Journal articles: 'Patient Clinician Relationship'

1

Finset, Arnstein, and Knut Ørnes. "Empathy in the Clinician–Patient Relationship." Journal of Patient Experience 4, no. 2 (May 9, 2017): 64–68. http://dx.doi.org/10.1177/2374373517699271.

Full text

Abstract:

The clinician-patient relationship is asymmetric in the sense that clinicians and patients have different roles in the medical consultation. Yet, there are qualities of reciprocity and mutuality in many clinician-patient encounters, and we suggest that such reciprocity may be related to the phenomenon of empathy. Empathy is often defined as the capacity to place oneself in another’s position, but empathy may also be understood as a sequence of reciprocal turns-of talk, starting with the patient’s expression of emotion, followed by the perception, vicarious experience, and empathic response by the clinician. These patterns of reciprocity may also include the patient’s experience of and response to the clinician’s emotions. Researchers in different fields of research have studied how informal human interaction often is characterized by mutuality of lexical alignment and reciprocal adjustments, vocal synchrony, as well as synchrony of movements and psychophysiological processes. A number of studies have linked these measures of reciprocity and synchrony in clinical encounters to the subjective experience of empathy.

APA, Harvard, Vancouver, ISO, and other styles

2

E. Stahl, James, Mark A. Drew, and Alexa Boer Kimball. "Patient-clinician concordance, face-time and access." International Journal of Health Care Quality Assurance 27, no. 8 (October 7, 2014): 664–71. http://dx.doi.org/10.1108/ijhcqa-04-2013-0048.

Full text

Abstract:

Purpose – People in socially disadvantageous positions may receive less time with their clinicians and consequently reduced access to healthcare resources, potentially magnifying health disparities. Socio-cultural characteristics of clinicians and patients may influence the time spent together. The purpose of this paper is to explore the relationship between clinician/patient time and clinician and patient characteristics using real-time location systems (RTLS). Design/methodology/approach – In the MGH/MGPO Outpatient RFID (radio-frequency identification) project clinicians and patients wore RTLS tags during the workday to measure face-time (FT), the duration patients and clinicians are co-located, wait time (WT); i.e. from registration to clinical encounter and flow time (FLT) from registration to discharge. Demographic data were derived from the health system's electronic medical record (EMR). The RTLS and EMR data were synthesized and analyzed using standard structured-query language and statistical analytic methods. Findings – From January 1, 2009 to January 1, 2011, 1,593 clinical encounters were associated with RTLS measured FTs, which differed with socioeconomic status and gender: women and lower income people received greater FT. WT was significantly longer for lower socioeconomic patients and for patients seeing trainee clinicians, women or majority ethnic group clinicians (Caucasian). FLT was shortest for men, higher socioeconomic status and for attending physician patients. Demographic concordance between patient and clinician did not significantly affect process times. Research limitations/implications – The study demonstrates the feasibility of using RTLS to capture clinically relevant process measures and suggests that the clinical delivery system surrounding a clinical encounter may more significantly influence access to clinician time than individual patient and clinician characteristics. Originality/value – Applying RTLS to healthcare is coming. We can now successfully install and run these systems in healthcare settings and extract useful information from them. Interactions with the clinical delivery system are at least as important as interactions with clinicians for providing access to care: measure FT, WT and FLT with RTLS; link clinical behavior, e.g. FT, with patient characteristics; explore how individual characteristics interact with system behavior.

APA, Harvard, Vancouver, ISO, and other styles

3

Moran, Mark. "Successful BPD Therapies Focus on Clinician-Patient Relationship." Psychiatric News 43, no. 13 (July 4, 2008): 16. http://dx.doi.org/10.1176/pn.43.13.0016.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

Arora, Vineet M., Sonia Madison, and Lisa Simpson. "Addressing Medical Misinformation in the Patient-Clinician Relationship." JAMA 324, no. 23 (December 15, 2020): 2367. http://dx.doi.org/10.1001/jama.2020.4263.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Buetow, Stephen, and Tim Kenealy. "Practical Pointers: Learning to 'see' in the clinician-patient relationship." Journal of Primary Health Care 1, no. 2 (2009): 148. http://dx.doi.org/10.1071/hc09148.

Full text

Abstract:

Medical education tends to praise or pay lip-service to the art of observation, while systematically teaching the science of technology. To the extent you were taught observation skills as clinicians, you may have learned how to listen and touch but not usually how to see your patients and yourself. This paper considers how to see in the clinicianpatient relationship, not merely in an optical sense but also to increase your perceptiveness. We suggest 10 strategies to enhance your ability to see. KEYWORDS: Observation, perception, visual, clinicianpatient relationship

APA, Harvard, Vancouver, ISO, and other styles

6

McGUIRE-SNIECKUS, REBECCA, ROSEMARIE McCABE, JOCELYN CATTY, LARS HANSSON, and STEFAN PRIEBE. "A new scale to assess the therapeutic relationship in community mental health care: STAR." Psychological Medicine 37, no. 1 (November 9, 2006): 85–95. http://dx.doi.org/10.1017/s0033291706009299.

Full text

Abstract:

Background. No instrument has been developed specifically for assessing the clinician–patient therapeutic relationship (TR) in community psychiatry. This study aimed to develop a measure of the TR with clinician and patient versions using psychometric principles for test construction.Method. A four-stage prospective study was undertaken, comprising qualitative semi-structured interviews about TRs with clinicians and patients and their assessment of nine established scales for their applicability to community care, administering an amalgamated scale of more than 100 items, followed by Principal Components Analysis (PCA) of these ratings for preliminary scale construction, test–retest reliability of the scale and administering the scale in a new sample to confirm its factorial structure. The sample consisted of patients with severe mental illness and a designated key worker in the care of 17 community mental health teams in England and Sweden.Results. New items not covered by established scales were identified, including clinician helpfulness in accessing services, patient aggression and family interference. The new patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and positive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version. Test–retest reliability was r=0·76 for STAR-P and r=0·68 for STAR-C. The factorial structure of the new scale was confirmed with a good fit.Conclusions. STAR is a specifically developed, brief scale to assess TRs in community psychiatry with good psychometric properties and is suitable for use in research and routine care.

APA, Harvard, Vancouver, ISO, and other styles

7

Knowlton, E. Katherine, Jeffrey L. Sternlieb, and John R. Freedy. "The clinician–patient relationship: The therapeutic value of the clinical encounter." International Journal of Psychiatry in Medicine 55, no. 1 (December 12, 2019): 3–7. http://dx.doi.org/10.1177/0091217419894472.

Full text

APA, Harvard, Vancouver, ISO, and other styles

8

Hlubocky, Fay J., Miko Rose, and Ronald M. Epstein. "Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout." American Society of Clinical Oncology Educational Book, no. 37 (May 2017): 771–81. http://dx.doi.org/10.1200/edbk_173874.

Full text

Abstract:

Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one’s relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.

