Web-based platforms used to enhance patient-provider communication are being explored to improve patient satisfaction and care delivery, and decrease cost. This study tested a web-based interactive patient-provider software platform (IPSP), JointCOACH, which enabled patient communication with their care team and preparatory/recovery guidance. The aims of this study are to compare (1) patient satisfaction and (2) healthcare resource utilization by patients who underwent total knee and hip replacements and added IPSP to standard of care (SOC).
This study is a prospective, randomized clinical trial at a single large academic healthcare system. Between May 2018 and March 2020, 399 patients undergoing elective total hip or knee arthroplasty were randomized to SOC arm (n= 204) or SOC+ IPSP arm (n= 195). Patient demographics, surgical details, and comorbidities were collected. Patient satisfaction was assessed using Visual Analog Scale and the Picker Patient Experience-15. Healthcare utilization was measured usieen the patient and provider, and should be evaluated as an element of virtual care rather than supplementing traditional in-office follow-up. CLINICALTRIALS.GOV More information on this study can be found at clinicaltrials.gov NCT03499028.
The 2018 Evidence-Based Polycystic Ovary Syndrome (PCOS) Clinical Guidelines recommend lifestyle management as first-line treatment for PCOS, yet implementation of PCOS lifestyle programs into practice is not well understood.
To complete systematic intervention mapping by identifying the facilitators and barriers to lifestyle management in women with PCOS using the theoretical domains framework (TDF) and the Capacity, Opportunity, Motivation and Behaviour model (COM-B).
Women (N = 20) in Australian with PCOS were interviewed.
Telephone semi-structured interviews.
Nine themes mapped onto seven TDF domains and the COM-B. Capability psychological co-morbidities, knowledge and awareness of lifestyle change and ability to identify and resolve barriers. Opportunity presence of other medical conditions, access to practical resources and availability of social support.
outcomes expectancies of lifestyle behaviour, personal values, enjoyment and readiness to change and the impact of stress on lifestyle choices.
This is the first study to explore barriers and facilitators to lifestyle change from the perspectives of women with PCOS using the TDF and COM-B. Addressing these themes will facilitate patient-centred care and long-term behaviour change.
May increase the efficacy and effectiveness of PCOS lifestyle programs and reduce the risk of PCOS-associated disease in this population.
May increase the efficacy and effectiveness of PCOS lifestyle programs and reduce the risk of PCOS-associated disease in this population.
Learning effective communication, particularly jargon avoidance, is important for medical training. Standardized methods exist to identify jargon but there is room to further refine those methods to define medical jargon and expand categorization. This project aims to classify jargon words as having a plain language alternative or not, to both standardize the definition of jargon and as a foundation for teaching jargon avoidance.
We analyzed 123 transcribed encounters between standardized patients and medical students to quantify and categorize medical jargon using a stepwise process based on published literature. This process eliminated common words (based on New Dale-Chall list) without distinct medical meaning. Uncommon words and words with distinct medical meanings found in Stedman's Medical Dictionary were considered jargon. Jargon words were cross-referenced with the Plain Language Thesaurus to identify plain language alternatives.
This process identified 310 jargon words, 102 with plain language alternative from the 123 encounters.
We objectively classified jargon into distinct categories with a novel focus on jargon words with and without plain language alternatives.
This objective classification system serves as an important step in gaining a comprehensive understanding of jargon use which is essential to improving and teaching communication skills.
This objective classification system serves as an important step in gaining a comprehensive understanding of jargon use which is essential to improving and teaching communication skills.
To explore the barriers to and facilitators of healthcare professionals' implementation of SDM regarding screening programmes.
A systematic review was conducted in PubMed, Cochrane Library, CINHAL, and PsyscInfo. The barriers and facilitators identified were classified into three factors based on their origin patients, healthcare system performance, and healthcare professionals themselves.
Eight studies were selected seven related to cancer screening. The most significant facilitators were literacy and interest in active participation, both of which have their origins in patients. The most significant barriers identified for the first time in a systematic review were legal conflict, lack of remuneration and lack of flexibility in clinical guidelines in screening programmes.
The results of this study show that there are differences between barriers and facilitators for SDM when it is applied in the context of healthy people who perform preventive activities, particularly screening, in contrast to general medical consultation contexts.
The authors suggest that to advance in the practice of SDM, we need to develop and disseminate training documents. Further, SDM should be incorporated into clinical guidelines. There should be more studies focusing on healthcare professionals' behaviour within the context of the uncertainty of screening programmes.
The authors suggest that to advance in the practice of SDM, we need to develop and disseminate training documents. Further, SDM should be incorporated into clinical guidelines. There should be more studies focusing on healthcare professionals' behaviour within the context of the uncertainty of screening programmes.
The surgical approaches and resection extent for rectal gastrointestinal stromal tumors (GISTs) are controversial due to the low incidence of this disease. A multicenter retrospective cohort study was conducted to compare the postoperative and oncologic outcomes of local excision (LE) and radical resection (RR) in patients with low rectal GIST.
The medical records of rectal GIST patients from 11 large-scale medical centers in China (January 2000-December 2019) were reviewed. All patients were divided into either the LE group or the RR group. Propensity score matching (PSM) was conducted to reduce confounders.
A total of 280 patients with low rectal GIST were enrolled. After PSM, 144 patients were included (72 in each group). KRT-232 datasheet The LE group showed a higher anal preservation rate (100.0% vs. 76.4%, P<0.001), shorter operation time (77.1±68.4min vs. 159.1±83.6min, P<0.001), fewer complications (8.3% vs. 22.2%, P=0.021) and shorter postoperative hospital stay (4.9±4.1d vs. 10.7±8.1d, P<0.001) than the RR group.KRT-232 datasheet
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