  
pp. 127-135 ◽  
Keyword(s):  
Quality Of Life ◽  
Psychiatric Patients ◽  
Clinical Care ◽  
Self Report ◽  
Psychiatric Research ◽  
Health Related Quality ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related

Health-related quality of life (HRQoL) is a multidimensional concept that includes subjective reports of symptoms, side effects, functioning in multiple life domains, and general perceptions of life satisfaction and quality. Rather than estimating it from external observations, interview, or clinical assessment, it is best measured by direct query. Due to a perception that respondents may not be reliable or credible, there has been some reluctance to use self-report outcomes in psychiatry. More recently, and increasingly, HRQoL assessment through direct patient query has become common when evaluating a range of psychiatric, psychological, and social therapies. With few exceptions, psychiatric patients are credible and reliable reporters of this information. This article summarizes studies that highlight the development, validation, and application of HRQoL measures in psychiatry. Thoughtful application of these tools in psychiatric research can provide a much-needed patient perspective in the future of comparative effectiveness research, patient-centered outcomes research, and clinical care.

scholarly journals Employing Long Short-Term Memory Networks in Trigger Detection for Emetophobia

2020 ◽  
Vol 65 (2) ◽  
pp. 17
Author(s):  
M.-M. Mircea
Keyword(s):  
Short Term Memory ◽  
Specific Phobia ◽  
Short Term ◽  
Patient Centered ◽  
Term Memory ◽  
Trigger Detection ◽  
Specific Phobias ◽  
Health Related ◽  
Long Short Term Memory ◽  
Specific Fear

Research focused on mental health-related issues is vital to the modern person’s life. Specific phobias are part of the anxiety disorder umbrella and they are distressing afflictions. Emetophobia is the rarely known, yet fairly common and highly disruptive specific phobia of vomiting. Unlike other phobias, emetophobia is triggered not only by the object of the specific fear, but also by verbal and written mentions of said object. This paper proposes and compares ten neural network-based architectures that discern between triggering and non-triggering groups of written words. An interface is created, where the best models can be used in emetophobia-related applications. This interface is then integrated into an application that can be used by emetophobes to censor online content such that the exposure to triggers is controlled, patient-centered, and patient-paced.

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