APA, Harvard, Vancouver, ISO, and other styles

9

Galazka, Anna Milena. "Beyond patient empowerment: clinician-patient advocacy partnerships in wound healing." British Journal of Healthcare Management 25, no. 6 (June 2, 2019): 1–6. http://dx.doi.org/10.12968/bjhc.2019.0030.

Full text

Abstract:

Background/Aims Enhanced clinician-patient interactions can offer benefits for patient care through harnessing shared knowledge, which can help to address challenges in healthcare. This study aimed to explore the relationship between wound care clinicians and their patients in order to understand the challenges faced in wound care as well as the innovative strategies that are used to address them. Methods A qualitative ethnography of three specialist outpatient wound healing clinics in the UK generated 120 hours of observations of consultations as well as 51 interviews with clinicians, patients and their relatives. Findings The study found that wounds were considered a low-profile condition in healthcare and a taboo by society. In response, clinicians harnessed their interaction with patients to support wound healing research and education – forming clinician-patient partnerships for wound healing advocacy. Conclusions In addition to encouraging educated participation in self-treatment, advocacy partnerships offered patients a proactive role in increasing the scientific knowledge regarding wound healing.

APA, Harvard, Vancouver, ISO, and other styles

10

Lown, Beth A. "Difficult Conversations: Anger in the Clinician-Patient/Family Relationship." Southern Medical Journal 100, no. 1 (January 2007): 34–39. http://dx.doi.org/10.1097/01.smj.0000223950.96273.61.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Campelia, Georgina D., and James N. Kirkpatrick. "Reinterpreting Informed Decision-Making Through The Clinician–Patient Relationship." Annals of Thoracic Surgery 108, no. 6 (December 2019): 1610–11. http://dx.doi.org/10.1016/j.athoracsur.2019.08.007.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Rose, Susannah, Heather McKee Hurwitz, Mary Beth Mercer, Sabahat Hizlan, Kari Gali, Pei-Chun Yu, Caroline Franke, et al. "Patient Experience in Virtual Visits Hinges on Technology and the Patient-Clinician Relationship: A Large Survey Study With Open-ended Questions." Journal of Medical Internet Research 23, no. 6 (June 21, 2021): e18488. http://dx.doi.org/10.2196/18488.

Full text

Abstract:

Background Patient satisfaction with in-person medical visits includes patient-clinician engagement. However, communication, empathy, and other relationship-centered care measures in virtual visits have not been adequately investigated. Objective This study aims to comprehensively consider patient experience, including relationship-centered care measures, to assess patient satisfaction during virtual visits. Methods We conducted a large survey study with open-ended questions to comprehensively assess patients’ experiences with virtual visits in a diverse patient population. Adults with a virtual visit between June 21, 2017, and July 12, 2017, were invited to complete a survey of 21 Likert-scale items and textboxes for comments following their visit. Factor analysis of the survey items revealed three factors: experience with technology, patient-clinician engagement, and overall satisfaction. Multivariable logistic regression was used to test the associations among the three factors and patient demographics, clinician type, and prior relationship with the clinician. Using qualitative framework analysis, we identified recurrent themes in survey comments, quantitatively coded comments, and computed descriptive statistics of the coded comments. Results A total of 65.7% (426/648) of the patients completed the survey; 64.1% (273/426) of the respondents were women, and the average age was 46 (range 18-86) years. The sample was geographically diverse: 70.2% (299/426) from Ohio, 6.8% (29/426) from Florida, 4.2% (18/426) from Pennsylvania, and 18.7% (80/426) from other states. With regard to insurance coverage, 57.5% (245/426) were undetermined, 23.7% (101/426) had the hospital’s employee health insurance, and 18.7% (80/426) had other private insurance. Types of virtual visits and clinicians varied. Overall, 58.4% (249/426) of patients had an on-demand visit, whereas 41.5% (177/426) had a scheduled visit. A total of 41.8% (178/426) of patients had a virtual visit with a family physician, 20.9% (89/426) with an advanced practice provider, and the rest had a visit with a specialist. Most patients (393/423, 92.9%) agreed that their virtual visit clinician was interested in them as a person, and their virtual visit made it easy to get the care they needed (383/421, 90.9%). A total of 81.9% (344/420) of respondents agreed or strongly agreed that their virtual visit was as good as an in-person visit by a clinician. Having a prior relationship with their virtual visit clinician was associated with less comfort and ease with virtual technology among patients (odds ratio 0.58, 95% CI 0.35-0.98). In terms of technology, patients found the interface easy to use (392/423, 92.7%) and felt comfortable using it (401/423, 94.8%). Technical difficulties were associated with lower odds of overall satisfaction (odds ratio 0.46, 95% CI 0.28-0.76). Conclusions Patient-clinician engagement in virtual visits was comparable with in-person visits. This study supports the value and acceptance of virtual visits. Evaluations of virtual visits should include assessments of technology and patient-clinician engagement, as both are likely to influence patient satisfaction.

APA, Harvard, Vancouver, ISO, and other styles

13

Hojat, Mohammadreza, Jennifer DeSantis, and Joseph S. Gonnella. "Patient Perceptions of Clinician’s Empathy." Journal of Patient Experience 4, no. 2 (March 20, 2017): 78–83. http://dx.doi.org/10.1177/2374373517699273.

Full text

Abstract:

The prominence of reciprocal understanding in patient–doctor empathic engagement implies that patient perception of clinician’s empathy has an important role in the assessment of the patient–clinician relationship. In response to a need for an assessment tool to measure patient’s views of clinician empathy, we developed a brief (5-item) instrument, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). This review article reports evidence in support of the validity and reliability of the JSPPPE.

APA, Harvard, Vancouver, ISO, and other styles

14

Beliaev, Andrei M. "Refusal of Treatment by Mentally Competent Patient: The Choice of Doctor-Patient Relationship Models." Acta Medica (Hradec Kralove, Czech Republic) 53, no. 4 (2010): 239–42. http://dx.doi.org/10.14712/18059694.2016.84.

Full text

Abstract:

Introduction: In modern medicine professional relationship between the clinician and the patient is patient-centered. Patients become actively involved in the treatment decision making process and are encouraged to express their health-related preferences. Some patients may, however, refuse a favorable risk/benefit ratio treatment. This manuscript presents three cases of refusal of treatment by mentally competent surgical patients and discusses differences in their management. Conclusion: To achieve the best medical outcome for patients who possess the Actual Understanding test of mental competence clinicians use the deliberate model of medical professional relationship. For patients demonstrating the Understanding test of mental competence and wishing to utilize their health-related preferences physicians are obliged to deploy the interpretive model of doctor-patient relationship. In mentally competent patients with an illness-induced acute psychological regression the interpretive model of doctor-patient relationship as an initial strategy and cognitive behavior therapy can be useful in modifying treatment rejecting behavior and improving medical outcome.

APA, Harvard, Vancouver, ISO, and other styles

15

Buetow, S. A. "Something in Nothing: Negative Space in the Clinician-Patient Relationship." Annals of Family Medicine 7, no. 1 (January 1, 2009): 80–83. http://dx.doi.org/10.1370/afm.914.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

Datz, Wong, and Löffler-Stastka. "Interpretation and Working through Contemptuous Facial Micro-Expressions Benefits the Patient-Therapist Relationship." International Journal of Environmental Research and Public Health 16, no. 24 (December 4, 2019): 4901. http://dx.doi.org/10.3390/ijerph16244901.

