scholarly journals Creating Long-Lasting Clinical Connections: A Trainee-Centered, Leadership-Based Perspective on Provider-Patient Relationship

2021 ◽  
Author(s):  
Mariah Janowski ◽  
Olivia Dahlgren ◽  
Kori-Ann Taylor ◽  
Isha Kaza ◽  
Ambreen Alam ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Holistic Approach ◽  
Well Being ◽  
Health Care Team ◽  
Patient Relationship ◽  
Care Providers ◽  
Chief Complaints ◽  
Tone Of Voice ◽  
Key Aspects

The nature of provider-patient relationship (PPR) goes far beyond the simplified paradigm of “chief complaints,” “clinical problems” and corresponding “therapeutic solutions.” In order to more comprehensively explore the scope of PPR in the context of leadership-based partnership (LBP), various factors and their contributions were researched in terms of both the success and optimization of health-care interactions. This is especially relevant to graduate medical education (GME) and advanced practice (AP) training programs. There are numerous nuances to PPR, including various communication, behavioral, ethical and leadership considerations. Body language and tone of voice are essential in establishing rapport, beginning with the so-called ‘first impression,’ which serves as a foundation for developing the PPR. Health-care providers (HCPs) with greater ability to empathize with their patients may achieve higher levels of treatment adherence, better clinical outcomes, and ultimately increased patient satisfaction. The inclusion of a patient as a co-leader and an essential member of their health-care team (HCT) should be a natural step and a top priority for GME and AP trainees. Such collaboration requires an open-minded approach by all stakeholders. Finally, recognizing patient well-being in all domains, including physical, emotional and spiritual, is critical to the holistic approach toward maximizing the benefits of an optimal PPR. Same can be said about the HCP. In this chapter, we will explore key aspects of PPR in the context of both the trainee and the patient being co-leaders within the bounds of the LBP framework.

scholarly journals Depression and Suicidality in Gay Men: Implications for Health Care Providers

2017 ◽  
Vol 11 (4) ◽  
pp. 910-919 ◽  
Author(s):  
Carrie Lee ◽  
John L. Oliffe ◽  
Mary T. Kelly ◽  
Olivier Ferlatte
Keyword(s):  
Health Care ◽  
Gay Men ◽  
Health Care Providers ◽  
Help Seeking ◽  
Adult Population ◽  
Well Being ◽  
Sexual Practices ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Prevalence Of Depression

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.

Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic

2021 ◽  
pp. 152483992110654
Author(s):  
Kathryn West ◽  
Karen R. Jackson ◽  
Tobias L. Spears ◽  
Brian Callender
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Series ◽  
Narrative Medicine ◽  
Well Being ◽  
Small Scale ◽  
Care Providers ◽  
Graphic Medicine ◽  
Racial Injustice ◽  
Pilot Implementation

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

Guidelines for the Reporting of Nongynecologic Cytopathology Specimens

2009 ◽  
Vol 133 (11) ◽  
pp. 1743-1756
Author(s):  
Barbara A. Crothers ◽  
William D. Tench ◽  
Mary R. Schwartz ◽  
Joel S. Bentz ◽  
Ann T. Moriarty ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ad Hoc ◽  
Clinical Laboratory ◽  
Needle Aspiration ◽  
Health Care Team ◽  
Major Elements ◽  
Pathology Report ◽  
Care Providers ◽  
Healthcare Organizations

Abstract Context.—Gynecologic cytology terminology and report formatting have been nationally standardized since the implementation of The Bethesda System of 1988, but standard reporting for nongynecologic cytology has never been formally addressed on the same scale. Objectives.—To promote patient safety through uniform reporting in nongynecologic cytology (including fine-needle aspiration cytology) and to improve communication between laboratories and health care providers. Data Sources.—Sources include the College of American Pathologists Cytopathology Resource Committee; the College of American Pathologists Council on Scientific Affairs Ad Hoc Committee on Pathology Report Standardization; the College of American Pathologists Laboratory Accreditation Program inspection checklists; the Joint Commission for Accreditation of Healthcare Organizations; and the Clinical Laboratory Improvement Amendments of 1988. Conclusions.—We describe the major elements of quality nongynecologic cytology reporting and discuss areas of controversy in cytology reporting. Standardized nongynecologic specimen reporting will expand the concept of common report elements already widely implemented in gynecologic cytology reporting. The intent is to improve communication with the health care team while remaining in compliance with federal mandates and accreditation guidelines.

Your Diabetes

2018 ◽  
pp. 75-91
Author(s):  
Mari Armstrong-Hough
Keyword(s):  
Health Care ◽  
Disease Progression ◽  
Health Care Providers ◽  
Lifestyle Changes ◽  
Patient Relationship ◽  
Care Providers ◽  
Course Of Disease ◽  
American Health Care ◽  
Low Expectations ◽  
Capacity For Change

This chapter uses interview data with American health care providers to examine clinicians’ strategies for negotiating with patients to elicit cooperation and participation in their own self-management. It argues that physicians in both countries switch between different models of the provider-patient relationship as they see fit to the situation. The American providers stressed that, ultimately, responsibility for managing the disease rested with the patient. However, they were markedly pessimistic about their patients’ capacity for change and likely course of disease progression. Providers’ low expectations and pessimism contributed to a preference for small, simple lifestyle changes in combination with medication rather than bold lifestyle change.