Full text

Abstract:

Introduction: The significance of psychotherapeutic micro-processes, such as nonverbal facial expressions and relationship quality, is widely known, yet hitherto has not been investigated satisfactorily. In this exploratory study, we aim to examine the occurrence of micro-processes during psychotherapeutic treatment sessions, specifically facial micro-expressions, in order to shed light on their impact on psychotherapeutic interactions and patient-clinician relationships. Methods: In analyzing 22 video recordings of psychiatric interviews in a routine/acute psychiatric care unit of Vienna General Hospital, we were able to investigate clinicians’ and patients’ facial micro-expressions in conjunction with verbal interactions and types. To this end, we employed the Emotion Facial Action Coding System (EmFACS)—assessing the action units and microexpressions—and the Psychodynamic Intervention List (PIL). Also, the Working Alliance Inventory (WAI), assessed after each session by both patients and clinicians, provided information on the subjective quality of the clinician–patient relationship. Results: We found that interpretative/confrontative interventions are associated with displays of contempt from both therapists and patients. Interestingly, displays of contempt also correlated with higher WAI scores. We propose that these seemingly contradictory results may be a consequence of the complexity of affects and the interplay of primary and secondary emotions with intervention type. Conclusion: Interpretation, confrontation, and working through contemptuous microexpressions are major elements to the adequate control major pathoplastic elements. Affect-cognitive interplay is an important mediator in the working alliance.

APA, Harvard, Vancouver, ISO, and other styles

17

Adams, Ted, Dana Sarnak, Joy Lewis, Jeff Convissar, and Scott S. Young. "What Do Clinicians Who Deliver Maternity Services Think Patient-Centered Care Is and How Is That Different for Vulnerable Women? A Qualitative Study." Journal of Pregnancy 2018 (December 2, 2018): 1–7. http://dx.doi.org/10.1155/2018/5853235.

Full text

Abstract:

Background. Patient-centered care is said to have a myriad of benefits; however, there is a lack of agreement on what exactly it consists of and how clinicians should deliver it for the benefit of their patients. In the context of maternity services and in particular for vulnerable women, we explored how clinicians describe patient-centered care and how the concept is understood in their practice. Methods. We undertook a qualitative study using interviews and a focus group, based on an interview guide developed from various patient surveys focused around the following questions: (i) How do clinicians describe patient-centered care? (ii) How does being patient-centered affect how care is delivered? (iii) Is this different for vulnerable populations? And if so, how? We sampled obstetricians and gynecologists, midwives, primary care physicians, and physician assistants from a health management organization and fee for service clinician providers from two states in the US covering insured and Medicaid populations. Results. Building a relationship between clinician and patient is central to what clinicians believe patient-centered care is. Providing individually appropriate care, engaging family members, transferring information from clinician to patient and from patient to clinician, and actively engaging with patients are also key concepts. However, vulnerable women did not benefit from patient-centered care without first having some of their nonmedical needs met by their clinician. Discussion. Most providers did not cite the core concepts of patient-centered care as defined by the Institute of Medicine and others.

APA, Harvard, Vancouver, ISO, and other styles

18

Fisch, Michael J., Michael L. Titzer, Jean L. Kristeller, Jianzhao Shen, Patrick J. Loehrer, Sin-Ho Jung, Steven D. Passik, and Lawrence H. Einhorn. "Assessment of Quality of Life in Outpatients With Advanced Cancer: The Accuracy of Clinician Estimations and the Relevance of Spiritual Well-Being—A Hoosier Oncology Group Study." Journal of Clinical Oncology 21, no. 14 (July 15, 2003): 2754–59. http://dx.doi.org/10.1200/jco.2003.06.093.

Full text

Abstract:

Purpose: To evaluate the association between quality-of-life (QOL) impairment as reported by patients and QOL impairment as judged by nurses or physicians, with and without consideration of spiritual well-being (SWB). Patients and Methods: A total of 163 patients with advanced cancer were enrolled onto a therapeutic trial, and cross-sectional data were derived from clinical and demographic questionnaires obtained at baseline, including assessment of patient QOL and SWB. Clinicians rated the QOL impairment of their patients as mild, moderate, or severe. Clinician-estimated QOL impairment and patient-derived QOL categories were compared. Correlation coefficients were estimated to associate QOL scores using different instruments. The analysis of variance method was used to compare Functional Assessment of Cancer Therapy–General scores on categorical variables. Results: There was no significant association between self-assessment scores and marital status, education level, performance status, or predicted life expectancy. However, a strong relationship between SWB and QOL was noted (P < .0001). Clinician-estimated QOL impairment matched the level of patient-derived QOL correctly in approximately 60% of cases, with only slight variation depending on the method of categorizing patient-derived QOL scores. The accuracy of clinician estimates was not associated with the level of SWB. Interestingly, a subset analysis of the inaccurate estimates revealed an association between lower SWB and clinician underestimation of QOL impairment (P = .0025). Conclusion: Clinician estimates of QOL impairment were accurate in more than 60% of patients. SWB is strongly associated with QOL, but it is not associated with the overall accuracy of clinicians’ judgments about QOL impairment.

APA, Harvard, Vancouver, ISO, and other styles

19

Leseth, Anne Birgitte. "What is culturally informed psychiatry? Cultural understanding and withdrawal in the clinical encounter." BJPsych Bulletin 39, no. 4 (August 2015): 187–90. http://dx.doi.org/10.1192/pb.bp.114.047936.

Full text

Abstract:

SummaryWhat is culturally informed psychiatry? What does it mean, and why is it important? These questions are discussed with a focus on the cultural aspects of the clinical encounter. The DSM-5 Outline for Cultural Formulation was developed as a method of assessing the cultural factors affecting the clinical encounter. It calls for the assessment of the cultural features of the relationship between the patient and the clinician; however, there is a lack of debate about what this means in practice. Clinicians run the risk of withdrawal rather than cultural understanding when facing patients with different cultural backgrounds. Using ethnographic material from anthropological fieldwork, I suggest that the encounter with cultural differences could be a useful point of departure for the clinician to develop cultural understanding. It is argued that recognising the experiences of differences is crucial in strengthening transcultural communication and preventing misdiagnosis in the clinician–patient encounter.

APA, Harvard, Vancouver, ISO, and other styles

20

Conijn, Judith M., Wilco H. M. Emons, Bethan F. Page, Klaas Sijtsma, Willem Van der Does, Ingrid V. E. Carlier, and Erik J. Giltay. "Response Inconsistency of Patient-Reported Symptoms as a Predictor of Discrepancy Between Patient and Clinician-Reported Depression Severity." Assessment 25, no. 7 (September 14, 2016): 917–28. http://dx.doi.org/10.1177/1073191116666949.

Full text

Abstract:

The aim of this study was to assess the extent to which discrepancy between self-reported and clinician-rated severity of depression are due to inconsistent self-reports. Response inconsistency threatens the validity of the test score. We used data from a large sample of outpatients ( N = 5,959) who completed the self-report Beck Depression Inventory–II (BDI-II) and the clinician-rated Montgomery–Åsberg Depression Rating Scale (MADRS). We used item response theory based person-fit analysis to quantify the inconsistency of the self-report item scores. Inconsistency was weakly positively related to patient–clinician discrepancy (i.e., higher BDI-II scores relative to MADRS scores). The mediating effect of response inconsistency in the relationship between discrepancy and demographic (e.g., ethnic origin) and clinical variables (e.g., cognitive problems) was negligible. The small direct and mediating effects of response inconsistency suggest that inaccurate patient self-reports are not a major cause of patient–clinician discrepancy in outpatient samples. Future research should investigate the role of clinician biases in explaining clinician–patient discrepancy.

APA, Harvard, Vancouver, ISO, and other styles

21

Patel, Minal R., Christopher R. Friese, Kari Mendelsohn-Victor, Alex J. Fauer, Bidisha Ghosh, Louise Bedard, Jennifer J. Griggs, and Milisa Manojlovich. "Clinician Perspectives on Electronic Health Records, Communication, and Patient Safety Across Diverse Medical Oncology Practices." Journal of Oncology Practice 15, no. 6 (June 2019): e529-e536. http://dx.doi.org/10.1200/jop.18.00507.

Full text

Abstract:

PURPOSE: We know little about how increased technological sophistication of clinical practices affects safety of chemotherapy delivery in the outpatient setting. This study investigated to what degree electronic health records (EHRs), satisfaction with technology, and quality of clinician-to-clinician communication enable a safety culture. METHODS: We measured actions consistent with a safety culture, satisfaction with practice technology, and quality of clinician communication using validated instruments among 297 oncology nurses and prescribers in a statewide collaborative. We constructed an index to reflect practice reliance on EHRs (1 = “all paper” to 5 = “all electronic”). Linear regression models (with robust SEs to account for clustering) examined relationships between independent variables of interest and safety. Models were adjusted for clinician age. RESULTS: The survey response rate was 68% (76% for nurses and 59% for prescribers). The mean (standard deviation) safety score was 5.3 (1.1), with a practice-level range of 4.9 to 5.4. Prescribers reported fewer safety actions than nurses. Higher satisfaction with technology and higher-quality clinician communication were significantly associated with increased safety actions, whereas increased reliance on EHRs was significantly associated with lower safety actions. CONCLUSION: Practices vary in their performance of patient safety actions. Supporting clinicians to integrate technology and strengthen communication are promising intervention targets. The inverse relationship between reliance on EHRs and safety suggests that technology may not facilitate clinicians’ ability to attend to patient safety. Efforts to improve cancer care quality should focus on more seamless integration of EHRs into routine care delivery and emphasize increasing the capacity of all care clinicians to communicate effectively and coordinate efforts when administering high-risk treatments in ambulatory settings.

APA, Harvard, Vancouver, ISO, and other styles

22

Gilligan, Timothy, Nessa Coyle, Richard M. Frankel, Donna L. Berry, Kari Bohlke, Ronald M. Epstein, Esme Finlay, et al. "Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline." Journal of Clinical Oncology 35, no. 31 (November 1, 2017): 3618–32. http://dx.doi.org/10.1200/jco.2017.75.2311.

Full text

Abstract:

Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016. Results The systematic review included 47 publications. With the exception of clinician training in communication skills, evidence for many of the clinical questions was limited. Draft recommendations underwent two rounds of consensus voting before being finalized. Recommendations In addition to providing guidance regarding core communication skills and tasks that apply across the continuum of cancer care, recommendations address specific topics, such as discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating family involvement in care, and clinician training in communication skills. Recommendations are accompanied by suggested strategies for implementation. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .

APA, Harvard, Vancouver, ISO, and other styles

23

&NA;. "CME Questions: Difficult Conversations: Anger in the Clinician-Patient/Family Relationship." Southern Medical Journal 100, no. 1 (January 2007): 40–41. http://dx.doi.org/10.1097/smj.0b013e318030be63.

Full text

APA, Harvard, Vancouver, ISO, and other styles

24

Truog, Robert D. "Expanding the Horizon of Our Obligations in the Clinician-Patient Relationship." Hastings Center Report 47, no. 4 (July 2017): 40–41. http://dx.doi.org/10.1002/hast.739.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Varming, Annemarie R., Michelle Hadjiconstantinou, and Natalia Piana. "Building the patient-clinician relationship through conversation based on narrative approaches." Practical Diabetes 35, no. 5 (September 2018): 178–80. http://dx.doi.org/10.1002/pdi.2188.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Buetow, Stephen. "Person-centred care: Bridging current models of the clinician-patient relationship." International Journal of Person Centered Medicine 1, no. 1 (April 2011): 196–203. http://dx.doi.org/10.5750/ijpcm.v1i1.46.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Prom, Maria C., Jeffrey Stovall, Luis E. Bedregal, James Phillips, and Mario A. Davidson. "Therapeutic alliance: satisfaction and attrition of patients from a mental health clinic in Ayacucho, Peru." International Psychiatry 11, no. 4 (November 2014): 95–97. http://dx.doi.org/10.1192/s1749367600004707.

Full text

Abstract:

This study examines the role of the patient–provider relationship (alliance) and patient satisfaction in early patient withdrawal from mental health therapy in rural Peru. A prospective comparison of 60 patients demonstrated that early withdrawal was associated with the clinician's, but not the patient's, evaluation of the patient–provider alliance. This suggests that the satisfaction and alliance questionnaires typically used in high-income countries may not be effective in evaluating patient attitudes in this population, but may be useful for clinician evaluations of the alliance. Clinicians can use the Working Alliance Inventory to indicate the need for early intervention to prevent patient drop-out in middle- and low-income countries.

APA, Harvard, Vancouver, ISO, and other styles

28

Parnas, Sophia, and Sophie Isobel. "Using relational mindfulness to facilitate safety in the clinical encounter." Australasian Psychiatry 27, no. 6 (August 19, 2019): 596–99. http://dx.doi.org/10.1177/1039856219866318.

Full text

Abstract:

Objective: The therapeutic relationship in psychiatry is reliant upon first establishing a sense of interpersonal safety. This paper explores relational mindfulness as a way to facilitate safety in the clinical encounter, as well as proposes factors that enhance a clinician’s capacity to remain mindfully present. Conclusions: Through the ongoing practice of mindful awareness, self-care and self-awareness all clinicians can benefit from increased capacity for relational mindfulness to enhance interpersonal safety. This is then likely to benefit not only the patient and the therapeutic relationship but also the clinician.

APA, Harvard, Vancouver, ISO, and other styles

29

Bhugra, Dinesh, and Kamaldeep Bhui. "Clinical management of patients across cultures." Advances in Psychiatric Treatment 3, no. 4 (July 1997): 233–39. http://dx.doi.org/10.1192/apt.3.4.233.