scholarly journals Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana

2019 ◽  
Vol 5 ◽  
pp. 233372141985545 ◽  
Author(s):  
Williams Agyemang-Duah ◽  
Charles Peprah ◽  
Francis Arthur-Holmes
Keyword(s):  
Health Care ◽  
Health Services ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Expenditure ◽  
Well Being ◽  
Health Care Use ◽  
Public Health Care ◽  
Care Providers ◽  
Health Lifestyle

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.

scholarly journals Risk Perception and Worries among Health Care Workers in the COVID-19 Pandemic: Findings from an Italian Survey

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 535
Author(s):  
Mariangela Valentina Puci ◽  
Guido Nosari ◽  
Federica Loi ◽  
Giulia Virginia Puci ◽  
Cristina Montomoli ◽  
...  
Keyword(s):  
Health Care ◽  
Risk Perception ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Well Being ◽  
Care Providers ◽  
Cross Sectional ◽  
Care Workers

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.

scholarly journals Breastfeeding in COVID-19: A Pragmatic Approach

2020 ◽  
Vol 37 (13) ◽  
pp. 1377-1384
Author(s):  
Yvonne Peng Mei Ng ◽  
Yi Fen Low ◽  
Xin Lei Goh ◽  
Doris Fok ◽  
Zubair Amin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Team ◽  
Care Staff ◽  
Future Research ◽  
Health Care Staff ◽  
Care Providers ◽  
Joint Decision ◽  
Skin Contact ◽  
Novel Coronavirus

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother–infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal–infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. Key Points

A Qualitative Study of a Compassion, Presence, and Resilience Training for Oncology Interprofessional Teams

2018 ◽  
Vol 37 (1) ◽  
pp. 30-44 ◽  
Author(s):  
Rinat Nissim ◽  
Carmine Malfitano ◽  
Mark Coleman ◽  
Gary Rodin ◽  
Mary Elliott
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Subjective Experience ◽  
Well Being ◽  
Holistic Health ◽  
Cancer Center ◽  
Care Practice ◽  
Care Providers ◽  
Interprofessional Teams ◽  
Resilience Training

The well-being of health care providers may be challenged by their work, with evidence that oncology health care providers are a high-risk group for burnout. The present qualitative pilot study evaluated a mindfulness-based group intervention, referred to as Compassion, Presence, and Resilience Training (CPR-T), for oncology interprofessional teams. The purpose of this study was to elucidate the subjective experience of oncology health care providers receiving CPR-T and their perceptions of its benefits, risks, or challenges. The CPR-T was delivered to providers from two oncology teams in a large cancer center in Canada. Ten of these providers participated in semistructured interviews 1 to 5 months after completing the CPR-T. The interview transcripts were coded using a thematic analysis strategy. Five benefits of the CPR-T were identified: learning to pause, acquiring a working definition of stress and self-care, becoming fully present, building self-compassion, and receiving organizational acknowledgment and recognition of stress. In addition, two participant-identified challenges were recognized: sharing vulnerability within interprofessional teams and committing to a sitting meditation practice. These findings demonstrate positive transformations as a result of the CPR-T, as well as important challenges, and have important implications for holistic health care practice in oncology. Further research is necessary to validate the findings of this explorative study.

Clinical Research With Pregnant Women: Perspectives of Pregnant Women, Health Care Providers, and Researchers

2018 ◽  
Vol 28 (13) ◽  
pp. 2033-2047 ◽  
Author(s):  
Kyoko Wada ◽  
Marilyn K. Evans ◽  
Barbra de Vrijer ◽  
Jeff Nisker
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Clinical Research ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Research Participation ◽  
Well Being ◽  
Constructivist Grounded Theory ◽  
Care Providers ◽  
Women Health

Limited clinical research with pregnant women has resulted in insufficient data to promote evidence-informed prenatal care. Charmaz’s constructivist grounded theory methodology was used to explore how research with pregnant women would be determined ethically acceptable from the perspectives of pregnant women, health care providers, and researchers in reproductive sciences. Semistructured interviews were conducted with a purposive sample of 12 pregnant women, 10 health care providers, and nine reproductive science researchers. All three groups suggested the importance of informed consent and that permissible risk would be very limited and complex, being dependent on the personal benefits and risks of each particular study. Pregnant women, clinicians, and researchers shared concerns about the well-being of the woman and her fetus, and expressed a dilemma between promoting research for evidence-informed prenatal care while securing the safety in the course of research participation.

Dignity and palliative end-of-life care

2015 ◽  
Author(s):  
Harvey Max Chochinov ◽  
Susan E. McClement ◽  
Maia S. Kredentser
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Vulnerable Groups ◽  
Clinical Settings ◽  
Life Care ◽  
Care Providers ◽  
Key Aspects ◽  
To Receive

The concept of dignity continues to receive attention in health care, with particular implications for end-of-life care. This chapter reviews current conceptualizations of dignity, integrating medical, philosophical, and ontological perspectives. The centrality of dignity to palliative care is discussed, exploring empirical findings, which examine what dignity means to patients and families in the context of illness and end-of-life care. The chapter provides an overview of validated tools, evidence-based therapies, and practical ‘everyday’ communication skills that health-care providers in diverse clinical settings can use to enhance patient dignity. Suggestions are provided for extending existing research into the notion of dignity as it relates to vulnerable groups, and how interventions aimed at supporting patient dignity can impact family members. Dignity subsumes many key aspects of comprehensive care, which can guide health-care providers towards improving end-of-life experiences for patients and families.

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