Full text

Abstract:

Clinical management of patients across cultures challenges the clinician's familiar tried and tested strategies. The relationship between the patient and the psychiatrist is often examined in isolation from a number of premises which both patient and professional bring to the encounter: previous experience of other cultures, contact with less familiar cultures, past experiences and socioeconomic status are some of the determinant influences. There are a number of ways in which the clinician can facilitate therapeutic effectiveness. However, a trusting relationship must first emerge such that the patient has faith in the treatment recommendations. Special difficulties can arise in the context of pharmacological, social, psychotherapeutic and psychological interventions. Community, out-patient, in-patient and emergency settings each require that consideration be given to the context of the assessment and treatment process, as well as the content and immediate outcome. The clinician must plan the assessment and intervention carefully. The rationale and goals of treatment should be discussed and agreed by participants in the therapeutic interaction. Special groups have unique cultural and historical obstacles to receiving health care. Potential problems are highlighted in this paper and suggestions made for managing conflicts when they arise.

APA, Harvard, Vancouver, ISO, and other styles

30

Janes, Ron, Janet Titchener, Joseph Pere, Rose Pere, and Joy Senior. "Understanding barriers to glycaemic control from the patients perspective." Journal of Primary Health Care 5, no. 2 (2013): 114. http://dx.doi.org/10.1071/hc13114.

Full text

Abstract:

INTRODUCTION: To better understand barriers to glycaemic control from the patients perspective. METHODS: An interpretative phenomenological approach was used to study the experiences of 15 adults with Type 2 diabetes. Participants each gave a semi-structured interview of their experiences of living with diabetes. Interviews were transcribed, and themes extracted and organised using a patient-centred framework. FINDINGS: Participants stories confirmed many of the barriers in the literature, particularly those related to context, such as family, finances, work. Barriers also related to negative emotional reactions to diabetes: fear of new events (diagnosis, starting pills/insulin); guilt about getting diabetes and not controlling it; and shame about having diabetes. Barriers also related to unscientific beliefs and personal beliefs. There were additional barriers related to poor clinicianpatient relationships. Overall, participants had a poor understanding of diabetes, and complained that their clinician simply told them what to do. CONCLUSION: Using a patient-centred approach, this study identified many barriers to glycaemic control. We suggest that a key barrier is clinician ignorance of their patients fears, beliefs, expectations, context; of what constitutes a positive therapeutic relationship; and of the limitations of a biomedical approach to patient non-adherence. Faced with both a worsening diabetes epidemic and increasing health care workforce shortages, clinicians urgently need to understand that it is they, not their patients, who must change their approach if diabetes care is to be improved. KEYWORDS: Communication barriers; diabetes mellitus, type 2; medication adherence; patient-centered care

APA, Harvard, Vancouver, ISO, and other styles

31

Lim, Christopher Taekyu, Avia Tadmor, Daisuke Fujisawa, James John MacDonald, Emily R. Gallagher, Jennifer S. Temel, Joseph A. Greer, and Elyse R. Park. "The practice of early palliative care: A qualitative study of patient-clinician encounters." Journal of Clinical Oncology 32, no. 31_suppl (November 1, 2014): 2. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.2.

Full text

Abstract:

2 Background: Studies have shown that palliative care (PC) integrated early in the course of metastatic cancer, shortly after diagnosis, leads to improved patient outcomes. Unlike PC in the inpatient setting, PC initiated early, in the ambulatory setting, had not been well studied. Our aim was to elucidate the practice of early PC through analysis of PC clinic visit transcripts. Methods: As part of an ongoing study of early PC in patients with advanced lung and gastrointestinal cancers at the Massachusetts General Hospital, we are audio-recording patients’ outpatient PC clinic visits. To capture the range of PC content, we randomly selected five patients and analyzed three clinic transcripts per patient: early, midway, and late in each patient’s clinical course. We performed thematic analysis on these clinic transcripts using NVivo 10. Results: Our analysis suggests that the elements of early PC that occur most frequently across the disease course are managing symptoms, facilitating coping, and developing the relationship with patients and their family caregivers. Elements that tend to occur during clinical transitions include advising treatment decision-making, facilitating medical understanding, and advance care planning. Our analysis also identifies four broad approaches to PC that are applied longitudinally, over the course of the patient-clinician relationship: 1) eliciting versus commenting on patients’ perspectives, 2) alluding to and preparing for the future, 3) transitioning between managing symptoms and facilitating coping, and 4) transitioning between developing the relationship and facilitating coping. Lastly, we observe three specific techniques applied by PC clinicians: 1) coordinating with oncologists, 2) providing referrals, and 3) addressing family dynamics. Conclusions: Our study identifies the predominant elements, four longitudinal approaches, and three specific techniques of early PC. These novel insights can be applied to care delivered by both PC and non-PC clinicians, well before patients approach the end of life. The longitudinal approaches in particular may help explain the significance of early integration of PC into cancer care.

APA, Harvard, Vancouver, ISO, and other styles

32

Myers, Natalie L., and Gilson J. Capilouto. "A Model for Rehabilitation Adherence in Athletes Demonstrating Different Attachment Styles." International Journal of Athletic Therapy and Training 21, no. 4 (July 2016): 12–17. http://dx.doi.org/10.1123/ijatt.2015-0029.

Full text

Abstract:

Adherence is a documented problem in collegiate athletics. The patient–clinician relationship is an important component of how one will receive the idea of rehabilitation and adhere to the prescribed treatment protocol. Attachment theory states that an emotional bond between two individuals usually flourishes when one individual looks for support and assurance during a time of need. Attachment theory was initially proposed to describe the parent–child relationship and has implications into adulthood. If clinicians understand and recognize the different attachment styles a given patient might portray, then the relationship between the two may flourish, and consequently lead to greater adherence. Therefore, the purpose of this paper is to propose a model for improving treatment adherence by adjusting the patient–clinician relationship based on a patient’s attachment style.

APA, Harvard, Vancouver, ISO, and other styles

33

Bulik, Catharine C., Justin C. Bader, Elizabeth A. Lakota, Sujata M. Bhavnani, Christopher M. Rubino, Kim L. Sweeney, Paul G. Ambrose, and Robert C. Owens. "Getting it Right the First Time: Relating Pharmacokinetic-Pharmacodynamic Target Attainment and Patient Outcomes." Open Forum Infectious Diseases 4, suppl_1 (2017): S26—S27. http://dx.doi.org/10.1093/ofid/ofx162.066.

Full text

Abstract:

Abstract Background The importance of delivering appropriate therapy to patients at the onset of treatment is well established. However, this goal is easier said than done given the complexity and uniqueness of each patient case. Nonetheless, treatment decisions driven by pharmacokinetic-pharmacodynamic (PK-PD) can account for patient variability and assist in selecting patient-specific therapies. Using data obtained from electronic decision support software (EDSS), we evaluated the relationship between the probability of PK-PD target attainment (PTA) and patient outcomes. Methods Data obtained over a 20-month period from an EDSS were evaluated and included: (1) patient demographics; (2) infection type; (3) pathogen; (4) clinician-selected antimicrobials; (4) pathogen susceptibility; (5) clinician-provided early and late outcomes. Data calculated by the EDSS included the PTA for all evaluated antimicrobial regimens. Using logistic regression, relationships between the probability of PTA and clinical improvement and clinical success at 48 hours and Days 7–10, respectively, were assessed. Results Data for 121 patient cases with various infection types were available. The most common pathogens reported were MRSA (14.9%) and K. pneumoniae (14.9%). Overall, 76.3% of patients demonstrated clinical improvement at 48 hours while 70.3% of patients demonstrated clinical success at Days 7–10. Based on the relationship between the probability of PTA and clinical improvement at 48 hours (Figure 1), for every 10% increase in PTA, patients were 1.74 times more likely to demonstrate clinical improvement (OR [95% CI] 1.74 [1.28–2.37], P < 0.001). At Days 7–10 (Figure 2), patients were 1.82 times more likely to have a successful response (OR [95% CI] 1.82 [1.29–2.58], p < 0.001). Based on these relationships, the predicted percent probability of a positive outcome at 48 hours and Days 7–10 for an initial treatment regimen with PTA of 90% was 77.2% and 76.1%, respectively. Conclusion Statistically significant positive relationships between PTA and clinical outcomes at 48 hours and Days 7–10 were identified. These data demonstrate the value of PK-PD in dosing regimen selection and provide a path toward delivering appropriate initial therapy to optimize patient outcomes. Disclosures S. M. Bhavnani, ICPD Technologies: Shareholder, stock options; C. M. Rubino, ICPD Technologies: Shareholder, stock options; P. G. Ambrose, ICPD Technologies: Shareholder, stock options

APA, Harvard, Vancouver, ISO, and other styles

34

Ratanawongsa, Neda, Jennifer L. Barton, Courtney R. Lyles, Michael Wu, Edward H. Yelin, Diana Martinez, and Dean Schillinger. "Computer use, language, and literacy in safety net clinic communication." Journal of the American Medical Informatics Association 24, no. 1 (June 6, 2016): 106–12. http://dx.doi.org/10.1093/jamia/ocw062.

Full text

Abstract:

Objective: Patients with limited health literacy (LHL) and limited English proficiency (LEP) experience suboptimal communication and health outcomes. Electronic health record implementation in safety net clinics may affect communication with LHL and LEP patients. We investigated the associations between safety net clinician computer use and patient-provider communication for patients with LEP and LHL. Materials and Methods: We video-recorded encounters at 5 academically affiliated US public hospital clinics between English- and Spanish-speaking patients with chronic conditions and their primary and specialty care clinicians. We analyzed changes in communication behaviors (coded with the Roter Interaction Analysis System) with each additional point on a clinician computer use score, controlling for clinician type and visit length and stratified by English proficiency and health literacy status. Results: Greater clinician computer use was associated with more biomedical statements (+12.4, P = .03) and less positive affect (−0.6, P < .01) from LEP/LHL patients. In visits with patients with adequate English proficiency/health literacy, greater clinician computer use was associated with less positive patient affect (−0.9, P < .01), fewer clinician psychosocial statements (−3.5, P < .05), greater clinician verbal dominance (+0.09, P < .01), and lower ratings on quality of care and communication. Conclusion: Higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy. Discussion: Implementation research should explore interventions to enhance relationship-centered communication for diverse patient populations in the computer era.

APA, Harvard, Vancouver, ISO, and other styles

35

Molassiotis, Alex, Kate Morris, and Ian Trueman. "The importance of the patient–clinician relationship in adherence to antiretroviral medication." International Journal of Nursing Practice 13, no. 6 (December 2007): 370–76. http://dx.doi.org/10.1111/j.1440-172x.2007.00652.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Moss, F. "The clinician, the patient and the organisation: a crucial three sided relationship." Quality and Safety in Health Care 13, no. 6 (December 1, 2004): 406–7. http://dx.doi.org/10.1136/qshc.2004.012872.

Full text

APA, Harvard, Vancouver, ISO, and other styles

37

Stange, K. C. "In this Issue: The Patient-Clinician Relationship and Practice-Based Network Research." Annals of Family Medicine 2, no. 5 (September 1, 2004): 386–87. http://dx.doi.org/10.1370/afm.234.

Full text

APA, Harvard, Vancouver, ISO, and other styles

38

Hutchinson, Gareth, and Stefanie Caroline Linden. "The challenge of functional neurological disorder – views of patients, doctors and medical students." Journal of Mental Health Training, Education and Practice 16, no. 2 (January 7, 2021): 123–38. http://dx.doi.org/10.1108/jmhtep-06-2020-0036.

Full text

Abstract:

Purpose This study aims to explore views and attitudes of doctors, patients and medical students in regard to Functional Neurological Disorders (FND), a common presentation in neurological and psychiatric practice. Design/methodology/approach We conducted semi-structured interviews with 11 clinicians and obtained online questionnaires from 21 patients and 75 medical students. We applied thematic analysis. Findings The clinician and patient surveys highlighted the importance of the therapeutic relationship and need for transparent communication. However, patients criticised excessive reliance on online resources in doctor–patient communication. They also emphasised the relevance of triggering life events, which was not a prominent theme for clinicians. Medical students had only scant knowledge of the concept of functional neurological disorder. Practical implications A good therapeutic relationship is considered central for outcome of FND by both clinicians and patients. The survey of medical students has identified considerable gaps in undergraduate medical education in FND. The patient survey can inform recommendations for the explanation of aetiological models and treatment options in clinical practice. Originality/value This is the first study exploring the attitudes of clinicians, medical students and patients to FND. The study highlights potential areas of disagreement between these groups.

APA, Harvard, Vancouver, ISO, and other styles

39

Ray, Jessica M., Raj M. Ratwani, Christine A. Sinsky, Richard M. Frankel, Mark W. Friedberg, Seth M. Powsner, David I. Rosenthal, Robert M. Wachter, and Edward R. Melnick. "Six habits of highly successful health information technology: powerful strategies for design and implementation." Journal of the American Medical Informatics Association 26, no. 10 (July 2, 2019): 1109–14. http://dx.doi.org/10.1093/jamia/ocz098.

Full text

Abstract:

Abstract Healthcare information technologies are now a routine component of patient–clinician interactions. Originally designed for operational functions including billing and regulatory compliance, these systems have had unintended consequences including increased exam room documentation, divided attention during the visit, and use of scribes to alleviate documentation burdens. In an age in which technology is ubiquitous in everyday life, we must re-envision healthcare technology to support both clinical operations and, above all, the patient–clinician relationship. We present 6 habits for designing user-centered health technologies: (1) put patient care first, (2) assemble a team with the right skills, (3) relentlessly ask WHY, (4) keep it simple, (5) be Darwinian, and (6) don’t lose the forest for the trees. These habits should open dialogues between developers, implementers, end users, and stakeholders, as well as outline a path for better, more usable technology that puts patients and their clinicians back at the center of care.

APA, Harvard, Vancouver, ISO, and other styles

40

Ng, Stella L., Shanon Phelan, MaryAnn Leonard, and Jason Galster. "A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient–Clinician Interactions." Journal of the American Academy of Audiology 28, no. 06 (June 2017): 506–21. http://dx.doi.org/10.3766/jaaa.15153.

Full text

Abstract:

Background: Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients’ needs, and attentive to society’s influence. Purpose: The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. “Connected” refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. Research Design: The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. Study Sample: The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. Data Collection and Analysis: The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. Results: The clinician case highlighted clinicians’ heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed patients’ perceptions of themselves as technologically competent or incompetent, and descriptions of how they learned to use the new technology. Between cases, the study found a difference in the response to how the connected hearing aid changed the clinician–patient relationship. While clinicians valued the increased time they spent “getting to know” their patients, patients experienced some frustration specific to the additional troubleshooting related to Bluetooth connectivity. Across cases, there was a resounding theme of “normalization” of hearing aids via their integration with a “normal” technology (mobile phones) and general lack of concern about privacy in relation to the smartphone application and its tracking and geotagging features. Both audiologists and patients credited the connected hearing aids with increased opportunities to participate more fully in everyday life. Conclusions: The introduction of smartphone-connected hearing aids influenced the identities and candidate profiles of hearing aid users, and the nature of time spent in clinical interactions, in important and interesting ways. The influence of connected hearing aids on patient experience and audiology practice calls for continued research and clinical consideration, with implications for clinical decision-making regarding hearing aid candidacy. Further study should look critically at normalization and possible unintended stigmatizing effects of making hearing aids increasingly discreet.

APA, Harvard, Vancouver, ISO, and other styles

41

Smith, C. Christopher, Lori R. Newman, and Grace C. Huang. "Those Who Teach, Can Do: Characterizing the Relationship Between Teaching and Clinical Skills in a Residency Program." Journal of Graduate Medical Education 10, no. 4 (August 1, 2018): 459–63. http://dx.doi.org/10.4300/jgme-d-18-00039.1.

Full text

Abstract:

ABSTRACT Background Teaching practice is presumed to have significant overlap with clinical skills, yet few studies to date have assessed how residents' teaching skills influence their clinical performance. Objective We examined the relationship between the professional roles of residents as teachers and as practicing clinicians as well as how learning about teaching contributes to enhanced skills in the clinical realm. Methods Using the framework method, the authors performed a 2-phased (exploratory and confirmatory) qualitative analysis on the data sets to characterize the relationship between resident teaching and clinical skills. To investigate the relationship between teaching and clinical work, we extracted qualitative data from 300 evaluations of clinical performance for residents in a large, urban, academic internal medicine residency program submitted over a 3-year period. Informed by the preliminary framework that evolved from this analysis, we conducted a focus group of 6 residents in a dedicated clinician-educator track to examine how teaching was related to clinical work. Results We identified attributes and skills of good resident teachers that enhance clinical skills, categorized as 18 subdomains within 4 domains: relationships, communication, relation to self, and relationship with knowledge. Conclusions Themes that link clinical and teaching skills are similar for both patient-physician and learner-teacher relationships. Improving residents' teaching skills may not only benefit the education of learners but also improve the care of patients.

APA, Harvard, Vancouver, ISO, and other styles

42

Reedy, Florence, Mark Pearson, Sarah Greenley, Joseph Clark, David C. Currow, Sabrina Bajwah, Marie Fallon, and Miriam J. Johnson. "Professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness: A systematic review using the framework method and pillar process." Palliative Medicine 35, no. 8 (July 24, 2021): 1421–33. http://dx.doi.org/10.1177/02692163211032114.

Full text

Abstract:

Background: In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. Aim: To synthesise the published literature regarding health professionals’, patients’ and families’ views on the use of opioids for chronic breathlessness, identifying issues which influence implementation in clinical practice. Design: Systematic review and synthesis using the five-stage framework synthesis method. Data sources: Three electronic databases (MEDLINE, Embase via OVID, ASSIA via Proquest) were searched (March 2020) using a predefined search strategy. Studies were also citation chained from key papers. Papers were screened against a priori eligibility criteria. Data were extracted from included studies using the framework synthesis method. Qualitative and quantitative data were synthesised using the pillar process. Included studies were critically appraised using the Mixed-Methods Appraisal Tool. Results: After de-duplication, 843 papers were identified. Following screening, 22 studies were included. Five themes were developed: (i) clinician/patient characteristics, (ii) education/knowledge/experience, (iii) relationship between clinician/family, (iv) clinician/patient fear of opioids and (v) regulatory issues. Conclusions: There are significant barriers and enablers to the use of opioids for the symptomatic reduction of chronic breathlessness based on the knowledge, views and attitudes of clinicians, patients and families. Clinicians’ interactions with patients and their families strongly influences adherence with opioid treatment regimens for chronic breathlessness. Clinicians’, patients’ and families’ knowledge about the delicate balance between benefits and risks is generally poor. Education for all, but particularly clinicians, is likely to be a necessary (but insufficient) factor for improving implementation in practice.

APA, Harvard, Vancouver, ISO, and other styles

43

Mazurenko, Olena, Jason Richter, Abby Swanson Kazley, and Eric Ford. "Examination of the relationship between management and clinician perception of patient safety climate and patient satisfaction." Health Care Management Review 44, no. 1 (2019): 79–89. http://dx.doi.org/10.1097/hmr.0000000000000156.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Toll, Elizabeth T. "The other office." Journal of the American Medical Informatics Association 26, no. 1 (November 22, 2018): 71–75. http://dx.doi.org/10.1093/jamia/ocy144.

Full text

Abstract:

Abstract Across recent decades, profound changes in the practice of medicine have been accompanied by parallel developments in the daily mental efforts of medical professionals. Using visual metaphors and hand-drawn illustrations, the author explores the evolution of one physician’s brain over the past 25 years. At the completion of training, the patient-practitioner relationship, medical knowledge, and care decisions dominated clinician thought, time, and effort. During the 1990’s, the growing constraints of third-party payers and government regulations presented new challenges to delivering relationship-based care. Over the past decade, the electronic health record (EHR) has added further cognitive complexity, disrupted human relationships, and contributed significantly to the current epidemic of clinician burnout. Solutions to these challenges include rethinking education, documentation, professional standards, institutional barriers, and regulatory mandates. It is important to pursue all solutions with the underlying premise of protecting healing relationships as the foundation of clinical care.

APA, Harvard, Vancouver, ISO, and other styles

45

Ma, Kenneth. "Attachment theory in adult psychiatry. Part 2: Importance to the therapeutic relationship." Advances in Psychiatric Treatment 13, no. 1 (January 2007): 10–16. http://dx.doi.org/10.1192/apt.bp.105.001867.

Full text

Abstract:

This article focuses on how the general adult psychiatrist, in thinking about everyday clinical problems, may usefully apply attachment theory to gain insight. Fictional case vignettes are used to illustrate the importance of attachment in shaping and understanding the clinician–patient relationship. Ways in which service configurations may be informed by attachment theory are also examined.

APA, Harvard, Vancouver, ISO, and other styles

46

Arpey, Nicholas C., Anne H. Gaglioti, and Marcy E. Rosenbaum. "How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study." Journal of Primary Care & Community Health 8, no. 3 (March 8, 2017): 169–75. http://dx.doi.org/10.1177/2150131917697439.

Full text

Abstract:

Introduction: Clinician perceptions of patients with low socioeconomic status (SES) have been shown to affect clinical decision making and health care delivery in this group. However, it is unknown how and if low SES patients perceive clinician bias might affect their health care. Methods: In-depth interviews with 80 enrollees in a state Medicaid program were analyzed to identify recurrent themes in their perceptions of care. Results: Most subjects perceived that their SES affected their health care. Common themes included treatment provided, access to care, and patient-provider interaction. Discussion: This study highlights complex perceptions patients have around how SES affects their health care. These results offer opportunities to reduce health care disparities through better understanding of their impact on the individual patient-provider relationship. This work may inform interventions that promote health equity via a multifaceted approach, which targets both providers and the health care system as a whole.

APA, Harvard, Vancouver, ISO, and other styles

47

Mazurenko, Olena, Jason Richter, Abby Swanson-Kazley, and Eric Ford. "Examination of the relationship between management and clinician agreement on communication openness, teamwork, and patient satisfaction in the US hospitals." Journal of Hospital Administration 5, no. 4 (April 26, 2016): 20. http://dx.doi.org/10.5430/jha.v5n4p20.

Full text

Abstract:

Background: Patient satisfaction has always been an area of focus for hospitals, but gained particular importance due to the changes in the Centers for Medicare and Medicaid reimbursement policies. Hospital managers and clinicians interact with patients in different ways and have different perspectives on safety culture, yet little is known about how that impacts patient satisfaction.Objective: To examine how the agreement between clinicians and management perspectives on patient safety culture is related to patient satisfaction by employing cross-sectional design with linear regressions.Methods: Two data sets were used: 2012 Hospital Survey on Patient Safety Culture and 2012 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The dependent variables were: overall rating of the hospital experience and willingness to recommend a hospital. The independent variables were four safety culture domains: communication openness, feedback, and communication about errors, teamwork within units, and teamwork between units.Results: The results suggest that manager and clinician agreement on high levels of communication openness, feedback and communication about errors, teamwork between units, and teamwork across units were positively and significantly associated with overall patient satisfaction and willingness to recommend. Additionally, more favorable perceptions about patient safety culture by only clinicians yielded similar findings.Conclusions: For policymakers, measuring managers and clinicians’ perceptions on patient safety culture may provide a valuable indicator of patient satisfaction throughout the country. While managers are more likely to have the power to devote resources to patient safety initiatives, they may not adequately judge culture in their unit and should take into account the perspectives of clinicians who have a more frontline perspective.

APA, Harvard, Vancouver, ISO, and other styles

48

Pocuis, Jesse, Sam Man-Hoi Li, Mary M. Janci, and Hilaire J. Thompson. "Exploring Diabetic Foot Exam Performance in a Specialty Clinic." Clinical Nursing Research 26, no. 1 (July 26, 2016): 82–92. http://dx.doi.org/10.1177/1054773815596699.

Full text

Abstract:

Detection of diabetic foot complications is key to amputation prevention. This study used survey and retrospective record review to examine the relationship between frequency and performance of clinician’s diabetic foot examinations on performance of patient home self-foot examinations. An additional aim was to assess clinician performance of annual foot examination per American Diabetes Association (ADA) guidelines in a specialty clinic. The relationships between demographic characteristics, diabetic foot ulcer beliefs, health literacy, HbA1c level, and foot self-exam performance was also examined. No relationship was found between the performance frequency of foot examinations by providers and patient self-examination ( N = 88). The presence of specific barriers to self-management was significantly higher in those patients who did not complete daily home self-foot examinations. Only 16% of patients’ charts reviewed met the ADA criteria for a complete annual foot exam. Motivational interviewing during patient visits could be a strategy to break down barriers to self-foot exam performance. Furthermore, the development of an Electronic Medical Record (EMR)–based diabetic foot exam template to improve provider documentation may improve compliance with ADA recommendations.

APA, Harvard, Vancouver, ISO, and other styles

49

Chesser, Amy K., Nicole C. Keene Woods, Aaron A. Davis, and Caleb J. Bowers. "Prescribing Information Therapy." Journal of Primary Care & Community Health 3, no. 1 (August 5, 2011): 6–10. http://dx.doi.org/10.1177/2150131911414712.

Full text

Abstract:

Background: Recently, experts have included information therapy (Ix) as a method for increasing clinician-patient communication, patient adherence, patient understanding of diagnosis and treatment options, and reduction in hospitalizations. Methods: This study, a secondary, retrospective analysis of survey data, independently examined participating patient perceptions of an Ix program between two Mid-western employers. Surveys were administered through the online platform from January 1, 2006 through December 31, 2009 for Employer 1 (N = 4105) and from June 1, 2007 through December 31, 2009 for Employer 2 (N = 8123). Results: Preliminary findings indicate the majority of patients were adherent to recommended treatment(s) and highly rated their physician’s performance. Additionally, patients indicated that their physician’s access to their questionnaire responses motivated them to improve their health literacy and change their health behaviors. Secondary data analysis indicated a positive relationship between prescribed Ix and self-reported health literacy. Conclusion: As Web-based Ix increases in frequency, the evaluation of patient and clinician communication is important and should be expanded to increase the benefits for both patients and clinicians.

APA, Harvard, Vancouver, ISO, and other styles

50

Elias, Richard M., Karen M. Fischer, Mustaqeem A. Siddiqui, Trevor Coons, Cindy A. Meyerhofer, Holly J. Pretzman, Hope E. Greig, Sheila K. Stevens, and M. Caroline Burton. "A Taxonomic Review of Patient Complaints in Adult Hospital Medicine." Journal of Patient Experience 8 (January 1, 2021): 237437352110073. http://dx.doi.org/10.1177/23743735211007351.

Full text

Abstract:

Previous studies show that patient complaints can identify gaps in quality of care, but it is difficult to identify trends without categorization. We conducted a review of complaints relating to admissions on hospital internal medicine (HIM) services over a 26-month period. Data were collected on person characteristics and key features of the complaint. The complaints were also categorized into a previously published taxonomy. Seventy-six unsolicited complaints were identified, (3.5 per 1000 hospital admissions). Complaints were more likely on resident services. The mean duration between encounter and complaint was 18 days, and it took an average of 12 days to resolve the complaint. Most patients (59%) had a complaint in the Relationship domain. Thirty-nine percent of complaints mentioned a specific clinician. When a clinician was mentioned, complaints regarding communication and humaneness predominated (68%). The results indicate that the efforts to reduce patient complaints in HIM should focus on the Relationships domain.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Patient Clinician Relationship'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles